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Dosimetry of Rhenium-186-Labeled Monoclonal Antibodies: Methods, Prediction from Technetium-99m-Labeled Antibodies and Results of Phase I Trials

Departments of Radiology and Medicine, Virginia Mason Medical Center, and NeoRx Corporation, Seattle, Washington
Health Physics Department, Battelle Pacific Northwest Laboratories, Richland, Washington

Correspondence: For correspondence or reprints contact: Hazel B. Breitz, MD, Virginia Mason Medical Center, 1100 Ninth Ave., P.O. Box 900, C5-NM, Seattle, WA 98111.

ABSTRACT

Rhenium-186 is a beta-emitting radionuclide that has been studied for applications in radioimmunotherapy. Its 137 keV gamma photon is ideal for imaging the biodistribution of the immunoconjugates and for obtaining gamma camera data for estimation of dosimetry. Methods used for determining radiation absorbed dose are described. We have estimated absorbed dose to normal organs and tumors following administration of two different ¹⁸⁶Re-labeled immunoconjugates, intact NR-LU-10 antibody and the F(ab')₂ fragment of NR-CO-02. Tumor dose estimates in 46 patients varied over a wide range, 0.4–18.6 reds/mCi, but were similar in both studies. Accuracy of activity estimates in superficial tumors was confirmed by biopsy. Prediction of ¹⁸⁶Re dosimetry from a prior ¹⁸⁶Tc imaging study using a tracer dose of antibody was attempted in the NR-CO-02 (Feb') ₂ study. Although ^99mTc was an accurate predictor of tumor localization and the mean predicted and observed radiation absorbed doses to normal organs compared favorably, ¹⁸⁶Re dosimetry could not be reliably predicted in individual patients. The methods described nevertheless provide adequate estimates of ¹⁸⁶Re dosimetry to tumor and normal organs.

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