Immunoscintigraphy of Adenocarcinomas by Means of Radiolabeled F(ab′)2 Fragments of an Anti-Carcinoembryonic Antigen Monoclonal Antibody: A Multicenter Study

A. G. Siccardi, G. Viale, G. L. Buraggi, M. Gasparini, E. Salvischiani, L. Callegaro, G. A. Scassellati, G. Deleide, A. Centi Colella, P. G. De Filippi, G. Galli, G. Mariani, R. Masi, E. Seregni, R. Palumbo, P. Riva, S. Benini, G. Paganelli, M. Salvatore, S. LastoriaL. Mansi, K. Scheidhauer, G. L. Turco, P. Zaniol, P. G. Natali

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Abstract

F(ab′)2 fragments of anti-carcinoembryonic antigen (CEA) monoclonal antibody P023C5, determined to be more suitable than intact IgG and Fab fragments for immunoscintigraphy, were labeled with 131I or conjugated to DTPA for instant “In-labeling, and administered i.v. (2-3 mCi/ 0.5 mg) to 509 patients in 11 nuclear medicine departments: 284 patients had gastrointestinal adenocarcinomas, 204 had nongastrointestinal adenocarcinomas and 21 were controls; serum CEA was elevated in 169 patients, normal in 115, and not determined in 225. The following results were obtained: (a) no adverse reactions; (b) tumor imaging in 324 patients (in particular, in 81.5% CEA-seropositive and in 69.0% CEA-seronega-tive patients); (c) no significant difference in sensitivity among the results of the 11 departments; (d) no significant difference in overall sensitivity between 131I- and “In-labeled immunoradiopharmaceuticals; (e) the fraction of documented lesions imaged was 733% in CEA-seropositive and 53.7% in CEA-seronegative patients; (/) the detection of liver metastases was hampered, particularly when using the ! “In-labeled reagent, by nonspecific radioactivity uptake; (g) the major cause of negative immunoscintigraphy results was a lack of CEA in tumor lesions, as documented by immunohistochemistry; (h) lesion size is also important since the sensitivity was 64% for lesions up to 2 cm in diameter and 84% for larger lesions; (i) many “unexpected” radiolocalizations were recorded. Most were identified as occult tumor lesions. In 35 patients, this finding contributed to the early detection of tumor recurrences.

Original languageEnglish
Pages (from-to)3095-3103
Number of pages9
JournalCancer Research
Volume49
Issue number11
StatePublished - 1 Jun 1989
Externally publishedYes

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