Efforts to control the errant products of a targeted in vivo generator Journal Article


Authors: Jaggi, J. S.; Kappel, B. J.; McDevitt, M. R.; Sgouros, G.; Flombaum, C. D.; Cabassa, C.; Scheinberg, D. A.
Article Title: Efforts to control the errant products of a targeted in vivo generator
Abstract: Alpha-particle immunotherapy by targeted α-emitters or α-emitting isotope generators is a novel form of extraordinarily potent cancer therapy. A major impediment to the clinical use of targeted actinium-225 ( 225Ac) in vivo generators may be the radiotoxicity of the systemically released daughter radio-nuclides. The daughters, especially bismuth-213 ( 213Bi), tend to accumulate in the kidneys. We tested the efficacy of various pharmacologic agents and the effect of tumor burden in altering the pharmacokinetics of the 225Ac daughters to modify their renal uptake. Pharmacologic treatments in animals were started before i.v. administration of the HuM195- 225 Ac generator. 223Ac, francium-221 ( 221Fr), and 213Bi biodistributions were calculated in each animal at different time points after 225Ac generator injection. Oral metal chelation with 2,3-dimercapto-1-propanesulfonic acid (DMPS) or meso-2,3-dimercaptosuccinic acid (DMSA) caused a significant reduction (P < 0.0001) in the renal 213Bi uptake; however, DMPS was more effective than DMSA (P < 0.001). The results with DMPS were also confirmed in a monkey model. The renal 213Bi and 221Fr activities were significantly reduced by furosemide and chlorothiazide treatment (P < 0.0001). The effect on renal 213Bi activity was further enhanced by the combination of DMPS with either chlorothiazide or furosemide (P < 0.0001). Competitive antagonism by bismuth sub-nitrate moderately reduced the renal uptake of 213Bi. The presence of a higher target-tumor burden significantly prevented the renal 213Bi accumulation (P = 0.003), which was further reduced by DMPS treatment (P < 0.0001). Metal chelation, diuresis with furosemide or chlorothiazide, and competitive metal blockade may be used as adjuvant therapies to modify the renal accumulation of 225Ac daughters. © 2005 American Association for Cancer Research.
Keywords: controlled study; drug efficacy; nonhuman; mouse; animals; mice; furosemide; in vivo study; mice, scid; cancer therapy; mice, inbred balb c; antibodies, monoclonal; kidney; lymphoma; radioisotope; radioimmunotherapy; monkey; chelating agents; chelation; macaca fascicularis; alpha radiation; immunotoxins; bismuth; alpha particles; actinium; bismuth 213; francium; succimer; unithiol; diuresis; generator; bismuth nitrate; chlorothiazide
Journal Title: Cancer Research
Volume: 65
Issue: 11
ISSN: 0008-5472
Publisher: American Association for Cancer Research  
Date Published: 2005-06-01
Start Page: 4888
End Page: 4895
Language: English
DOI: 10.1158/0008-5472.can-04-3096
PUBMED: 15930310
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 25" - "Export Date: 24 October 2012" - "CODEN: CNREA" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Jaspreet Jaggi
    21 Jaggi
  2. Michael R Mcdevitt
    144 Mcdevitt
  3. Barry J Kappel
    28 Kappel