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Prepublished online as a Blood First Edition Paper on April 17, 2002; DOI 10.1182/blood-2002-01-0107.
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Blood, 1 July 2002, Vol. 100, No. 1, pp. 208-216
NEOPLASIA
Pretargeting radioimmunotherapy of a murine model of adult T-cell
leukemia with the -emitting radionuclide, bismuth 213
Meili Zhang,
Zhengsheng Yao,
Kayhan Garmestani,
Donald B. Axworthy,
Zhuo Zhang,
Robert W. Mallett,
Louis J. Theodore,
Carolyn K. Goldman,
Martin W. Brechbiel,
Jorge A. Carrasquillo, and
Thomas A. Waldmann
From the Metabolism Branch, Center for Cancer Research,
National Cancer Institute; Nuclear Medicine Department, Clinical
Center; Radiation Oncology Branch, National Cancer Institute, National
Institutes of Health, Bethesda, MD; and NeoRx Corporation, Seattle, WA.
We used a pretargeting technique to treat a nonobese
diabetic/severe combined immunodeficient murine model of human adult T-cell leukemia with an anti-Tac antibody-streptavidin (HAT-SA) conjugate, which recognizes CD25, followed by bismuth 213 (213Bi)-1,4,7,10-tetraazacyclododecane-N,N',N'',N'''-tetraacetic
acid (DOTA)- biotin. In the 3-step pretargeting
radioimmunotherapy protocol, HAT-SA (140 or 400 µg) was administered
intravenously (i.v.) to bind to the interleukin 2 receptor (IL-2R ; CD25)-expressing tumor cells. After 24 hours, 100 µg of a
synthetic clearing agent was administered i.v. to remove unbound
circulating HAT-SA conjugate from the circulation. Four hours later,
213Bi-DOTA-biotin was administered i.v. for therapy.
Tumor growth was significantly inhibited in 3 trials by using 250 µCi
(9.25 MBq) of 213Bi-DOTA-biotin with a
pretargeting technique as monitored by serum levels of soluble
IL-2R and/or human -2-microglobulin
(P < .05, t test) and by
survival of tumor-bearing mice in the treatment groups
(P < .02, log rank test) as compared with the control
groups. No prolongation of survival was observed with a nonspecific
antibody-SA conjugate or in the absence of the radionuclide.
Additionally, no prolongation of survival resulted from administration
of 213Bi directly linked to intact HAT. Furthermore,
there was no prolongation of survival when the -emitting
radionuclide yttrium 90 instead of the -emitting radionuclide
213Bi was used. The pretargeting approach with
213Bi inhibited tumor growth more effectively than did
immunotherapy with unmodified HAT. The best results were obtained with
combination therapy that involved 213Bi-DOTA-biotin with a
pretargeting technique supplemented by 4 weekly doses of HAT. The
findings of this study support the use of this combination approach in
a clinical trial in patients with IL-2R -expressing leukemias.

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