[Immunoscintigraphy and radioimmunotherapy of cancer using monoclonal antibodies]

Abstract

Technologies using radiolabeled antibodies have advanced significantly over the past decade, although radioimmunotherapy still requires improvements. This paper describes the implications of nuclear medicine in the management of cancer in terms of detection, staging, and qualification of patients for immunotherapy. The results of a clinical trial performed at our institution using 99mTc-labeled anti-CEA monoclonal antibody are briefly reviewed. Immunoscintigraphy has shown particular promise as a means of whole body imaging in patients with colorectal, breast, or lung cancer, and the antibodies used for diagnostic imaging are now being used for radioimmunotherapy. Radioimmunotherapy of B-cell lymphoma has been successfully performed using 131I or 90Y labeled anti-lymphocyte monoclonal antibodies, although the treatment of solid tumors is still a major difficulty. Elimination of the immune response by generating humanized monoclonal antibodies, which are virtually devoid of immunogenicity, is necessary to allow repeated administration. This is especially true of patients with solid tumors as compared with patients with hematopoietic ones.