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Radioimmunoguided Surgery Using Iodine 125 B72.3 in Patients With Colorectal Cancer

Radioimmunoguided Surgery Using Iodine 125 B72.3 in Patients With Colorectal Cancer Abstract • Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4×10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure. (Arch Surg. 1991;126:349-352) References 1. Mitchell EP, Schlom J. Monoclonal antibodies in gastrointestinal cancers . Semin Oncol . 1988;15:170-180. 2. Goldenberg DM, Goldenberg H, Sharkey RM, et al. Imaging of colorectal carcinoma with radiolabeled antibodies . Semin Nucl Med . 1989;19:262-281.Crossref 3. Begent RHJ, Keep PA, Searle F, et al. Radioimmunolocalization and selection for surgery in recurrent colorectal cancer . Br J Surg . 1986;73:64-67.Crossref 4. Abdel-Nabi HH, Shwartz AN, Higano CS, Wechter DG, Unger MW. Colorectal carcinoma: detection with indium-111 anticarcinoembryonic-antigen monoclonal antibody ZCE-0251 . Radiology . 1987;164:617-621.Crossref 5. Beatty JD, Hyams DM, Morton BA, et al. Impact of radiolabeled antibody imaging on management of colon cancer . Am J Surg . 1989;157:13-19.Crossref 6. Doerr RJ, Abdel-Nabi H, Merchant B. Indium 111 ZCE-025 immunoscintigraphy in occult recurrent colorectal cancer with elevated carcinoembryonic antigen level . Arch Surg . 1990;125:226-229.Crossref 7. Patt YZ, Lamki LM, Haynie TP, et al. Improved tumor localization with increasing dose of indium-111-labeled anti-carcinoembryonic antigen monoclonal antibody ZCE-025 in metastatic colorectal cancer . J Clin Oncol . 1988;6:1220-1230. 8. Brown BA, Comeau RD, Jones PL, et al. Pharmacokinetics of the monoclonal antibody B72.3 and its fragments labeled with either 125 I or 111 In . Cancer Res . 1987;47:1149-1154. 9. Renda A, Salvatore M, Sava M, et al. Immunoscintigraphy in the follow-up of patients operated on for carcinoma of the sigmoid and rectum: preliminary report with a new monoclonal antibody–B72.3 . Dis Colon Rectum . 1987;30:683-686.Crossref 10. Kaplan EH, Hartman DD, Fordham EW, Rayudu GVS. 111 Indium-labeled monoclonal antibody (MoAb), 111 In-CYT-103, imaging of colorectal carcinoma: a surgical correlation. In: Proceedings of the American Society of Clinical Oncology; May 20-22, 1990; Washington, DC. Abstract 496. 11. Maguire R, Pascucci V, Maroli A, Schmelter R, Conklin J, McKearn T. Radioimaging with 111 In-CYT-103: effect on the presurgical management of colorectal cancer patients. In: Proceedings of the American Society of Clinical Oncology; May 20-22, 1990; Washington, DC. Abstract 397. 12. Aitken DR, Hinkle GH, Thurston MO, et al. A gamma detecting probe for radioimmune detection of CEA-producing tumours: successful experimental use and clinical case report . Dis Colon Rectum . 1984;27:279-282.Crossref 13. Martin DT, Aitken D, Thurston M, et al. Successful experimental use of a self-contained gamma detecting device . Curr Surg . 1984;41:193-194. 14. Martin DT, Hinkle GH, Tuttle S, et al. Intraoperative radioimmunodetection of colorectal tumor with hand-held radiation detector . Am J Surg . 1985;150:672-675.Crossref 15. Martin EW Jr, Mojzisik CM, Hinkle GH Jr, et al. Radioimmunoguided surgery using monoclonal antibody . Am J Surg . 1988;156:386-392.Crossref 16. Martin EW Jr, Tuttle SE, Rousseau M, et al. Radioimmunoguided surgery: intraoperative use of monoclonal antibody 17-1A in colorectal cancer . Hybridoma . 1986;5:S97-S108. 17. Sickle-Santanello BJ, O'Dwyer PJ, Mojzisik CM, et al. Radioimmunoguided surgery using the monoclonal antibody B72.3 in colorectal tumors . Dis Colon Rectum . 1987;30:761-764.Crossref 18. Goldenberg DM, DeLand F, Kim E, et al. Use of radiolabeled antibodies to carcinoembryonic antigen in the detection and localization of diverse cancers by external photoscanning . N Engl J Med . 1978;298:1384-1388.Crossref 19. Mach JP, Carrel S, Forni M, Ritzchard J, Donnath A, Alberto P. Tumor localization of radiolabeled antibodies against carcinoembryonic antigen in patients with carcinoma . N Engl J Med . 1980;303:5-10.Crossref 20. Leyden MJ, Thompson CH, Lichtenstein M, et al. Visualization of metastases from colon carcinoma using an iodine 131-radiolabeled monoclonal antibody . Cancer . 1986;57:1135-1139.Crossref 21. Armitage NC, Perkins AC, Pimm MV, Farrands PA, Baldwin RW, Hardcastle JD. The localization of an anti-tumour monoclonal antibody (791T/36) in gastrointestinal tumours . Br J Surg . 1984;71:407-412.Crossref 22. Colcher D, Keenan AM, Larson SM, Schlom J. Prolonged binding of a radiolabeled monoclonal antibody (B72.3) used for the in situ radioimmunodetection of human colon carcinoma xenografts . Cancer Res . 1984;44:5744-5751. 23. Colcher D, Esteban JM, Carrasquillo JA, Surgarbaker P, Reynolds JC, Bryant G, et al. Quantitative analyses of selective radiolabeled monoclonal antibody localization in metastatic lesions of colorectal cancer patients . Cancer Res . 1987;47:1185-1189. 24. Schlom J, Colcher D, Roselli M, et al. Tumor targeting with monoclonal antibody B72.3 . Nucl Med Biol . 1988;16:137-142. 25. Skinner JM, Whitehead R. Tumor-associated antigens in polyps and carcinoma of the large bowel . Cancer . 1981;47:1241-1245.Crossref 26. O'Dwyer PJ, Mojzisik CM, Hinkle GH, et al. Intraoperative probe-directed radioimmunodetection using a monoclonal antibody . Arch Surg . 1986;121:1391-1394.Crossref 27. Bertoglio S, Percivale P, Bartolomeo S, et al. B72.3 125-I monoclonal antibody for intraoperative detection of primary and recurrent colorectal cancer by radioimmunoguided (RIGS tm) surgery. In: Proceedings of the American Society of Clinical Oncology; May, 1990; Washington, DC. Abstract 491. 28. Molinolo A, Simpson JF, Thor A, Schlom J. Enchanced tumor binding using immunohistochemical analyses by second generation anti-tumor-associated glycoprotein 72 monoclonal antibodies versus monoclonal antibody B72.2 in human tissue . Cancer Res . 1990;50:1291-1298. 29. Nieroda C, Mojzisik C, Houchens D, Hinkle G, Thurston M, Martin EW Jr. Intraoperative radioimmunodetection: a dose range study. In: Proceedings of the American Association for Cancer Research; May 22-24, 1990; Washington, DC. Abstract 1562. 30. Lottich SC, Szpak CA, Johnston WW, Thor A, Schlom J. Phenotypic heterogeneity of a tumor-associated antigen in adenocarcinomas of the colon and their metastases as demonstrated by monoclonal antibody B72.3 . Cancer Invest . 1986;4:387-395.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Surgery American Medical Association

Radioimmunoguided Surgery Using Iodine 125 B72.3 in Patients With Colorectal Cancer

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References (30)

Publisher
American Medical Association
Copyright
Copyright © 1991 American Medical Association. All Rights Reserved.
ISSN
0004-0010
eISSN
1538-3644
DOI
10.1001/archsurg.1991.01410270095015
Publisher site
See Article on Publisher Site

Abstract

Abstract • Preliminary data using B72.3 murine monoclonal antibody labeled with iodine 125 suggested that both clinically apparent as well as occult sites of colorectal cancer could be identified intraoperatively using a hand-held gamma detecting probe. We report the preliminary data of a multicenter trial of this approach in patients with primary or recurrent colorectal cancer. One hundred four patients with primary, suspected, or known recurrent colorectal cancer received an intravenous infusion of 1 mg of B72.3 monoclonal antibody radiolabeled with 7.4×10 Bq of iodine 125. Twenty-six patients with primary colorectal cancer and 72 patients with recurrent colorectal cancer were examined. Using the gamma detecting probe, 78% of the patients had localization of the antibody in their tumor; this included 75% of primary tumor sites and 63% of all recurrent tumor sites; 9.2% of all tumor sites identified represented occult sites detected only with the gamma detecting probe. The overall sensitivity was 77% and a predictive value of a positive detection was 78%. A total of 30 occult sites in 26 patients were identified. In patients with recurrent cancer, the antibody study provided unique data that precluded resection in 10 patients, and in another eight patients it extended the potentially curative procedure. (Arch Surg. 1991;126:349-352) References 1. Mitchell EP, Schlom J. Monoclonal antibodies in gastrointestinal cancers . Semin Oncol . 1988;15:170-180. 2. Goldenberg DM, Goldenberg H, Sharkey RM, et al. Imaging of colorectal carcinoma with radiolabeled antibodies . Semin Nucl Med . 1989;19:262-281.Crossref 3. Begent RHJ, Keep PA, Searle F, et al. Radioimmunolocalization and selection for surgery in recurrent colorectal cancer . Br J Surg . 1986;73:64-67.Crossref 4. Abdel-Nabi HH, Shwartz AN, Higano CS, Wechter DG, Unger MW. Colorectal carcinoma: detection with indium-111 anticarcinoembryonic-antigen monoclonal antibody ZCE-0251 . Radiology . 1987;164:617-621.Crossref 5. Beatty JD, Hyams DM, Morton BA, et al. Impact of radiolabeled antibody imaging on management of colon cancer . Am J Surg . 1989;157:13-19.Crossref 6. Doerr RJ, Abdel-Nabi H, Merchant B. Indium 111 ZCE-025 immunoscintigraphy in occult recurrent colorectal cancer with elevated carcinoembryonic antigen level . Arch Surg . 1990;125:226-229.Crossref 7. Patt YZ, Lamki LM, Haynie TP, et al. Improved tumor localization with increasing dose of indium-111-labeled anti-carcinoembryonic antigen monoclonal antibody ZCE-025 in metastatic colorectal cancer . J Clin Oncol . 1988;6:1220-1230. 8. Brown BA, Comeau RD, Jones PL, et al. Pharmacokinetics of the monoclonal antibody B72.3 and its fragments labeled with either 125 I or 111 In . Cancer Res . 1987;47:1149-1154. 9. Renda A, Salvatore M, Sava M, et al. Immunoscintigraphy in the follow-up of patients operated on for carcinoma of the sigmoid and rectum: preliminary report with a new monoclonal antibody–B72.3 . Dis Colon Rectum . 1987;30:683-686.Crossref 10. Kaplan EH, Hartman DD, Fordham EW, Rayudu GVS. 111 Indium-labeled monoclonal antibody (MoAb), 111 In-CYT-103, imaging of colorectal carcinoma: a surgical correlation. In: Proceedings of the American Society of Clinical Oncology; May 20-22, 1990; Washington, DC. Abstract 496. 11. Maguire R, Pascucci V, Maroli A, Schmelter R, Conklin J, McKearn T. Radioimaging with 111 In-CYT-103: effect on the presurgical management of colorectal cancer patients. In: Proceedings of the American Society of Clinical Oncology; May 20-22, 1990; Washington, DC. Abstract 397. 12. Aitken DR, Hinkle GH, Thurston MO, et al. A gamma detecting probe for radioimmune detection of CEA-producing tumours: successful experimental use and clinical case report . Dis Colon Rectum . 1984;27:279-282.Crossref 13. Martin DT, Aitken D, Thurston M, et al. Successful experimental use of a self-contained gamma detecting device . Curr Surg . 1984;41:193-194. 14. Martin DT, Hinkle GH, Tuttle S, et al. Intraoperative radioimmunodetection of colorectal tumor with hand-held radiation detector . Am J Surg . 1985;150:672-675.Crossref 15. Martin EW Jr, Mojzisik CM, Hinkle GH Jr, et al. Radioimmunoguided surgery using monoclonal antibody . Am J Surg . 1988;156:386-392.Crossref 16. Martin EW Jr, Tuttle SE, Rousseau M, et al. Radioimmunoguided surgery: intraoperative use of monoclonal antibody 17-1A in colorectal cancer . Hybridoma . 1986;5:S97-S108. 17. Sickle-Santanello BJ, O'Dwyer PJ, Mojzisik CM, et al. Radioimmunoguided surgery using the monoclonal antibody B72.3 in colorectal tumors . Dis Colon Rectum . 1987;30:761-764.Crossref 18. Goldenberg DM, DeLand F, Kim E, et al. Use of radiolabeled antibodies to carcinoembryonic antigen in the detection and localization of diverse cancers by external photoscanning . N Engl J Med . 1978;298:1384-1388.Crossref 19. Mach JP, Carrel S, Forni M, Ritzchard J, Donnath A, Alberto P. Tumor localization of radiolabeled antibodies against carcinoembryonic antigen in patients with carcinoma . N Engl J Med . 1980;303:5-10.Crossref 20. Leyden MJ, Thompson CH, Lichtenstein M, et al. Visualization of metastases from colon carcinoma using an iodine 131-radiolabeled monoclonal antibody . Cancer . 1986;57:1135-1139.Crossref 21. Armitage NC, Perkins AC, Pimm MV, Farrands PA, Baldwin RW, Hardcastle JD. The localization of an anti-tumour monoclonal antibody (791T/36) in gastrointestinal tumours . Br J Surg . 1984;71:407-412.Crossref 22. Colcher D, Keenan AM, Larson SM, Schlom J. Prolonged binding of a radiolabeled monoclonal antibody (B72.3) used for the in situ radioimmunodetection of human colon carcinoma xenografts . Cancer Res . 1984;44:5744-5751. 23. Colcher D, Esteban JM, Carrasquillo JA, Surgarbaker P, Reynolds JC, Bryant G, et al. Quantitative analyses of selective radiolabeled monoclonal antibody localization in metastatic lesions of colorectal cancer patients . Cancer Res . 1987;47:1185-1189. 24. Schlom J, Colcher D, Roselli M, et al. Tumor targeting with monoclonal antibody B72.3 . Nucl Med Biol . 1988;16:137-142. 25. Skinner JM, Whitehead R. Tumor-associated antigens in polyps and carcinoma of the large bowel . Cancer . 1981;47:1241-1245.Crossref 26. O'Dwyer PJ, Mojzisik CM, Hinkle GH, et al. Intraoperative probe-directed radioimmunodetection using a monoclonal antibody . Arch Surg . 1986;121:1391-1394.Crossref 27. Bertoglio S, Percivale P, Bartolomeo S, et al. B72.3 125-I monoclonal antibody for intraoperative detection of primary and recurrent colorectal cancer by radioimmunoguided (RIGS tm) surgery. In: Proceedings of the American Society of Clinical Oncology; May, 1990; Washington, DC. Abstract 491. 28. Molinolo A, Simpson JF, Thor A, Schlom J. Enchanced tumor binding using immunohistochemical analyses by second generation anti-tumor-associated glycoprotein 72 monoclonal antibodies versus monoclonal antibody B72.2 in human tissue . Cancer Res . 1990;50:1291-1298. 29. Nieroda C, Mojzisik C, Houchens D, Hinkle G, Thurston M, Martin EW Jr. Intraoperative radioimmunodetection: a dose range study. In: Proceedings of the American Association for Cancer Research; May 22-24, 1990; Washington, DC. Abstract 1562. 30. Lottich SC, Szpak CA, Johnston WW, Thor A, Schlom J. Phenotypic heterogeneity of a tumor-associated antigen in adenocarcinomas of the colon and their metastases as demonstrated by monoclonal antibody B72.3 . Cancer Invest . 1986;4:387-395.Crossref

Journal

Archives of SurgeryAmerican Medical Association

Published: Mar 1, 1991

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