Medu-04. a Phase Ii Study of Radioimmunotherapy With Intraventricular 131i-3f8 for Medulloblastoma
Year: 2017
Type: conference-abstract
Abstract: BACKGROUND: High-risk and recurrent medulloblastoma is associated with significant mortality. The murine monoclonal antibody 3F8 targets the cell-surface disialoganglioside GD2 on medulloblastoma. We tested the efficacy, toxicity, and dosimetry of compartmental radioimmunotherapy (cRIT) with intraventricular 131Ilabeled 3F8 in patients with medulloblastoma on a phase II clinical trial. METHODS: Patients with histopathologically confirmed high-risk or recurrent medulloblastoma were eligible for cRIT. After determining adequate cerebral spinal fluid (CSF) flow, patients received 2 mCi 124I-3F8 or 131I-3F8 with nuclear imaging for dosimetry, followed by a maximum of 4 therapeutic (10 mCi /dose)131I-3F8 injections. Dosimetry estimates were based on serial CSF and blood samplings over 48 hours plus region-of-interest analyses on serial imaging scans. Disease evaluation included pre- and post-therapy brain/spine MRI approximately every 3 months for the first year after treatment, and every 6–12 months thereafter. RESULTS: Forty-three patients received a total of 167 injections; 42 patients were evaluable for outcome. No treatment-related deaths occurred. Toxicities included acute bradycardia with somnolence, headache, fatigue and CSF pleocytosis consistent with chemical meningitis, and dystonic reaction. Total CSF absorbed dose was 1453 (350.0–2784) cGy. Median OS from first dose of cRIT was 24.9 months (95% CI: 16.3–55.8). Patients treated in radiographic and cytologic remission were at a lower risk of death compared to patients with radiographically measurable disease (HR: 0.40, 95%CI: 0.18–0.88, p=0.024). CONCLUSIONS: cRIT with 131I-3F8 is safe, has favorable dosimetry to CSF and when added to salvage therapy using conventional modalities, may have clinical utility in maintaining remission in high-risk or recurrent medulloblastoma.
Source: Neuro-Oncology
Authors: Kim Kramer, Neeta Pandit-Taskar, John Humm, Pat Zanzonico, Sofia Haque, Ira Dunkel, Suzanne Wolden, Maria Donzelli, Debra Goldman, Jason Lewis, Serge Lyashchenko, Yasmin Khakoo, Jorge Carrasquillo, Mark Souweidane, Jeffrey Greenfield, David Lyden, Kevin De Braganca, Stephen Gilheeney, Steven Larson, Nai-Kong Cheung
Institution: Memorial Sloan Kettering Cancer Center
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2617331997