Single-dose versus fractionated radioimmunotherapy: Model comparisons for uniform tumor dosimetry

Joseph A. O'Donoghue, George Sgouros, Chaitanya R. Divgi, John L. Humm

Research output: Contribution to journalArticle

Abstract

Targeting molecules with reduced immunogenicity will enable repetitive administrations of radioimmunotherapy. In this work a mathematical model was used to compare 2 different treatment strategies: large single administrations (LSAs) and rapid fractionation (RF) of small individual administrations separated by short time intervals. Methods: An integrated compartmental model of treatment pharmacokinetics and tumor response was used to compare alternative treatments that delivered identical absorbed doses to red marrow. Results: Based on the key assumption of uniform dose distributions, the LSA approach consistently produced smaller nadir values of tumor cell survival and tumor size. The predicted duration of remission was similar for both treatment structures. These findings held for both macroscopic and microscopic tumors and were independent of tumor cell radiosensitivity, proliferation rate, rate of tumor shrinkage, and uptake characteristics of radiolabeled material in tumor. Conclusion: Clinical situations for which each treatment is most appropriate may be tentatively identified. An LSA using a short-range-emitting radionuclide would be most appropriate for therapy of microscopic disease, if uptake is relatively homogeneous. RF using a longer range emitter would be most appropriate for macroscopic disease, if uptake is heterogeneous and varies from one administration to another. There is a rationale for combining LSA and RF treatments in clinical situations in which slowly growing macroscopic disease and rapidly growing microscopic disease exist simultaneously.

Original languageEnglish (US)
Pages (from-to)538-547
Number of pages10
JournalJournal of Nuclear Medicine
Volume41
Issue number3
StatePublished - Mar 1 2000

    Fingerprint

Keywords

  • Cure
  • Fractionation
  • Gompertzian growth
  • Mathematical model
  • Radioimmunotherapy
  • Remission
  • Tumor response

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this