Antibody-based targeted radiation to pediatric tumors Journal Article


Authors: Modak, S.; Cheung, N. K. V.
Article Title: Antibody-based targeted radiation to pediatric tumors
Abstract: Radioimmunotherapy (RIT) for pediatric tumors remains in its infancy despite its potential as an attractive therapeutic modality. Most childhood tumors are radiation sensitive, but the side effects of external beam radiation are well recognized. Despite achieving complete remissions with sophisticated combination therapies, treatment failure primarily results from the inability to eradicate minimal residual disease, which is typically distant and occult. RIT can conceivably target such disease and improve cancer treatment. Because intensive chemotherapy regimens used in most childhood cancers are highly immunosuppressive, repeated administration of radiolabeled monoclonal antibodies is possible without the immediate induction of human antimouse or human antichimeric antibody responses. Despite the differences in biology between childhood and adult hematologic malignancies, they share several tumor antigens for which RIT agents are now available. However, safety and efficacy profiles in children remain to be defined. On the other hand, the antigen repertoire of pediatric solid tumors differs substantially from that in adults, partly because of differing lineages: pediatric solid tumors are typically of embryonal origin, whereas adult tumors are usually carcinomas of epithelial origin. Hence, RIT agents licensed for adult tumors are generally not applicable to pediatric solid tumors. Tumor-selective radioimmunoconjugates specific for embryonal tumors of childhood are currently being actively investigated. Without substantial policy changes in drug development for orphan indications, however, these agents are not likely to be widely available in the near future.
Keywords: osteosarcoma; adolescent; child; preschool child; treatment outcome; child, preschool; acute granulocytic leukemia; clinical trial; review; solid tumor; drug targeting; radiation dose; brain tumor; methodology; sensitivity and specificity; radiopharmaceuticals; clinical practice; neoplasm; neoplasms; physician's practice patterns; practice guideline; tumor antigen; acute lymphoblastic leukemia; childhood cancer; monoclonal antibody; drug delivery systems; t cell lymphoma; antibodies, monoclonal; nonhodgkin lymphoma; iodine 131; drug distribution; infant; infant, newborn; neuroblastoma; newborn; radiopharmaceutical agent; radioisotope; drug half life; rhabdomyosarcoma; radioimmunotherapy; indium 111; radioisotopes; clinical trials; drug delivery system; pediatrics; desmoplastic small round cell tumor; cell adhesion molecule; pediatric cancer; radioimmunoassay; radioimmunodetection; yttrium 90; practice guidelines; rhenium 188; copper 67
Journal Title: Journal of Nuclear Medicine
Volume: 46
Issue: Suppl. 1
ISSN: 0161-5505
Publisher: Society of Nuclear Medicine  
Date Published: 2005-01-01
Start Page: 157S
End Page: 163S
Language: English
PUBMED: 15653664
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 10" - "Export Date: 24 October 2012" - "CODEN: JNMEA" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Nai-Kong Cheung
    648 Cheung
  2. Shakeel Modak
    249 Modak