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Roll, W.* ; Müther, M.* ; Böning, G.* ; Delker, A.* ; Warneke, N.* ; Gildehaus, F.J.* ; Schäfers, M.* ; Stummer, W.* ; Zeidler, R. ; Reulen, H.J.* ; Stegger, L.*

First clinical experience with fractionated intracavitary radioimmunotherapy using [177Lu]Lu-6A10-Fab fragments in patients with glioblastoma: A pilot study.

EJNMMI Res. 13:78 (2023)
Publ. Version/Full Text DOI PMC
Open Access Gold
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Background: Following resection and standard adjuvant radio- and chemotherapy, approved maintenance therapies for glioblastoma are lacking. Intracavitary radioimmunotherapy (iRIT) with 177Lu-labeled 6A10-Fab fragments targeting tumor-associated carbonic anhydrase XII and injected into the resection cavity offers a novel and promising strategy for improved tumor control. Methods: Three glioblastoma patients underwent tumor resection followed by standard radio- and chemotherapy. These patients with stable disease following completion of standard therapy underwent iRIT on compassionate grounds. After surgical implantation of a subcutaneous injection reservoir with a catheter into the resection cavity, a leakage test with [99mTc]Tc-DTPA was performed to rule out leakage into other cerebral compartments. IRIT comprised three consecutive applications over three months for each patient, with 25%, 50%, 25% of the total activity injected. A dosimetry protocol was included with blood sampling and SPECT/CT of the abdomen to calculate doses for the bone marrow and kidneys as potential organs at risk. Results: All three patients presented without relevant leakage after application of [99mTc]Tc-DTPA. Two patients underwent three full cycles of iRIT (592 MBq and 1228 MBq total activity). One patient showed histologically proven tumor progression after the second cycle (526 MBq total activity). No relevant therapy-associated toxicities or adverse events were observed. Dosimetry did not reveal absorbed doses above upper dose limits for organs at risk. Conclusions: In first individual cases, iRIT with [177Lu]Lu-6A10-Fab appears to be feasible and safe, without therapy-related side effects. A confirmatory multicenter phase-I-trial was recently opened and is currently recruiting.
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Carbonic Anhydrase Xii ; Glioblastoma ; Immunoglobulin Fab Fragments ; Lutetium-177 ; Radioimmunotherapy; Monoclonal-antibody 81c6; Newly-diagnosed Patients; Malignant Gliomas; Resection Cavity; Phase-ii; Dosimetry; Fab
ISSN (print) / ISBN 2191-219X
e-ISSN 2191-219X
Journal EJNMMI Research
Quellenangaben Volume: 13, Issue: 1, Pages: , Article Number: 78 Supplement: ,
Publisher Springer
Publishing Place One New York Plaza, Suite 4600, New York, Ny, United States
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Structural Biology (STB)
Grants Helmholtz-Gemeinschaft
Bundesministerium für Bildung und Forschung