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  • Review Article
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Clinical radioimmunotherapy—the role of radiobiology

Nature Reviews Clinical Oncology volume 8, pages 720–734 (2011)Cite this article

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Abstract

Conventional external-beam radiation therapy is dedicated to the treatment of localized disease, whereas radioimmunotherapy represents an innovative tool for the treatment of local or diffuse tumors. Radioimmunotherapy involves the administration of radiolabeled monoclonal antibodies that are directed specifically against tumor-associated antigens or against the tumor microenvironment. Although many tumor-associated antigens have been identified as possible targets for radioimmunotherapy of patients with hematological or solid tumors, clinical success has so far been achieved mostly with radiolabeled antibodies against CD20 (131I-tositumomab and 90Y-ibritumomab tiuxetan) for the treatment of lymphoma. In this Review, we provide an update on the current challenges aimed to improve the efficacy of radioimmunotherapy and discuss the main radiobiological issues associated with clinical radioimmunotherapy.

Key Points

  • Radioimmunotherapy is a multi-disciplinary approach that requires the cooperation of radiobiologists, radiolabeling chemists, physicists, immunologists, nuclear medicine physicians, and oncologists

  • Although two radioimmunotherapy agents for patients with non-Hodgkin lymphoma have been approved by the FDA, few clinical radioimmunotherapy trials in patients with solid tumors have progressed beyond phase II trials

  • As for external-beam radiation therapy (EBRT), radioimmunotherapy schedules need to be rationalized on the basis of accurate and personalized dosimetry, dose fractionation and dose intensification

  • Strategies that increase the absorbed dose by tumor tissue while minimizing the exposure of healthy organs (for example pretargeting strategies) must be developed for improving the efficacy of radioimmunotherapy

  • The radiobiology of radioimmunotherapy is not identical to that of EBRT and must thus be investigated in preclinical models

  • The success of radioimmunotherapy will depend on finding the best combinations with other therapeutic agents

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Figure 1: Radiobiology of radioimmunotherapy.
Figure 2: Patterns of cellular damage caused by radiation sorted by LET.
Figure 3: Track length of alpha-particles, beta-particles, and Auger electrons relative to the cell diameter.
Figure 4: Survival curves of irradiated cells.
Figure 5: Personalized dosimetry before tailored radioimmunotherapy could improve radioimmunotherapy efficacy in solid tumors.

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Authors and Affiliations

  1. Direction de la Radioprotection de l'Homme, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, F-92262, France

    Jean-Pierre Pouget

  2. Institut de Recherche en Cancérologie de Montpellier, INSERM, Centre Régional de Lutte Contre le Cancer Val d'Aurelle, Université Montpellier 1, Campus Val d'Aurelle, F-34298, Montpellier, France

    Isabelle Navarro-Teulon, Nicolas Chouin, André Pèlegrin & David Azria

  3. Centre de Recherche en Cancérologie de Toulouse, UMR1037 INSERM, Université Toulouse 3-ERL 5294 Centre National de la Recherche Scientifique, F-31024, Toulouse, France

    Manuel Bardiès

  4. Département d'Hématologie, Centre Hospitalier Universitaire, Unité Mixte de Recherches Centre National de la Recherche Scientifique 5235, Université Montpellier 1 et 2, F-34295, Montpellier, France

    Guillaume Cartron

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All authors researched data for the article, wrote the article, and reviewed or edited the manuscript before submission. J. P. Pouget, I. Navarro-Teulon, A. Pelegrin, and D. Azria provided substantial contributions to the discussion of content.

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Pouget, JP., Navarro-Teulon, I., Bardiès, M. et al. Clinical radioimmunotherapy—the role of radiobiology. Nat Rev Clin Oncol 8, 720–734 (2011). https://doi.org/10.1038/nrclinonc.2011.160

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