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Colorectal Cancer Imaging with Iodine-123-Labeled CEA Monoclonal Antibody Fragments

Garden State Cancer Center at the Center for Molecular Medicine and Immunology, Newark, New Jersey
Immunomedics, Inc. , Morris Plains, New Jersey
University of Cincinnati, Departments of Radiology and Medicine, Cincinnati, Ohio
University of Miami, Departments of Radiology and Medicine, Miami, Florida
St. Vincent's Hospital, Department of Radiology, New York, New York
University Hospital—New Jersey Medical School, Department of Nuclear Medicine, Newark, New Jersey
Department of Nuclear Medicine, Cleveland Clinic Florida, Ft. Lauderdale, Florida
Department of Nuclear Medicine, George Washington University, Washington, DC
Department of Radiology, Morristown Memorial Hospital, Morristown, New Jersey

Correspondence: For correspondence or reprints contact: David M. Goldenberg, MD, Center for Molecular Medicine and Immunology, 1 Bruce St., Newark, NJ 07103.

ABSTRACT

This prospective, randomized multicenter study in 62 patients was designed to evaluate the efficacy and safety of radioimmunodetection (RAID) with ¹²³I-Iabeled fragments, F(ab')₂ and Fab', of IMMU-4, an anti-CEA monoclonal antibody (ImmuRAID-CEA). It was found that ImmuRAID-CEA was safe and disclosed colorectal cancer sites at least 1 cm in size. The positive predictive value by lesions was 77% initially, and increased to 91% after 7 mo of follow-up. Only one patient developed a low level of HAMA. In 17 patients with 32 surgically confirmed lesions, there were 9% true-positive lesions for CT when RAID was false-negative, and 22% for RAID when CT was false-negative. Either CT or RAID detected all 32 lesions. In this small series, therefore, RAID was shown to complement CT findings by confirming suspected tumors and disclosing new lesions which had previously been occult.

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