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Society of Nuclear Medicine
June 13, 2009 - June 17, 2009

June 16-1:06 PM
No. 445
Dosimetry of phase I interstitial 131I-chTNT-1/B MAb (Cotara) for the treatment of recurrent glioma S Shen; R Lustig; K Judy; W Shapiro; K Spicer; S Patel; J Fiveash; J Lai; J Shan; 1. U Alabama , Birmingham, AL, United States; 2. U Penn, Philadelphia, PA, United States; 3. BNI St.Joseph's MedCtr, Phoenix, AR, United States; 4. Med U S Carolina, Charleston, SC, United States; 5. Peregrine Phar Inc, Tustin, CA, .


Objectives:
Dose from external beam radiotherapy or brachytherapy is limited by normal brain toxicity or target coverage. Radiolabeled target molecules can deliver localized radiation to the tumor cells. This study is to characterize the biodistribution and radiation dosimetry of 131I-chTNT-1/B MAb (Cotara), a radioiodinated chimeric monoclonal antibody that targets tumor necrosis.

Methods:
Patients with recurrent glioblastoma multiforme (GBM) receive 3 mCi of Cotara for imaging and dosimetry followed 2-4 weeks later by a therapy dose. Using convection enhanced delivery, Cotara is administered interstially via two catheters into the tumor over 25 hours. A quantitative data acquisition protocol is followed based on MIRD guidelines. Data includes blood samples, sequential whole body images with scatter correction, and pinhole image for thyroid.

Results:
In this ongoing trial, dosimetry data has been collected from 6 patients. The thyroid, of particular interest in this study, showed only minimal uptake of Cotara at 0.7-4.8 cGy/mCi. The results obtained from pinhole image agreed with that from whole body images. Similarly, uptake of Cotara could be only faintly visualized in stomach (1.6-3.0 cGy/mCi) and heart (0.7-1.7 cGy/mCi). Marrow from radioactivity in blood was 0.62-1.1 cGy/mCi. Cotara was concentrated in the brain tumor (246-671 cGy/mCi), with minimal exposure to the contralateral healthy brain (0.7-1.6 cGy/mCi). Mean tumor-to-body dose ratio was 605 and ranged 319-797.

Conclusions:
CED administered Cotara specifically localized only in tumor with minimal systemic radiation exposure, demonstrating its great potential for treatment of glioma.

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