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Title: Astatine-211 conjugated to an anti-CD20 monoclonal antibody eradicates disseminated B-cell lymphoma in a mouse model

Abstract

Alpha emitting radionuclides release a large amount of energy within a few cell diameters and may be particularly effective for radioimmunotherapy targeting minimal residual disease (MRD) conditions in which micrometastatic disease satellites are broadly distributed. To evaluate this hypothesis, 211At conjugated 1F5 mAb (anti-CD20) was studied in both bulky lymphoma tumor xenograft and MRD animal models. Superior treatment responses to 211At conjugated 1F5 mAb were evident in the MRD setting. Lymphoma xenograft tumor bearing animals treated with doses of up to 48µCi of anti-CD20 211At-decaborate [211At-B10-1F5] experienced modest responses (0% cures but 2-3-fold prolongation of survival compared to negative controls). In contrast, 70% of animals in the MRD lymphoma model demonstrated complete eradication of disease when treated with 211At-B10-1F5 at a radiation dose that was less than one-third (15 µCi) of the highest dose given to xenograft animals. Tumor progression among untreated control animals in both models was uniformly lethal. After 130 days, no significant renal or hepatic toxicity is observed in the cured animals receiving 15 µCi of 211At-B10-1F5. These findings suggest that in a MRD lymphoma model, where isolated cells and tumor microclusters prevail, α-emitters may be uniquely efficacious.

Authors:
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Publication Date:
Research Org.:
Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
Sponsoring Org.:
USDOE
OSTI Identifier:
1221465
Report Number(s):
PNNL-SA-107680
DOE Contract Number:
AC05-76RL01830
Resource Type:
Journal Article
Resource Relation:
Journal Name: Blood, 125(13):2111-2119
Country of Publication:
United States
Language:
English
Subject:
1Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA

Citation Formats

Green, Damian J., Shadman, Mazyar, Jones, Jon C., Frayo, Shani, Kenoyer, Aimee L., Hylarides, Mark, Hamlin, Donald K., Wilbur, D. Scott, Balkan, Ethan R., Lin, Yukang, Miller, Brian W., Frost, Sophia, Gopal, Ajay K., Orozco, Johnnie J., Gooley, Ted, Laird, Kelley L., Till, B. G., Back, Tom, Sandmaier, B. M., Pagel, John M., and Press, Oliver W. Astatine-211 conjugated to an anti-CD20 monoclonal antibody eradicates disseminated B-cell lymphoma in a mouse model. United States: N. p., 2015. Web. doi:10.1182/blood-2014-11-612770.
Green, Damian J., Shadman, Mazyar, Jones, Jon C., Frayo, Shani, Kenoyer, Aimee L., Hylarides, Mark, Hamlin, Donald K., Wilbur, D. Scott, Balkan, Ethan R., Lin, Yukang, Miller, Brian W., Frost, Sophia, Gopal, Ajay K., Orozco, Johnnie J., Gooley, Ted, Laird, Kelley L., Till, B. G., Back, Tom, Sandmaier, B. M., Pagel, John M., & Press, Oliver W. Astatine-211 conjugated to an anti-CD20 monoclonal antibody eradicates disseminated B-cell lymphoma in a mouse model. United States. doi:10.1182/blood-2014-11-612770.
Green, Damian J., Shadman, Mazyar, Jones, Jon C., Frayo, Shani, Kenoyer, Aimee L., Hylarides, Mark, Hamlin, Donald K., Wilbur, D. Scott, Balkan, Ethan R., Lin, Yukang, Miller, Brian W., Frost, Sophia, Gopal, Ajay K., Orozco, Johnnie J., Gooley, Ted, Laird, Kelley L., Till, B. G., Back, Tom, Sandmaier, B. M., Pagel, John M., and Press, Oliver W. Thu . "Astatine-211 conjugated to an anti-CD20 monoclonal antibody eradicates disseminated B-cell lymphoma in a mouse model". United States. doi:10.1182/blood-2014-11-612770.
@article{osti_1221465,
title = {Astatine-211 conjugated to an anti-CD20 monoclonal antibody eradicates disseminated B-cell lymphoma in a mouse model},
author = {Green, Damian J. and Shadman, Mazyar and Jones, Jon C. and Frayo, Shani and Kenoyer, Aimee L. and Hylarides, Mark and Hamlin, Donald K. and Wilbur, D. Scott and Balkan, Ethan R. and Lin, Yukang and Miller, Brian W. and Frost, Sophia and Gopal, Ajay K. and Orozco, Johnnie J. and Gooley, Ted and Laird, Kelley L. and Till, B. G. and Back, Tom and Sandmaier, B. M. and Pagel, John M. and Press, Oliver W.},
abstractNote = {Alpha emitting radionuclides release a large amount of energy within a few cell diameters and may be particularly effective for radioimmunotherapy targeting minimal residual disease (MRD) conditions in which micrometastatic disease satellites are broadly distributed. To evaluate this hypothesis, 211At conjugated 1F5 mAb (anti-CD20) was studied in both bulky lymphoma tumor xenograft and MRD animal models. Superior treatment responses to 211At conjugated 1F5 mAb were evident in the MRD setting. Lymphoma xenograft tumor bearing animals treated with doses of up to 48µCi of anti-CD20 211At-decaborate [211At-B10-1F5] experienced modest responses (0% cures but 2-3-fold prolongation of survival compared to negative controls). In contrast, 70% of animals in the MRD lymphoma model demonstrated complete eradication of disease when treated with 211At-B10-1F5 at a radiation dose that was less than one-third (15 µCi) of the highest dose given to xenograft animals. Tumor progression among untreated control animals in both models was uniformly lethal. After 130 days, no significant renal or hepatic toxicity is observed in the cured animals receiving 15 µCi of 211At-B10-1F5. These findings suggest that in a MRD lymphoma model, where isolated cells and tumor microclusters prevail, α-emitters may be uniquely efficacious.},
doi = {10.1182/blood-2014-11-612770},
journal = {Blood, 125(13):2111-2119},
number = ,
volume = ,
place = {United States},
year = {Thu Mar 26 00:00:00 EDT 2015},
month = {Thu Mar 26 00:00:00 EDT 2015}
}
  • The short-lived isotope /sup 211/At (half-life, 7.2 hr), an alpha particle-emitting halogen, has been attached to a monoclonal antibody (anti-thy 1.1, IgG1, OX7) and used in mice in the treatment of a thy 1.1 T-cell lymphoma (A120). Forty-eight hours after receiving an iv injection of 10(3) or 10(5) A120 cells, mice were treated with phosphate-buffered saline, /sup 211/At-, antibody alone, or /sup 211/At conjugated to OX7. Treatment with the /sup 211/At-labeled OX7 conjugate increased the median survival time of mice and probably cured (survival at 200 days) 6 of the 15 mice given 10(5) cells and 21 of the 27more » mice given 10(3) cells.« less
  • Radioimmunotherapy (RIT) is a promising treatment approach for B-cell lymphomas. This is our first opportunity to report long-term follow-up data and late toxicities in 29 patients treated with myeloablative doses of iodine-131-anti-CD20 antibody (anti-B1) and autologous stem-cell rescue. PATIENTS AND METHODS: Trace-labeled biodistribution studies first determined the ability to deliver higher absorbed radiation doses to tumor sites than to lung, liver, or kidney at varying amounts of anti-B1 protein (0.35, 1.7, or 7 mg/kg). Twenty- nine patients received therapeutic infusions of single-agent (131)I- anti-B1, given at the protein dose found optimal in the biodistribution study, labeled with amounts of (131)Imore » (280 to 785 mCi[10.4 to 29.0 GBq]) calculated to deliver specific absorbed radiation doses to the normal organs, followed by autologous stem-cell support. RESULTS: Major responses occurred in 25 patients (86%), with 23 complete responses (CRs; 79%). The nonhematopoietic do se-limiting toxicity was reversible cardiopulmonary insufficiency, which occurred in two patients at RIT doses that delivered > or = 27 Gy to the lungs. With a median follow-up time of 42 months, the estimated overall and progression-free survival rates are 68% and 42%, respectively. Currently, 14 of 29 patients remain in unmaintained remissions that range from 27+ to 87+ months after RIT. Late toxicities have been uncommon except for elevated thyroid-stimulating hormone (TSH) levels found in approximately 60% of the subjects. Two patients developed second malignancies, but none have developed myelodysplasia (MDS). CONCLUSION: Myeloablative (131)I-anti- B1 RIT is relatively well tolerated when given with autologous stem- cell support and often results in prolonged remission durations with few late toxicities.« less
  • Bispecific antibodies (bsAbs) are second generation antibodies for therapeutic application in immunotherapy. One of the major strategies of the bsAb platform is the recruitment of immune effector T cells by incorporating an anti-CD3 domain. A bispecific T-cell engager (BiTE), with one end having an affinity for CD3 and the other end with affinity for CD19, has been approved in the US and Europe for the treatment of acute lymphoblastic leukemia. However, due to their small size and lack of Fc region, these single-chain variable fragment (scFv) bsAbs have short half-lives in vivo. Additionally, poor solubility, structural instability, and low production yieldsmore » have also become major challenges in the bulk production process. To overcome these challenges, we have engineered a tetravalent bsAb with bivalent binding specificity for the CD20 and CD3 antigen in an immunoglobulin G (IgG) format. The fusion of the anti-CD3 scFvs to the CD20 antibody via a linker-hinge domain (LHD) results in improved antibody stabilization and properties. Here we demonstrate this antibody's highly efficient cancer cell elimination in a dose-dependent manner in a CD20-expressing B lymphoblastoid cell line in vitro. Our data suggest the potential clinical application of this bsAb for the treatment of CD20-expressing B cell malignancies. - Highlights: • A bispecific antibody (bsAb) can increase immunotherapeutic efficacy. • A tetravalent bsAb with binding specificity for the CD20 and CD3 antigens is proposed. • A linker-hinge domain (LHD) within the bsAb results in improved antibody properties.« less
  • Purpose: The majority of patients with relapsed or refractory B-cell, non-Hodgkin’s lymphoma (NHL) are over 60 years of age, yet they are often denied potentially curative high-dose therapy and autologous stem cell transplants (ASCT) due to the risk of excessive treatment-related morbidity and mortality. Myeloablative anti-CD20 radioimmunotherapy (RIT) can deliver curative radiation doses to tumor sites while limiting exposure to normal organs and may be particularly suited for older adults requiring high-dose therapy. Methods: Patients over age 60 with relapsed B-NHL received infusions of tositumomab anti-CD20 antibody labeled with 5-10mCi I-131 tracer for dosimetry purposes followed 10 days later bymore » individualized therapeutic infusions of I-131-tositumomab (median 525 mCi, range 328-1154 mCi) to deliver 25-27Gy to the critical normal organ receiving the highest radiation dose. ASCT was performed approximately 2 weeks after therapy. Results: Twenty-four patients with a median age of 64 (range 60-76) who had received a median of four prior regimens (range 2-14) were treated. Thirteen (54%) had chemotherapy-resistant disease. The estimated 3-year overall and progression-free survivals were 59% and 51%, respectively with a median follow-up of 2.9 years (range 1-6 years). All patients experienced expected myeloablation with engraftment of platelets (≥20K/µL) and neutrophils (≥500/µL) occurring a median of 9 and 15 days, respectively following ASCT. There were no treatment-related deaths, and only two patients experienced grade 4 non-hematologic toxicity. Conclusions: Myeloablative RIT and ASCT is a safe and effective therapeutic option for older adults with relapsed B-NHL.« less
  • The potential usefulness of {alpha}-particle radioimmunotherapy in the treatment of osteosarcoma was studied in vitro by using the monoclonal antibody TP-3 and cells of three human osteosarcoma cell lines (OHS, SAOS and KPDX) differing in antigen expression. Cell survival curves were established after treatment with (a) {sup 211}At-TP-3 of different specific activities, (b) {sup 211}At-labeled bovine serum albumin (BSA), (c) free {sup 211}At and (d) external-beam X rays. The three osteosarcoma cell lines showed similar survival curves, whether treated with external-beam X rays, {sup 211}At-BSA or free {sup 211}At. The D{sub o}`s were lower for free {sup 211}At than formore » {sup 211}At-BSA. The survival curves for {sup 211}At-TP-3 treatment, on the other hand, differed significantly among the cell lines, suggesting that sensitivity to {sup 211}At-TP-3 treatment was governed by cellular properties other than sensitivity to external-beam X rays. The cellular property most important for sensitivity to {sup 211}At-TP-3 treatment was the antigen expression. Cell inactivation after {sup 211}At-TP-3 treatment increased substantially with increasing specific activity of the {sup 211}At-TP-3. At high specific activities, the cytotoxic effect of {sup 211}At-TP-3 was significantly higher than that of {sup 211}At-BSA. In conclusion, {sup 211}At-TP-3 has the potential to give clinically favorable therapeutic ratios in the treatment of osteosarcoma. 39 refs., 5 figs., 2 tabs.« less