Intraperitoneal yttrium-90-labeled monoclonal antibody in ovarian cancer

J Clin Oncol. 1990 Dec;8(12):1941-50. doi: 10.1200/JCO.1990.8.12.1941.

Abstract

From March 1987 to March 1988, a phase I to II study was carried out in 25 patients with ovarian cancer. They received escalating doses of intraperitoneally (IP) administered yttrium-90 (Y-90)-labeled monoclonal antibody, HMFG1, against a tumor cell-surface antigen. Myelosuppression prevented an escalation of the administered Y-90 activity above 25 mCi. Y-90-labeled antibody was absorbed from the peritoneal cavity into the circulation. Maximum blood Y-90 activity was observed 40 hours after the IP injection with a mean of 21% of the injected activity (range, 14.2% to 26.4%) in the circulation. The radiation dose the bone marrow received from circulating Y-90-labeled antibody (the blood radiation dose) was calculated by applying the Medical Internal Radiation Dose (MIRD) formulation to the measured Y-90 activity in patients blood. Myelosuppression occurred following calculated blood radiation doses to bone marrow of only 10 to 30 cGy. The excessive myelosuppression following such modest radiation doses from circulating Y-90-labeled antibody could be explained by the uptake of Y-90 by bone. In an attempt to reduce bone absorption of Y-90, seven patients received an intravenous (IV) infusion of EDTA (Sinclair Pharmaceuticals Ltd, Godalming, United Kingdom). This increased the urinary excretion of Y-90 from a mean of 11.1% to 32.3% of the injected activity (P = .0001). Fourteen patients had assessable tumor at laparoscopy. Tumor regression was observed in one patient, and palliation of ascites in a further patient.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal / pharmacokinetics
  • Antibodies, Monoclonal / therapeutic use
  • Bone Marrow / radiation effects
  • Female
  • Humans
  • Immunotoxins / administration & dosage
  • Immunotoxins / pharmacokinetics*
  • Immunotoxins / therapeutic use
  • Injections, Intraperitoneal
  • Middle Aged
  • Ovarian Neoplasms / drug therapy
  • Ovarian Neoplasms / metabolism*
  • Radiotherapy Dosage
  • Remission Induction
  • Yttrium Radioisotopes / administration & dosage
  • Yttrium Radioisotopes / pharmacokinetics*
  • Yttrium Radioisotopes / therapeutic use

Substances

  • Antibodies, Monoclonal
  • Immunotoxins
  • Yttrium Radioisotopes