Comparative dual label study of first and second generation antitumor-associated glycoprotein-72 monoclonal antibodies in colorectal cancer patients.

Radiolabeled first-generation anti-tumor-associated glycoprotein-72 (TAG-72) monoclonal antibody (MAb), B72.3, has proven useful in detecting primary and secondary colorectal carcinoma. It has been anticipated that the development of second-generation, higher affinity, anti-TAG-72 MAbs, CC49 and CC83, would be of greater use in cancer detection and of value in radioimmunotherapy of human cancer. We compared the pharmacokinetics, biodistribution, and immune responses of 131I-labeled CC49 and CC83 to 125I-labeled B72.3 by preoperatively coninjecting dual-labeled MAbs into 16 colorectal cancer patients. The imaging properties of radiolabeled CC49 and CC83 were also assessed. Pharmacokinetics of all three MAbs were identical, and there were no differences in the uptake of any of three MAbs in tumor and normal tissues. Maximum tumor uptake was 0.0041% of the injected dose/g for 125I-B72.3, 0.0024% for 131I-CC49, and 0.0029% for 131I-CC83. Radiolabeled CC49 and CC83 detected most known tumor sites on scintigrams without any clear advantage for either MAb. Nonspecific splenic and testicular uptake was frequently observed. Anti-idiotypic human anti-mouse antibody responses were seen more frequently with B72.3 than with CC49 or CC83. We conclude that higher affinity, radiolabeled anti-TAG-72 MAbs can detect colorectal cancer but do not penetrate these tumors more effectively than B72.3. Improvements in tumor detection and radioimmunotherapeutic strategies will likely require the administration of smaller fragments of MAb molecules or novel delivery systems rather than the continued development of higher affinity MAbs.

In vitro and in vivo evaluation of streptavidin immunoconjugates of the second generation TAG-72 monoclonal antibody CC49.

Streptavidin was conjugated to the second-generation TAG-72 monoclonal antibody CC49 at lysine amino acids, oxidized carbohydrates or reduced disulfides on the immunoglobulin. The streptavidin immunoconjugates were radiolabelled with 111In-DTPA-biocytin and their immunological characteristics evaluated in vitro and in vivo. FPLC analysis showed a single peak (mol. wt > 350 kDa) for the lysine conjugate and sulfhydryl conjugate (mol. wt approximately 210 kDa) but multiple peaks (approximately 210 to > 350 kDa) for the carbohydrate conjugate. There were only small differences in immunoreactivity against bovine submaxillary mucin in vitro. However, in mice bearing subcutaneous LS174T tumours, the lysine conjugate exhibited significantly lower tumour uptake (< 2% i.d./g) compared to the other streptavidin-CC49 conjugates (10-40% i.d./g) or DTPA-CC49 (14-18% i.d./g). Due to the monomeric nature and smaller molecular size of the sulphhydryl conjugate, and its similar in vitro and in vivo characteristics compared with DTPA-CC49, this conjugate has been selected for future pretargeting studies with 111In and 90Y biotin.

Pretargeted tumour imaging with streptavidin immunoconjugates of monoclonal antibody CC49 and 111In-DTPA-biocytin.

Pretargeted tumour imaging was performed in nude mice bearing subcutaneous LS174T human colon cancer xenografts with streptavidin-CC49 monoclonal antibody and 111In-DTPA-biocytin. Mice were administered 250 micrograms of streptavidin-CC49, followed 6 or 9 days later by 40 ng (250 microCi) of 111In-DTPA-biocytin. Tumors were visualized at 24 h postinjection of 111In-DTPA-biocytin. Tumour uptake was 0.9-2.5% injected dose/g with tumour/nontarget ratios from 2:1 to 37:1 (except for kidney, which was 0.5-3:1). Tumour uptake in mice pretargeted with streptavidin or streptavidin-conjugated nonspecific normal mouse IgG was < 0.1% i.d./g.

Compartmental analysis of the pharmacokinetics of radioiodinated monoclonal antibody B72.3 in colon cancer patients.

Sixteen patients with colorectal cancer were administered 37-74 MBq (1 mg) of radioiodinated B72.3 monoclonal antibody. Pharmacokinetic analysis was carried out on plasma and urine samples. Elimination from the plasma was biexponential with a mean T1/2 alpha of 3.7 h and T1/2 beta of 62.4 h. The plasma clearance was fit to a two-compartmental model. This was combined with a previously reported model for radioiodine to construct a composite model. There was a good correlation (r = 0.952) between the model-predicted and observed excretion of radioiodine suggesting that the composite model is compatible with the pharmacokinetics of the radiolabelled antibody.

Rapid quality control of 99Tcm-sestamibi.

The thin layer chromatographic (TLC) method for determining the radiochemical purity of 99Tcm-sestamibi suggested by the manufacturer of the kit is slow and inconvenient. In this study a more rapid reversed phase chromatography (Sep-Pak) technique is compared with the TLC method for measurement of the radiochemical purity of 99Tcm-sestamibi. The levels of free 99Tcm-pertechnetate in 99Tcm-sestamibi were accurately determined using the Sep-Pak technique. However, due to binding of variable amounts of reduced-hydrolysed unbound 99Tcm to the chromatography cartridge, the Sep-Pak method overestimated the radiochemical purity of the radiopharmaceutical by approximately 3%. In practice, this overestimation is not important and the Sep-Pak technique can be used as a rapid method of determining radiochemical purity of 99Tcm-sestamibi.

Immunoscintigraphy of human colon cancer xenografts in nude mice using a second-generation TAG-72 monoclonal antibody labelled with 99Tcm.

Monoclonal antibody CC83 is a second-generation high-affinity antibody directed against the TAG-72 antigen in colorectal cancer. Our objectives were to evaluate the biodistribution, pharmacokinetics and imaging properties of CC83 labelled with 99Tcm via a modified Schwartz technique. The immunological integrity of 99Tcm-CC83 was evaluated by size-exclusion FPLC and by determining the immunoreactive fraction in vitro against bovine submaxillary mucin. The biodistribution of 99Tcm-CC83 up to 24 h postinjection was evaluated in nude mice bearing subcutaneous LS174T human colon cancer xenografts. Blood radioactivity data was fitted to a one-compartment pharmacokinetic model. Images of tumour-bearing mice were obtained at 17-24 h postinjection with 99Tcm-CC83. 99Tcm-CC83 was eluted as intact immunoglobulin by FPLC analysis and the mean immunoreactive fraction was 0.49 +/- 0.15. Tumour uptake at 24 h postinjection was 11.2 +/- 4.1% i.d.g-1. Radioactivity in the blood was eliminated rapidly with a half-life of 8 h and tumour:blood ratios were > 2:1 at 24 h postinjection. LS174T tumours were successfully imaged in 3/3 mice. In vitro studies showed instability of 99Tcm-CC83 when challenged with cysteine and glutathione but not metallothionein, suggesting a metabolic route for the 99Tcm antibody in vivo. We conclude that CC83 labelled directly with 99Tcm retains its immunological integrity and capability specifically to target subcutaneous LS174T human colon cancer tumours hosted in nude mice. These results further suggest that 99Tcm-CC83 may have potential for imaging colorectal cancer in humans.

Radioimmunodetection of colorectal cancer metastases with 131I-labeled monoclonal antibody B72.3: a pilot study to determine efficacy of detection and pharmacokinetics.

We performed radioimmunoscintigraphy (RIS) and/or pharmacokinetic (PCK) studies in 12 patients with primary or metastatic colorectal carcinoma, utilizing an intravenous administration of 1-4 mCi (1 mg) of 131I-B72.3 monoclonal antibody. Metastatic lesions were correctly identified in 4/8 patients by RIS. Two patients with small lesions (> 2 cm diameter) had a false-negative RIS scan. Two patients had a true-negative RIS scan. Optimal images were obtained at 1 week postinjection. PCK studies showed that the plasma clearance of 131I-B72.3 was biexponential with an alpha-phase half-life ranging from 0.5 to 7.1 hr and a beta-phase half-life ranging from 47.5 to 85.3 hr. Systemic and renal clearance data indicated that 131I-B72.3 was cleared very slowly and almost entirely by deiodination. This pilot study was conducted to gain an understanding of the pharmacokinetics of this radiolabeled antibody. On the basis of these data, we are now studying second-generation antibodies as part of our long-range objectives to incorporate them in early detection and treatment protocols.