Immunoscintigraphy of adenocarcinomas by means of radiolabeled F(ab')2 fragments of an anti-carcinoembryonic antigen monoclonal antibody: a multicenter study

• Published in: Cancer research (Chicago, Ill.) Vol. 49; no. 11; pp. 3095 - 3103
• Main Authors: SICCARDI, A. G, BURAGGI, G. L, SALVATORE, M, SCASSELLATI, G. A, SCHEIDHAUER, K, TURCO, G. L, ZANIOL, P, BENINI, S, DELEIDE, G, GASPARINI, M, LASTORIA, S, MANSI, L, CALLEGARO, L, PAGANELLI, G, SALVISCHIANI, E, SEREGNI, E, VIALE, G, NATALI, P. G, COLELLA, A. C, DE FILIPPI, P. G, GALLI, G, MARIANI, G, MASI, R, PALUMBO, R, RIVA, P
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Association for Cancer Research 01.06.1989
• Subjects: 550601 - Medicine- Unsealed Radionuclides in Diagnostics; Adenocarcinoma - diagnostic imaging; Adenocarcinoma - metabolism; ANTIBODIES; ANTIGENS; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; Biological and medical sciences; CARCINOEMBRYONIC ANTIGEN; Carcinoembryonic Antigen - immunology; CARCINOMAS; Contrast media. Radiopharmaceuticals; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DIGESTIVE SYSTEM; DISEASES; DISTRIBUTION; ELECTRON CAPTURE RADIOISOTOPES; False Positive Reactions; GASTROINTESTINAL TRACT; GLOBULINS; Humans; Immunoglobulin Fab Fragments - metabolism; Immunoglobulin G - metabolism; IMMUNOGLOBULINS; INDIUM 111; INDIUM ISOTOPES; Indium Radioisotopes - metabolism; INTERMEDIATE MASS NUCLEI; IODINE 131; IODINE ISOTOPES; Iodine Radioisotopes; ISOMERIC TRANSITION ISOTOPES; ISOTOPE APPLICATIONS; ISOTOPES; Medical sciences; MINUTES LIVING RADIOISOTOPES; MONOCLONAL ANTIBODIES; Multicenter Studies as Topic; NEOPLASMS; Neoplasms, Unknown Primary - diagnostic imaging; NUCLEI; ODD-EVEN NUCLEI; ORGANIC COMPOUNDS; PATIENTS; Pharmacology. Drug treatments; PROTEINS; RADIOIMMUNODETECTION; RADIOIMMUNOSCINTIGRAPHY; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY AND NUCLEAR MEDICINE; Radionuclide Imaging; SCINTISCANNING; SENSITIVITY ANALYSIS; SPECIFICITY; TISSUE DISTRIBUTION; TRACER TECHNIQUES; Radionuclide study; Human; Carcinoembryonic antigen; Radiodiagnosis; Multicenter study; Fab'-Fragment; Tumor; Monoclonal antibody; Radioisotope; Scintigraphy
• ISSN: 0008-5472; 1538-7445

F(ab')2 fragments of anti-carcinoembryonic antigen (CEA) monoclonal antibody F023C5, determined to be more suitable than intact IgG and Fab fragments for immunoscintigraphy, were labeled with 131I or conjugated to DTPA for instant 111In-labeling, and administered i.v. (2-3 mCi/0.5 mg) to 509 patients in 11 nuclear medicine departments: 284 patients had gastrointestinal adenocarcinomas, 204 had nongastrointestinal adenocarcinomas and 21 were control; serum CEA was elevated in 169 patients, normal in 115, and not determined in 225. The following results were obtained: (a) no adverse reactions; (b) tumor imaging in 324 patients (in particular, in 81.5% CEA-seropositive and in 69.0% CEA-seronegative patients); (c) no significant difference in sensitivity among the results of the 11 departments; (d) no significant difference in overall sensitivity between 131I-and 111In-labeled immunoradiopharmaceuticals; (e) the fraction of documented lesions imaged was 73.3% in CEA-seropositive and 53.7% in CEA-seronegative patients; (f) the detection of liver metastases was hampered, particularly when using the 111In-labeled reagent, by nonspecific radioactivity uptake; (g) the major cause of negative immunoscintigraphy results was a lack of CEA in tumor lesions, as documented by immunohistochemistry; (h) lesion size is also important since the sensitivity was 64% for lesions up to 2 cm in diameter and 84% for larger lesions; (i) many "unexpected" radiolocalizations were recorded. Most were identified as occult tumor lesions. In 35 patients, this finding contributed to the early detection of tumor recurrences.