Radioimmunotherapy in patients with head and neck squamous cell carcinoma: Initial experience

• Published in: Head & neck Vol. 23; no. 7; pp. 559 - 565
• Main Authors: Colnot, David R., Quak, Jasper J., Roos, Jan C., de Bree, Remco, Wilhelm, Abraham J., Snow, Gordon B., van Dongen, Guus A. M. S.
• Format: Journal Article
• Language: English
• Published: New York John Wiley & Sons, Inc 01.07.2001; John Wiley & Sons
• Subjects: Aged; Antibodies, Monoclonal - therapeutic use; Biological and medical sciences; Carcinoma, Squamous Cell - radiotherapy; Diseases of the upper aerodigestive tract; Ent and stomatology; Female; head and neck cancer; Head and Neck Neoplasms - radiotherapy; Humans; Male; Medical sciences; Middle Aged; monoclonal antibodies; Neoplasm Recurrence, Local - radiotherapy; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Radioimmunotherapy; Radioisotopes - pharmacokinetics; Radioisotopes - therapeutic use; Radiotherapy Dosage; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Recombinant Fusion Proteins; Rhenium - pharmacokinetics; Rhenium - therapeutic use; Tomography, Emission-Computed, Single-Photon; Tumors; Radionuclide study; Toxicity; Monoclonal antibody; Bone marrow disease; Immunotherapy; Clinical biology; Secondary effect; Bone marrow; Head and neck; ENT disease; Adult; Complication; Rhenium; Tumor cell; Human; Treatment efficiency; Exploration; Myelotoxicity; Malignant tumor; Radiotherapy; Nuclear magnetic resonance imaging; Photon; Radiation dose; Platelet; Treatment; Medical imagery; Blood cell count; Emission tomography
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.1078

Background Despite improvements in locoregional treatment of stages III/IV squamous cell carcinoma of the head and neck (HNSCC), local and distant failure rates remain high. An effective adjuvant therapy is required for these patients. Among novel approaches is radioimmunotherapy, in which monoclonal antibodies (MAbs) are used for selective delivery of radiation to tumor cells. Methods The suitability of 186Re‐labeled chimeric MAb U36 (186Re‐cMAb U36) for radioimmunotherapy was evaluated in a phase I study, with radiation dose escalating steps of 11, 27, and 41 mCi/m2. Tumor targeting was monitored with a gamma camera, and the maximum tolerated dose was established in 13 patients with recurrent or metastatic disease. Results Administrations were well tolerated, and excellent targeting of tumor lesions was seen. Myelotoxicity was the only toxicity observed, resulting in dose‐limiting toxicity in two patients treated with 41 mCi/m2. The MTD was established at 27 mCi/m2. A marked reduction in tumor size was observed in two patients, another showed stable disease for 6 months. Conclusions Radioimmunotherapy with 186Re‐cMAb U36 seems to be well tolerated, with bone marrow being the dose‐limiting organ. The observation of antitumor effects is encouraging for further development of radioimmunotherapy for HNSCC. © 2001 John Wiley & Sons, Inc. Head Neck 23: 559–565, 2001.