Comparative Efficacy of <superscript>177</superscript>Lu and <superscript>90</superscript>Y for Anti-CD20 Pretargeted Radioimmunotherapy in Murine Lymphoma Xenograft Models.

Purpose: Pretargeted radioimmunotherapy (PRIT) is a multi-step method of selectively delivering high doses of radiotherapy to tumor cells while minimizing exposure to surrounding tissues. Yttrium-90 ( 90 Y) and lutetium-177 ( 177 Lu) are two of the most promising beta-particle emitting radionuclides used for radioimmunotherapy, which despite having similar chemistries differ distinctly in terms of radiophysical features. These differences may have important consequences for the absorbed dose to tumors and normal organs. Whereas 90 Y has been successfully applied in a number of preclinical and clinical radioimmunotherapy settings, there have been few published pretargeting studies with 177 Lu. We therefore compared the therapeutic potential of targeting either 90 Y or 177 Lu to human B-cell lymphoma xenografts in mice. Methods: Parallel experiments evaluating the biodistribution, imaging, dosimetry, therapeutic efficacy, and toxicity were performed in female athymic nude mice bearing either Ramos (Burkitt lymphoma) or Granta (mantle cell lymphoma) xenografts, utilizing an anti-CD20 antibody-streptavidin conjugate (1F5-SA) and an 90 Y- or 177 Lu-labeled 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-biotin second step reagent. Results: The two radionuclides displayed comparable biodistributions in tumors and normal organs; however, the absorbed radiation dose delivered to tumor was more than twice as high for 90 Y (1.3 Gy/MBq) as for 177 Lu (0.6 Gy/MBq). More importantly, therapy with 90 Y-DOTA-biotin was dramatically more effective than with 177 Lu-DOTA-biotin, with 100% of Ramos xenograft-bearing mice cured with 37 MBq 90 Y, whereas 0% were cured using identical amounts of 177 Lu-DOTA-biotin. Similar results were observed in mice bearing Granta xenografts, with 80% of the mice cured with 90 Y-PRIT and 0% cured with 177 Lu-PRIT. Toxicities were comparable with both isotopes. Conclusion: 90 Y was therapeutically superior to 177 Lu for streptavidin-biotin PRIT approaches in these human lymphoma xenograft models. [ABSTRACT FROM AUTHOR]

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