Monoclonal antibody uptake in B-cell lymphomas: experimental studies in nude mouse xenografts

Potential of optimal preloading in anti-CD20 antibody radioimmunotherapy: an investigation based on pharmacokinetic modeling

Recently, it has been suggested that the concept of preloading is limited by using a standard amount of unlabeled antibody. To identify the potential of optimal preloading, a pharmacokinetic model that describes the biodistribution of anti-CD20 antibody was developed. Simulations were conducted for different tumor burdens, spleen sizes, and tumor permeabilities. The optimal amount of unlabeled antibody was determined for each scenario. These simulations show that the currently administered standard amount is not optimal. A preload of 150 mg or lower would result in equal or higher tumor uptake in all cases. For tumors with high permeability, the uptake of labeled antibody could be increased by a factor of 8.5 using the considerably reduced optimal preload. The most sensitive parameter for the choice of the optimal amount of unlabeled antibody is the tumor uptake index. The results indicate that a personalized approach for radioimmunotherapy (RIT) with anti-CD20 antibody is required to account for the interpatient variability. The optimal amount of unlabeled antibody, which has to be determined by using a pharmacokinetic model, could substantially improve tumor uptake and thus RIT with anti-CD20 antibody.

Antibodies to CD20 and MHC class II antigen bound to B-lymphoma cells accumulate in shed cytoplasmic fragments

Antibodies (Abs) to CD20 and MHC class II antigen were found to exhibit a novel processing pathway after binding to the surface of RL B-lymphoma cells. The Abs were ‘excreted’ as a part of large cytoplasmic fragments. These fragments formed at cell–cell junctions, but gentle dispersal of the cells, to form a single-cell suspension of high viability, caused the release of most of the fragments. This process also occurred in Raji cells and in three other B-lymphoma cell lines (of seven tested). Six B-lymphoblastoid cell lines tested did not form these objects. Once they were recognised, the fragments could be identified in cell preparations by phase contrast microscopy or after staining with Wright's stain. They were induced by the binding of certain Abs, but not by most Abs bound to the cell surface. The mode of formation, detailed morphology and function of these cytoplasmic fragments remain to be determined. They are similar in many respects to the lymphoglandular bodies that have been described by pathologists for many years, which are characteristic of B-cell lymphoma, but which have not previously been described in cell lines. This type of Ab processing, if it occurs in patients, will have an impact on the therapeutic use of these Abs.

The advantage of residualizing radiolabels for targeting B-cell lymphomas with a radiolabeled anti-CD22 monoclonal antibody

CD22 antibodies (Abs) bound to B-cell lymphomas are known to be internalized and catabolized rapidly. Therefore, it would be expected that use of CD22 as a target for radioimmunotherapy should be enhanced by the use of "residualizing" radiolabels, which are trapped within the cell after catabolism of the Ab to which they had been conjugated. Our study was intended to evaluate this hypothesis using Ab LL2. In initial experiments, we found that LL2 binding was strongly temperature dependent, with approximately 15-fold greater binding at 37 degrees C than at 0 degrees C. A series of experiments suggested that this difference is due to a conformational change in the antigen at low temperature, so that the LL2 epitope is partially blocked. In vitro, residualizing labels-including 125I-dilactitol tyramine and 111In-DTPA-were retained by cells much longer than a conventional iodine label. In vivo, residualizing labels also showed a marked advantage in terms of uptake by Ramos B-cell lymphoma xenografts in nude mice. However, the absolute Ab uptake by xenografts was quite low, in comparison with results obtained with many carcinoma xenografts, which appears to be due in part to vascular properties of the B-cell lymphoma xenografts.

Radioimmunotherapy of solid tumors: a review "of mice and men"

Radioimmunotherapy in lymphoma is crossing the threshold to become a standard mode of treatment. Whereas in solid tumors in preclinical studies, radioimmunotherapy has proven to be superior to conventional chemotherapy, clinical success is still limited. The purpose of this brief review is to analyze recent developments in preclinical as well as clinical radioimmunotherapy of solid, CEA-expressing tumors. Advances in experimental radioimmunotherapy are characterized by the development of metastatic, rather than subcutaneous, tumor models in nude mice, which seem to reflect the actual clinical situation much more accurately. Furthermore, the recent development of strategies to reduce the renal accretion of antibody fragments and peptides enables the use of such smaller molecules for therapy, especially those also labeled with radiometals and other forms of intracellularly retained radionuclides. Recent developments in clinical radioimmunotherapy are characterized by a trend toward the treatment of small-volume and micrometastatic disease, as is the case, e.g., in adjuvant settings. Interestingly, despite dramatic differences in size, weight and percent-of-injected-dose-per-gram uptake values, only small differences between animal models and the actual patient situation exist with respect to activity concentrations (in microCi/gram) in the tumors and tissues. Because the activity concentration over time determines the radiation absorbed dose, and thus biological effects, we postulate that animal models should be able to predict actual clinical scenarios fairly well. These findings could be used as guidelines in the design of future preclinical, as well as clinical, trials.