Radiofármacos en inmunocentelleografía y radioinmunoterapia

René Leyva Montaña

Resumen

La alta morbilidad y letalidad del cáncer, hacen que esta enfermedad se considere, tanto en Cuba como en el mundo, un serio problema de salud. La radioimmunodiagnosis y la radioinmunoterapia, basadas en los crecientes avances en biotecnología y el conocimiento que hoy aportan la biología molecular y celular, devienen herramientas muy prometedoras en la lucha contra el cáncer. En este trabajo se hace una breve revisión de los radiofármacos desarrollados en Cuba, a partir de biomoléculas producidas y una panorámica de una serie de anticuerpos monoclonales y radionúclidos utilizados en aplicaciones clínicas. Las aplicaciones en radioimmunodiagnosis, se han basado en radiofármacos de obtenidos a partir de kits liofilizados de anticuerpos monoclonales murinos. Se examinan también las perspectivas de la aplicación de radioinmunoterapia a partir de las experiencias internacionales, particularmente en el tratamiento del linfoma no Hodgkin, teniendo en cuenta la disponibilidad de diferentes anticuerpos monoclonales ya humanizados y de a partir de tecnologías existentes en centros cubanos de investigación–producción.

Palabras clave

radiofármacos, anicuerpos monoclonales, radioinmunoterapia, radioinmunoescintigrafía, marcado

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Referencias

Cancer epidemiology. News medical [artículo en línea]. . [consulta: 09 de junio 2012].

Oficina Nacional de Estadística e Información (ONE). Anuario Estadístico de Cuba 2010. Principales causas de muerte de todas las edades. [documento en línea]. . [consulta: 12 de junio 2012].

ECKELMAN WC, PAIK CH, STEIGMAN J. Three approach to radio labeling antibodies with 99mTc. Nucl. Med. Biol. 1989; 16(2): 171-176.

PASSCHIER J. Regulatory and Practical Considerations for Choosing the Right Synthesis Module. 15th European Symposium on Radiopharmacy and Radiopharmaceuticals. Scotland, UK, April 2010.

COLCHER D, ESTEBAN JM, CARRASQUILLO JA, et. al. Quantitative analyses of selective radiolabeled monoclonal antibody localization in metastatic lesions of colorectal cancer patients. Cancer Res. 1987; 47(4): 1185-1189.

BOSWELL CA, BRECHBIEL MW. Development of radioimmunotherapeutic and diagnostic antibodies: an inside-out view. Nucl. Med. Biol. 2007; 34(7):757–778.

Cancer death rates continue 10-year decline in U.S. [artículo en línea]. . [consulta: 12 de junio 2012].

BOSWELL CA, BRECHBIEL, MW. Development of radioimmunotherapeutic and diagnostic antibodies:an inside-out view. Nuclear Medicine and Biology. 2007; 34(7): 757–778.

SODEE DB, MALGURIA N, FAULHABER P, et. al. Multicenter prostascint imaging findings in 2154 patients with prostate cancer. the prostascint imaging centers. Urology. 2000; 56(6): 988-993.

JANI AB, SPELBRING D, HAMILTON R, et. al. Impact of radioimmunoscintigraphy on definition of clinical target volume for radiotherapy after prostatectomy. J Nucl Med. 2004; 45(2): 238-246.

RAY G, BAIDOO K, WONG K, et. al. Preclinical evaluation of a monoclonal antibody targeting the epidermal growth factor receptor as a radioimmunodiagnostic and radioimmunotherapeutic agent. British Journal of Pharmacology. 2009. 157(8): 1541–1548. doi: 10.1111/j.1476-5381.2009.00327.x

ALAZRAKI NP, SHUMATE MJ, KOOBY DA. A Clinician´s guide to nuclear oncology: practical molecular imaging and radionuclide therapies. Society of Nuclear Medicine, 2007. p. 46-47.

NAYAK TK, GARMESTANI K, BAIDOO KE, et. al. Preparation, biological evaluation, and pharmacokinetics of the human anti-her1 monoclonal antibody panitumumab labeled with 86y for quantitative pet of carcinoma. J Nucl Med. 2010; 51(6): 942–950. doi: 10.2967/jnumed.109.071290.

NAYAK TK, GARMESTANI K, MILENIC DE, BRECHBIEL M. PET and MRI of metastatic peritoneal and pulmonary colorectal cancer in mice with human epidermal growth factor receptor 1-targeted 89Zr-Labeled panitumumab. J Nucl Med. 2012; 53(1): 113-120. doi: 10.2967/jnumed.111.094169

SHARKEY RM, GOLDENBERG DM. Targeted therapy of cancer: new prospects for antibodies and immunoconjugates. CA Cancer J Clin. 2006, 56(4): 226-243.

DeNARDO G. Molecular Imaging/Therapy: It’s Only Useful If It’s Useful–and available. J Nucl Med. 2008; 49(9): 40N-42N, 44N.

VAKILI A, JALILIAN A, RADFAR E, et. al. Optimization of 90Y-antiCD20 preparation for radioimmunotherapy. Iran J Nucl Med. 2010; 18:(suppl 1). 14th Iranian Annual and International Congress of Nuclear Medicine, Mashhad, Iran.4-6 November 2010

KAMESWARAN M, PANDEY U, SAMUEL G, et. al. Preparation and evaluation of 90Y rituximab for its potential as a radioimmunotherapeutic agent for non Hodgkin?s lymphoma. Indian Journal of Nuclear Medicine. 2010; 25(3): 117-120.

FORRER F, CHEN J, FANI M, et. al. In vitro characterization of 177Lu-radiolabelled chimeric anti-CD20 monoclonal antibody and a preliminary dosimetry study. Eur J Nucl Med and Mol Imaging. 36(9) 1443-1452. doi: 10.1007/s00259-009-1120-2

DAHLE J, JONASDOTTIR TJ, HEYERDAHL H, et. al. Assessment of long-term radiotoxicity after treatment with the low-dose-rate alpha-particle-emitting radioimmunoconjugate (227)Th-rituximab. Eur J Nucl Med Mol Imaging. 2010; 37(1): 93-102.

SMITH-JONES PM. Radioimmunotherapy of prostate cancer. Q J Nucl Med Mol Imaging. 2004; 48(4): 297-304.

DADACHOVA E, NOSANCHUK JD, SHI L, et. al. Dead cells in melanoma tumors provide abundant antigen for targeted delivery of ionizing radiation by a monoclonal antibody to melanin. Proc Natl Acad Sci USA. 2004; 101(41): 14865-70.

ZALUTSKY MR, POZZI OR. Radioimmunotherapy with alpha-particle emitting radionuclides. Q J Nucl Med Mol Imaging. 2004; 48(4): 289-96.

BURKE JM, JURCIC JG. Radioimmunotherapy of leukemia. Adv Pharmacol. 2004; 51: 185-208.

QUANG TS, BRADY LW. Radioimmunotherapy as a novel treatment regimen: 125I-labeled monoclonal antibody 425 in the treatment of high-grade brain gliomas. Int J Radiat Oncol Biol Phys. 2004; 58(3): 972-5.

WONG JY, SHIBATA S, WILLIAMS LE, et. al. A Phase I trial of 90Y-anti-carcinoembryonic antigen chimeric T84.66 radioimmunotherapy with 5-fluorouracil in patients with metastatic colorectal cancer. Clin Cancer Res. 2003; 9(16 Pt 1): 5842-52

HARRIS M, WANG HG, JIANG Z, et. al. Radioimmunotherapy of experimental head and neck squamous cell carcinoma (HNSCC) with E6-specific antibody using a novel HPV-16 positive HNSCC cell line. Head Neck Oncol. 2011; 3(1): 9. doi:10.1186/1758-3284-3-9.The electronic version of this article is the complete one and can be found online at: http://www.headandneckoncology.org/content/3/1/9

GOLDENBERG DM, CHATAL JF, BARBET J, et. al. Cancer Imaging and Therapy with Bispecific Antibody Pretargeting. Update Cancer Ther. 2007; 2(1): 19-31.

New pretargeted radioimmunotherapy for colorectal cancer [artículo de periódico en línea]. ScienceDaily (2011, June 6). [consulta: 4 Jan 2012].

PERERA A, PAREDES M, MISHRA AK, et. al. Marcaje indirecto de anticuerpos monoclonales empleando la N2-dietilentriamino-pentaacetil lisina amida como agente quelatante del 99mTc. ALASBIMN J. 2009; 11(45): Julio 2009.

RAMOS SUZARTE M, RODRIGUEZ N, OLIVA JP, et. al. 99mTc-labeled antihuman epidermal growth factor receptor antibody in patients with tumors of epithelial origin: Part III. Clinical trials safety and diagnostic efficacy. J Nucl Med. 1999; 40(5): 768-775.

RAMOS M, RODRÍGUEZ N, OLIVA JP, et. al. ior egf/r3: A murine monoclonal antibody for diagnosis of epithelial tumors. J Radioanal Nucl Chem. 1999; 240(2): 499-503.

RAMOS M, RODRÍGUEZ N, OLIVA JP, et. al. Estudio del reconocimiento in vivo de los tumores de origen epitelial con los anticuerpos monoclonales ior c5, ior egf/r3 y hR3 humanizado, mediante la técnica de inmunogammagrafía. Nucleus. 2003; (33): 54-63.

TORRES LA, PERERA A, BATISTA JF, et. al. Phase I/II clinical trial of the humanized anti-EGF-r monoclonal antibody h-R3 labelled with 99mTc in patients with tumour of epithelial origin. Nucl Med Commun. 2005; 26(12): 1049-57.

CROMBET T, TORRES L, NENINGER E, et. al. Pharmacological evaluation of the humanized anti-Epidermal Growth Factor Receptor monoclonal antibody h-R3, in patients with advanced epithelial-derived cancer. J. Immunother. 2003; 26(2): 139-48.

RAMOS SUZARTE M. Reconocimiento “in vivo”por inmunogammagrafía de tumors de origin epithelial con los anticuerpos monoclonales ior C5, ior egf/r3 y hR3 humnaizado [trabajo de tesis para optar por el grado de doctor en ciencas]. La Habanaj, 2002.

OLIVA JP, et. al. Clinical evidences of GM3 (NeuGc) ganglioside expression in human breast cancer using the 14F7 monoclonal antibody labelled with (99m)Tc. Breast Cancer Res Treat. 2006; 96(2): 115-121

SOLANO ME, PERERA A, BATISTA JF, et. al. Immunoscintigraphic diagnosis of ovarian cancer with Tc-99m labeled MAb ior-c5: First Clinical Results. World J Nucl Med. 2003; 2: 30-36.

RAMOS SUZARTE M, PINTADO AP, RODRÍGUEZ NM, et. al. Diagnostic Efficacy and Safety of 99mTc-Labeled monoclonal antibody ior c5 in patients with colorectal and anal carcinomas: Final Report Clinical Trial Phase I/II. Cancer Biol Ther 2007; 6(1): 22-29.

TORRES LA, COCA MA, BATISTA JF, et. al. Biodistribution and internal dosimetry of the 188Re-labelled humanizad monoclonal antibody anti-epidermal growth factor receptor, nimotuzumab, in the locoregional treatment of malignant gliomas. Nuc. Med. Comm. 2008; 29: 66-75.

CASACÓ A, LÓPEZ G, GARCÍA I, et. al. Phase I single-dose study of intracavitary-administered Nimotuzumab labeled with 188Re in adult recurrent high-grade glioma. Canc. Biol. And Ther. 2008; 7(3): 1-6.

NUÑEZ G, MORALES A, CABALLERO I, et. al. Bioequivalence study of a freeze-dried kit 99mTc-Labelled mAb cea1 for immunoscintigraphics studies. Eur J Nucl Med. 1998; 25(8): 1162 (Abstract PS-715).

PIMENTEL G, GARCÍA I, GONZÁLEZ J, et. al. Phase I Clinical Trial of the 131I-Labeled Anticarcinoembryonic Antigen CIGB-M3 Multivalent Antibody Fragment. Cancer Biother Radiopharm. 2011; 26(3): 353-363. doi: 10.1089/cbr.2010.0899.