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S M Larson

Publications and source records attributed to S M Larson.

At least 181 records · Page 10Linked to original sources
PubMed1990

Clinical radioimmunodetection, 1978-1988: overview and suggestions for standardization of clinical trials.

In the last decade of radioimmunodetection studies the radiolabeled antibody preparations used have gradually changed from polyclonal antibodies labeled predominantly with 131I to monoclonal antibodies labeled with diverse radionuclides including 131I, 111In, 123I, and 99mTc. Over this period progressive improvement in tumor imaging has been observed when one compares the best examples of early studies, performed with 131I labeled heterosera, to the best of modern images, obtained with 123I, 99mTc, or 111In labeled monoclonal antibodies. Important findings in 61 clinical studies reviewed include the reports from several centers which demonstrate occult disease in patients with carcinoma of colon, melanoma, and lymphoma, and the improved sensitivity and specificity of radioimmunodetection in comparison to transmission computerized tomography in the lymph nodes and abdomen, in lymphoma and colon cancer, and ovarian cancer. Evaluation of the liver remains a difficult problem with this technique and standard approaches are superior in most reports. The general principle of targeting radioactivity to tumor with radiolabeled antitumor antibody and the feasibility of developing practical clinical methodology which will add new diagnostic information have clearly been established. Toxicity, particularly for index studies, is reassuringly limited. In all the studies with surgical confirmation after i.v. injection, uptake in tumor is in the range of 0.005% injected dose/g tumor, and this low tumor uptake remains the single greatest limitation of the method. A second important problem is the prompt development of human anti-mouse antibody, which reduces the usefulness of follow-up studies. A serious criticism of the information currently available on radioimmunodetection is that the clinical studies reported to date vary greatly in approach and results. The vast majority of studies are early Phase I clinical trials, from which toxicity information and biodistribution data can be derived but which give limited information about impact on clinical management. Standardization in the study design is needed in order to establish the efficacy of radioimmunodetection in adequate and well controlled clinical trials.

Antibodies, Monoclonal↗
PubMed1990

Synthesis of a fluorinated fatty acid, dl-erythro-9,10-[18F]difluoropalmitic acid, and biodistribution studies in rats.

9,10-Difluoropalmitic acid (DFPA) labeled with the cyclotron produced, positron emitting radionuclide 18F has been synthesized as a potential analogue of 9,10-[3H]palmitic acid, a fatty acid which has been used to study lipid metabolism in rat brain and pituitary. [18F]DFPA was prepared by the direct and stereoselective addition of [18F]F2 to the double bond of cis-9,10-palmitoleic acid. The fluorination was carried out in FCCl3 at -70 degrees C using a low concentration of F2 (0.5%) in neon. [18F]DFPA has been obtained in radiochemical yields of 12-16% from end-of-bombardment (EOB) in approx. 2.5 h. Chemical and radiochemical purity exceeded 95%, and specific activities calculated to EOB ranged from 500 to 1000 mCi/mmol. [18F]DFPA crosses the blood-brain barrier and is incorporated into rat brain at about twice the level of that of 9,10-[3H]palmitic acid. The synthesis of [18F]DFPA permits us to study the biological disposition and metabolism of a vicinal-difluoro fatty acid.

Animals↗
PubMed1990

Differential cellular catabolism of 111In, 90Y and 125I radiolabeled T101 anti-CD5 monoclonal antibody.

We evaluated the differences in catabolism of 125I, 111In and 90Y-T101 monoclonal antibody (anti-CD5) by peripheral blood mononuclear cells (PBMNC), HUT 102, CCRF-CEM and MOLT-4 cells. All cells showed higher retention of 111In than of 125I. PBMNC showed similar retention of 90Y and 111In. The release of 125I was reduced by using metabolic inhibitors, F(ab')2 of T101, pure lymphocytes or incubating at 4 degrees C. Our findings suggest differences in the intracellular catabolism of the radionuclides.

Animals↗
PubMed1990

Toxicity, immunogenicity, and tumor radioimmunodetecting ability of two human monoclonal antibodies in patients with metastatic colorectal carcinoma.

Two human immunoglobulin M (IgM) monoclonal antibodies (MoAbs), 16.88 and 28A32, which react with cytoplasmic (28A32 and 16.88) or cell surface (28A32) determinants on human colon carcinoma cells, were administered intravenously to 26 patients with metastatic colorectal carcinoma to determine if they could localize to sites of metastatic disease, if they had any antitumor or toxic effects, and to determine whether they would elicit an antihuman MoAb response. Serial scans showed tumor uptake of radioisotope in 12 of 16 patients receiving 131I-labeled 28A32 and in nine of 12 patients receiving 131I-labeled 16.88. No antitumor effects were seen with either antibody. No antibody-related toxic effects were observed following administration of 16.88, but two patients developed localized urticarial reactions following injection with antibody 28A32. No patient developed an antibody response to 16.88. Anti-28A32 reactivity was found in five of 12 (42%) normal sera and in seven of 23 (30%) patients before receiving any antibody. Following administration of 28A32, a low titer (1:10 dilution) of anti-28A32 developed in four patients with no preexisting antibody, a decrease in the preexisting titer was seen in three other patients, the titer remained constant in one patient, and no anti-28A32 was ever detected in six patients. In most cases, anti-28A32 activity was lost at dilutions greater than 1:10 and did not appear to affect antibody half-life in the serum or whole body retention of the antibody. We conclude that these human IgM MoAbs are capable of localizing at sites of disease in vivo, are nontoxic, and are poorly immunogenic in humans. Further studies to determine the specificity of targeting and to improve the delivery of antibody to sites of tumor are indicated.

Antibodies, Monoclonal↗
PubMed1990

Brain glucose metabolism in noninsulin-dependent diabetes mellitus: a study in Pima Indians using positron emission tomography during hyperinsulinemia with euglycemic glucose clamp.

To determine whether insulin or noninsulin-dependent diabetes mellitus affects brain glucose metabolism, brain glucose utilization was studied in the basal state and during hyperinsulinemic euglycemic glucose clamps in nondiabetic and diabetic Pima Indians by positron emission tomography with 2-[18F]fluoro-2-deoxy-D-glucose (18FDG). Glucose utilization in 75 brain areas was determined by analysis of single scans and by least squares estimation of the rate parameters for the FDG model; these data were compared to results in normal caucasian volunteers. No effect of ethnicity or diabetic status on brain glucose utilization was observed. During the hyperinsulinemic clamps (mean insulin, 11,708 +/- 3,026 pmol/L), clearance of 18FDG from blood was accelerated, and accumulation of brain radioactivity was reduced. However, glucose utilization by the brain was identical to results during sham glucose clamps (mean insulin, 204 +/- 56 pmol/L) performed in the same patients. During the studies with hyperinsulinemia, k4 (representing loss of tissue radioactivity) was increased in most brain areas (mean increase, 0.0031 +/- 0.0018 min-1; P less than 0.02). The possible mechanisms for this effect are multiple, and the physiological significance, if any, is unknown. Further studies of the effects of insulin on brain glucose metabolism are needed.

Adult↗
PubMed1990

Binding of radiolabeled MAb B72.3 administered intravenously and intraperitoneally in colorectal cancer patients. An overview.

Monoclonal antibody (MAb) B72.3 coupled to 131I is currently being used in clinical trials for the diagnostic imaging of gastrointestinal, ovarian, and breast carcinomas. The MAb has also been used extensively in immunohistochemical studies and in the development of radioimmunoassays to define antigen levels in tissues and sera of cancer patients. When administered intravenously, the radionuclide-conjugated MAb has localized tumor in over 70 percent of patients. When intraperitoneal administration was studied, the MAb-radionuclide conjugate successfully imaged peritoneal lesions; moreover, in 3 of 10 patients, B72.3 detected lesions not found by conventional methods. Concomitant administration of 131I labeled B72.3 intraperitoneally and 125I labeled B72.3 intravenously showed that the intraperitoneal route localized peritoneal implants at least two times better than the intravenously administered MAb. Conversely, hematogenously borne or non-implant lesions were better localized with intravenously administered B72.3.

Antibodies, Monoclonal↗
PubMed1990

Immunoreactivity affects the biodistribution and tumor targeting of radiolabeled anti-P97 Fab fragment.

Hydroxylapatite high performance liquid chromatography was used to prepare two fractions from 125I- Fab 96.5. One fraction (peak 1) had relatively low immunoreactivity (25-38%) and the second fraction (peak 2) had high immunoreactivity (70-81%). Scatchard analysis showed similar affinity constants for the two preparations (2.9 x 10(9) M-1 for peak 1; 3.4 x 10(9) M-1 for peak 2). In biodistribution and imaging studies in athymic mice with human melanoma (FEMX-II) xenografts the high immunoreactivity preparation rapidly cleared from the blood and nontumor organs while retention of radioactivity in the tumor was prolonged. The low immunoreactivity preparation, had slower blood and nontumor organ clearance but faster tumor clearance than the high immunoreactivity fraction. Thus, in these studies highly immunoreactive antibody gave higher tumor to nontumor ratios and enhanced the target to nontarget image contrast.

Animals↗
PubMed1990

In vivo fate of monoclonal antibody B72.3 in patients with colorectal cancer.

Radiolabeled B72.3 (anti-TAG-72) has been shown to selectively localize metastatic lesions in 70%-80% of the cases. Serum samples from 27 colorectal carcinoma patients who received iodine-131-(131I) B72.3 by i.v. administration were analyzed. Circulating immunoreactive antibody followed a biphasic clearance pattern. High-performance liquid chromatography (HPLC) and SDS-polyacrylamide gel electrophoresis demonstrated that 131I-B72.3 retained its integrity in the patients' sera. HPLC analysis also demonstrated the presence of immune complexes in the sera of 12 patients; this correlated with elevated levels of circulating TAG-72. Several different HAMA response patterns were detected in the 25 patients' sera that were analyzed; some patients developed HAMA as early as 5-7 days post-MAb injection. Higher doses of administered MAb B72.3 correlated with the development of HAMA (p = 0.007). The presence of elevated levels of TAG-72 in the patients' pre-inoculum serum was shown to correlate with the detection of lesions by gamma scanning. Serum TAG-72 may serve as a criteria for patient selection for immunodiagnostic or immunotherapeutic procedures using MAb B72.3.

Adenocarcinoma↗
PubMed1989

Local distribution and concentration of intravenously injected 131I-9.2.27 monoclonal antibody in human malignant melanoma.

Regional measurements of 131I-9.2.27 distribution in human melanoma tumors were obtained using quantitative autoradiography. Tumors were removed from patients 72-96 h after they had received an i.v. injection of 9.15 mCi (100 mg) of 131I-9.2.27. The autoradiographic images showed that the radioactivity reaching the tumor was heterogeneously distributed. Areas of relative high and low uptake were selected in each tumor. Regions of high activity contained from 51 to 1371 nCi/g, while areas with low uptake had radioactivity ranging from 12 to 487 nCi/g. The reliability of the autoradiographic measurements was demonstrated by the strong positive correlation with direct tissue sample counting (r = 0.994 P less than 0.001). Since comparative immunocytochemistry showed a homogeneous and diffuse staining of target antigen on viable tumor cells, variability of monoclonal antibody uptake within individual tumors was not primarily due to heterogeneity of antigen expression in these cases. However, antigen levels accounted for some of the variation from tumor to tumor. When immunoperoxidase staining was repeated on adjacent sections without the addition of 9.2.27, it confirmed the nonuniform distribution of monoclonal antibody found at autoradiography. Thus, quantitative autoradiography gives information about the distribution and the local concentration of radioactive antibody in tumors allowing calculation of the radiation dose delivered to small regions within tumors.

Adult↗
PubMed1989

Anti-murine antibody response to mouse monoclonal antibodies: clinical findings and implications.

Many patients given murine monoclonal antibody become immune to these proteins. Important factors in the development of immunity are (1) the patient's ability to become immune and (2) whether whole immunoglobulin or Fab fragment was used. Circulating anti-murine antibodies increase the murine antibody plasma clearance and the liver or spleen uptake while reducing tumor targeting. Clearance rates and radioassay measured levels of anti-murine antibodies are related to serum murine/anti-murine antibody complexes. Unlabeled murine antibody displaces radiolabeled antibody from these complexes.

Animals↗
PubMed1989

Comparison of bone marrow dosimetry and toxic effect of high dose 131I-labeled monoclonal antibodies administered to man.

131I-labeled monoclonal antibodies were used in therapeutic trials in two potentially useful clinical situations: disseminated melanoma (intravenously administered Fab fragments; 21 patients) and disseminated peritoneal adenocarcinomatosis (intraperitoneal injection of IgG; 5 patients). Acute toxicity observed is consistent with mild bone marrow suppression of acute radiation syndrome and the observed toxicity is dose related in a manner that conforms to the expected human response to total body irradiation. For single doses of both i.p. administered and intravenously administered 131I-labeled anti-tumor antibodies, 100 rad to red marrow, calculated by the absorbed dose fraction method (MIRD), appeared to be a threshold below which significant acute toxicity was unlikely.

Adenocarcinoma↗
PubMed1989

In vivo diagnosis and therapy of human tumors with monoclonal antibodies: selection of antibodies and preliminary clinical studies in small cell carcinoma of the lung.

Initial monoclonal antibody therapy trials include an attempt to control malignant proliferation of small cell lung cancer by blocking the autocrine stimulation of gastrin releasing peptide. A critical issue is the adequacy of antibody penetration into the tumor bed to effect immunologic blockade of the mitogenic peptide. The use of an indium-111 antibody chelate which is coadministered with the first therapeutic antibody administration facilitates analysis of the pharmacokinetic dynamics for this trial. If this approach is successful with gastrin releasing peptide, other peptide hormones with autocrine effects could also be targeted. A combination of anti growth factor therapies could lead to successful therapeutic control of this lethal disease.

Antibodies, Monoclonal↗
PubMed1989

Radiolabeled monoclonal antibodies in the diagnosis and treatment of malignant melanoma.

The use of antibodies directed against tumors has found increasing usefulness after the discovery by Kohler and Milstein of hybridoma technology, which made it possible to obtain monoclonal antibody (MoAb) that reacted specifically against a particular epitope on a particular antigen site. Relative tumor specificity and a lack of significant toxicity, together with the ability to link radionuclides (both halogens and metals) without significant deterioration of biologic behavioral characteristics such as immunoreactivity, have enabled widespread use of radiolabeled MoAbs in several malignancies, including and especially malignant melanoma. There is a significant body of data indicating that radiolabeled MoAbs directed against melanoma-associated antigens have an important role in the detection and therapy of metastatic malignant melanoma. Detection of visceral disease, while currently suboptimal, will in the future improve with optimization of SPECT imaging using 99mTc-labeled MoAb Fab fragments. This may result in an attenuated or absent antimouse response, especially after one injection, unless of course coinfused with either specific and/or nonspecific intact immunoglobulin (Ig). Radiolabeled fragments play an important role in radioimmunotherapy in metastatic melanoma. This role may be enhanced by the development of newer chelating agents that will decrease nonspecific hepatic uptake of radionuclide, enabling the use of beta-emitting radiometals such as 90Y. The recent report demonstrating diminished hepatic uptake of 99mTc-labeled anti-high molecular weight antigen (HMWA) Fab shows promise, since the same labeling technique can be used to deliver radiotherapeutic agents such as 186Re, which may be labeled to MoAb with methods similar to those used for 99mTc. Creation of single-chain MoAb determinants, chimera, and human MoAb will obviate the human immune response to foreign proteins that are currently in use and enable multiple administrations of tumor-toxic quantities of radiolabeled MoAbs.

Antibodies, Monoclonal↗
PubMed1989

Tumor localization of adoptively transferred indium-111 labeled tumor infiltrating lymphocytes in patients with metastatic melanoma.

Lymphoid cells infiltrating into human tumors can be expanded in vitro in medium containing interleukin-2 (IL-2). Adoptive transfer of these tumor-infiltrating lymphocytes (TIL) mediates potent antitumor effects in murine tumor models. Clinical trials to evaluate the efficacy of these cells in patients with advanced cancer are underway. We have investigated whether infused TIL labeled with indium 111 (111In) oxine can traffic and localize to metastatic deposits of tumor. Six patients with metastatic malignant melanoma who had multiple sites of subcutaneous, nodal, and/or visceral disease were the subjects of the study. The patients received cyclophosphamide 36 hours before receiving the intravenous (IV) infusion of TIL followed by IL-2 IV every eight hours. The distribution and localization of the TIL were evaluated using serial whole body gamma camera imaging, serial blood and urine samplings, and serial biopsies of tumor and normal tissue. 111In-labeled TIL localized to lung, liver, and spleen within two hours after the infusion of activity. Activity in the lung diminished within 24 hours. As early as 24 hours after injection of 111In-labeled TIL, localization of TIL to sites of metastatic deposits was demonstrated in all six patients using either imaging studies or biopsy specimens or both. 111In activity in tumor tissue biopsies ranged from three to 40 times greater than activity in normal tissue. A progressive increase in the radioactive counts at sites of tumor deposit was seen. This study shows that labeled TIL can localize preferentially to tumor, and provides information concerning the possible mechanism of the therapeutic effects of TIL.

Adult↗
PubMed1989

Diagnosis of coronary artery disease by radionuclide angiography: effect of combining indices of left ventricular function.

The aim of this study was to determine whether the diagnostic capability of radionuclide angiography (RNA) in detecting coronary artery disease (CAD) might be improved by using several indices of left ventricular (LV) function in concert. Three different models (rest data, exercise data, and rest plus exercise data) were derived by stepwise multivariate discriminant analysis of RNA data in 65 normal volunteers and 111 patients with CAD and normal ejection fraction (EF) at rest. The model with only resting indices yielded a diagnostic capability comparable to the simple measure of EF response to exercise (area under receiver operating characteristic curve = 89% and 91%, respectively). Both the exercise and rest plus exercise models gave better results (area = 94% and 97%, respectively), but only the rest plus the exercise model was better than the EF response alone (p less than 0.001). Thus (a) if resting studies alone are performed, the diagnostic potential of RNA may be improved by combining several indices of resting function; and (b) combined rest and exercise data may improve the sensitivity of RNA in detecting CAD over what could be obtained with the EF response to exercise alone.

Adult↗