Quantitative analysis of antibody localization in human metastatic colon cancer: A phase I study of monoclonal antibody A33 Journal Article


Authors: Welt, S.; Divgi, C. R.; Real, F. X.; Yeh, S. D.; Garin-Chesa, P.; Finstad, C. L.; Sakamoto, J.; Cohen, A.; Sigurdson, E. R.; Kemeny, N.; Carswell, E. A.; Oettgen, H. F.; Old, L. J.
Article Title: Quantitative analysis of antibody localization in human metastatic colon cancer: A phase I study of monoclonal antibody A33
Abstract: A33 is a mouse immunoglobulin G2a (lgG2a) monoclonal antibody (mAb) that detects a heat-stable, protease- and neuraminidase-resistant epitope. The antigen is homogeneously expressed by virtually all colon cancers and in the colon mucosa but not other epithelial tissues. The biodistribution and imaging characteristics of iodine-131 (131l)-mAbA33 were studied in colorectal carcinoma patients with hepatic metastases. Antibody labeled with 2 to 5 mCi of 131I was administered intravenously (IV) 7 to 8 days before surgery at five dose levels, ranging from 0.2 mg to 50 mg, with three or more patients entered at each dose level. In addition, three patients received 2 mg 131I-mAbTA99 (an isotype-matched control mAb) together with 125l-mAbA33. Evaluation included whole-body imaging with a gamma camera, technetium-99 (99mTc)-human serum albumin blood pool scans, liver/spleen scans, abdominal computed tomographic (CT) scans, hepatic arteriograms, antibody pharmacokinetics, and assessment of antibody distribution in biopsied malignant and normal tissues. Selective mAbA33 localization to tumor tissue was demonstrated in 19 of 20 patients, and external imaging correlated with surgical inspection, pathologic examination, and tissue radioactivity. One week after antibody administration, tumor:liver ratios ranged from 6.9:1 to 100:1 and tumor:serum ratios from 4.1:1 to 25.2:1. 99mTc-albumin blood pool studies showed that liver metastases were hypovascular, emphasizing the selective localization of mAbA33 despite poor tumor-blood flow. Control mAbTA99 studies showed mAbA33 localization was antigen-specific; tumonliver ratios were 2.3- to 45-fold higher for specific antibody. In metastatic lesions, radioisotope was localized primarily in the viable periphery; however, even the necrotic tumor core concentrated specific antibody. External imaging showed isotope visualization in some patients' large bowel; whether this represents specific antibody uptake or gastric iodine secretion is unclear. © 1990 by American Society of Clinical Oncology.
Keywords: adult; clinical article; aged; unclassified drug; liver neoplasms; technetium 99m; animal; mice; colonic neoplasms; liver metastasis; antibodies, monoclonal; immunoglobulin g; iodine 131; isotope labeling; iodine radioisotopes; colon cancer; neoplasm metastasis; imaging; phase 1 clinical trial; radioisotope; intravenous drug administration; middle age; drug evaluation; human; male; female; priority journal; article; monoclonal antibody a33; support, non-u.s. gov't; support, u.s. gov't, p.h.s.
Journal Title: Journal of Clinical Oncology
Volume: 8
Issue: 11
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 1990-11-01
Start Page: 1894
End Page: 1906
Language: English
DOI: 10.1200/jco.1990.8.11.1894
PUBMED: 2230877
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 27 January 2020 -- Source: Scopus
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MSK Authors
  1. Samuel D J Yeh
    107 Yeh
  2. Chaitanya Divgi
    163 Divgi
  3. Alfred M Cohen
    244 Cohen
  4. Herbert F Oettgen
    130 Oettgen
  5. Lloyd J Old
    593 Old
  6. Nancy Kemeny
    544 Kemeny
  7. Sydney   Welt
    98 Welt
  8. Connie L. Finstad
    45 Finstad
  9. Francisco X. Real
    42 Real