Targeted radioimmunotherapy for embryonal tumor with multilayered rosettes Journal Article

Authors: Bailey, K.; Pandit-Taskar, N.; Humm, J. L.; Zanzonico, P.; Gilheeney, S.; Cheung, N. K. V.; Kramer, K.
Article Title: Targeted radioimmunotherapy for embryonal tumor with multilayered rosettes
Abstract: PurposeWe explored the use of intraventricular I-131-Omburtamab targeting B7-H3 in patients with ETMR.MethodsPatients were enrolled in an IRB approved, phase 1, 3+3 dose escalation trial. Patients with CNS disease expressing the antibody target antigen B7-H3 were eligible. We report on a cohort of three patients with ETMR who were enrolled on the study. Three symptomatic children (ages 14 months, 3 and 3.5years) had large parietal masses confirmed to be B7-H3-reactive ETMR. Patients received 2mCi I-131-Omburtamab as a tracer followed by one or two therapeutic I-131-Omburtamab injections. Dosimetry was based on serial CSF, blood samplings and region of interest (ROI) on nuclear scans. Brain and spine MRIs and CSF cytology were done at baseline, 5 weeks after I-131-Omburtamab, and approximately every 3months thereafter. Acute toxicities and survival were noted.ResultsPatients received surgery, focal radiation, and high dose chemotherapy. Patients 1 and 2 received I-131-Omburtamab (80 and 53mCi, respectively). Patient 3 had a local recurrence prior to I-131-Omburtamab treated with surgery, external beam radiation, chemotherapy, then I-131-Omburtamab (36mCi). I-131-Omburtamab was well-tolerated. Mean dose delivered by I-131-Omburtamab was 68.4cGy/mCi to CSF and 1.95cGy/mCi to blood. Mean ROI doses were 230.4 (ventricular) and 58.2 (spinal) cGy/mCi. Patients 1 and 2 remain in remission 6.8years and 2.3years after diagnosis, respectively; patient 3 died of progressive disease 7months after therapy (2years after diagnosis).Conclusions(131)I-Omburtamab appears safe with favorable dosimetry therapeutic index. When used as consolidation following surgery and chemoradiation therapy, I-131-Omburtamab may have therapeutic benefit for patients with ETMR.
Keywords: radioimmunotherapy; children; abundant neuropil; etmr; embryonal tumor with multilayered rosettes; i-131-omburtamab; i-131-8h9
Journal Title: Journal of Neuro-Oncology
Volume: 143
Issue: 1
ISSN: 0167-594X
Publisher: Springer  
Date Published: 2019-05-01
Start Page: 101
End Page: 106
Language: English
ACCESSION: WOS:000465615000011
DOI: 10.1007/s11060-019-03139-6
PUBMED: 30879172
Notes: Article -- Source: Wos
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MSK Authors
  1. Nai-Kong Cheung
    472 Cheung
  2. Kim Kramer
    176 Kramer
  3. John Laurence Humm
    349 Humm
  4. Pat B Zanzonico
    256 Zanzonico
  5. Kayleen Amelia Bailey
    4 Bailey