Reinfusion of unprocessed, granulocyte colony-stimulating factor-stimulated whole blood allows dose escalation of 186Relabeled chimeric monoclonal antibody U36 radioimmunotherapy in a phase I dose escalation study.

Abstract

PURPOSE:

In an earlier Phase I radioimmunotherapy (RIT) study with rhenium-186-labeled chimeric monoclonal antibody (cMAb) U36 in patients with refractory head and neck squamous cell carcinoma, the maximum tolerated activity was established at 1.0 GBq/m2, at which bone marrow doses ranged from 0.7 to 1.1 Gy. In the present study, further dose escalation in RIT was evaluated using a facile method of reinfusion of granulocyte colony-stimulating factor (G-CSF)-stimulated unprocessed whole blood.

EXPERIMENTAL DESIGN:

Nine patients with recurrent or metastatic head and neck squamous cell carcinoma were treated at radiation dose levels of 1.0, 1.5, and 2.0 GBq/m2. Before RIT, G-CSF (10 microg/kg/day) was administered s.c. at home during 5 days. On day 6, just before administration of 186Relabeled cMAb U36, 1 liter of whole blood was harvested and kept unprocessed at 4 degrees C until reinfusion after 72 h. Blood samples were taken for analysis of pharmacokinetics and bone marrow dosimetry. Patients were evaluated for myelotoxicity and tumor response.

RESULTS:

Blood harvesting, RIT, and reinfusion of whole blood were well tolerated by all patients. G-CSF stimulation resulted in a mean of 0.41 x 10(6) CD34+ cells/kg (range, 0.15-0.83 x 10(6) CD34+cells/kg) and a mean committed colony-forming units granulocyte macrophage count of 5.62 x 10(4)/kg (range, 0.62-13.37 x 10(4)/kg). The mean biological half-life of 186Relabeled cMAb U36 in blood was 72.6 +/- 16.0 h, and bone marrow doses ranged from 2.1 to 2.8 Gy at the highest dose level. Myelotoxicity exceeding grade 3 was not observed. Stable disease was observed in five of nine patients, ranging from 3 to 5 months, and was still ongoing in one of these patients.

CONCLUSIONS:

This study indicates that a doubling of the maximum tolerated activity and bone marrow dose of 186Relabeled cMAb U36 can be achieved using reinfusion of G-CSF-stimulated unprocessed whole blood.

• Authors: David R Colnot, Gert J Ossenkoppele, Jan C Roos, Jasper J Quak, Remco de Bree, Pontus K Börjesson, Peter C Huijgens, Gordon B Snow, Guus A M S van Dongen
• Journal: Clinical cancer research : an official journal of the American Association for Cancer Research (Clin Cancer Res) Vol. 8 Issue 11 Pg. 3401-6 (Nov 2002) ISSN: 1078-0432 [Print] United States
• PMID: 12429627 (Publication Type: Clinical Trial, Clinical Trial, Phase I, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Antibodies, Monoclonal
• Antigens, CD34
• Radioisotopes
• Granulocyte Colony-Stimulating Factor
• Rhenium

Topics

• Aged
• Antibodies, Monoclonal
• Antigens, CD34 (biosynthesis)
• Bone Marrow Cells (radiation effects)
• Carcinoma, Squamous Cell (pathology, therapy)
• Dose-Response Relationship, Radiation
• Female
• Granulocyte Colony-Stimulating Factor (pharmacology)
• Head and Neck Neoplasms (pathology, therapy)
• Humans
• Male
• Middle Aged
• Radioimmunotherapy
• Radioisotopes (therapeutic use)
• Radiometry
• Recurrence
• Rhenium (therapeutic use)
• Time Factors
• Tissue Distribution