A pilot study: 131I-antitenascin monoclonal antibody 81c6 to deliver a 44-Gy resection cavity boost.

Academic Article

Abstract

  • The purpose of this study was to determine the feasibility and assess the efficacy and toxicity, among newly diagnosed malignant glioma patients, of administering (131)I-labeled murine antitenascin monoclonal antibody 81C6 ((131)I-81C6) into a surgically created resection cavity (SCRC) to achieve a patient-specific, 44-Gy boost to the 2-cm SCRC margin. A radioactivity dose of (131)I-81C6 calculated to achieve a 44-Gy boost to the SCRC was administered, followed by conventional external beam radiotherapy (XRT) and chemotherapy. Twenty-one patients were enrolled in the study: 16 with glioblastoma multiforme (GBM) and 5 with anaplastic astrocytoma. Twenty patients received the targeted 44-Gy boost (+/-10%) to the SCRC. Attributable toxicity was mild and limited to reversible grade 3 neutropenia or thrombocytopenia (n = 3; 14%), CNS wound infections (n = 3; 14%), and headache (n = 2; 10%). With a median follow-up of 151 weeks, median overall survival times for all patients and those with GBM are 96.6 and 90.6 weeks, respectively; 87% of GBM patients are alive at 1 year. It is feasible to consistently achieve a 44-Gy boost dose to the SCRC margin with patient-specific dosing of (131)I-81C6. Our study regimen ((131)I-81C6 + XRT + temozolomide) was well tolerated and had encouraging survival. To determine if selection of good-prognosis patients affects outcome associated with this approach, the U.S. Food and Drug Administration has approved a trial randomizing newly diagnosed GBM patients to either our study regimen or standard XRT plus temozolomide.
  • Authors

    Published In

  • Neuro-Oncology  Journal
  • Keywords

  • Adult, Aged, Animals, Antibodies, Monoclonal, Antineoplastic Combined Chemotherapy Protocols, Brain Neoplasms, Catheters, Indwelling, Combined Modality Therapy, Female, Glioma, Humans, Injections, Intralesional, Iodine Radioisotopes, Kaplan-Meier Estimate, Male, Mice, Middle Aged, Pilot Projects, Radioimmunotherapy, Tenascin
  • Digital Object Identifier (doi)

    Pubmed Id

  • 3857138
  • Author List

  • Reardon DA; Zalutsky MR; Akabani G; Coleman RE; Friedman AH; Herndon JE; McLendon RE; Pegram CN; Quinn JA; Rich JN
  • Start Page

  • 182
  • End Page

  • 189
  • Volume

  • 10
  • Issue

  • 2