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Capromab Pendetide

A Review of its Use as an Imaging Agent in Prostate Cancer

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Summary

Capromab pendetide, radiolabelled with indium-111, is a radioimmunoscintigraphic imaging agent used in patients with prostate cancer. It consists of a murine monoclonal antibody (7E11-C5.3) covalently joined to a linker-chelator molecule. 7E11-C5.3 is thought to be directed against the intracellular domain of human prostate-specific membrane antigen (PSMA), a transmembrane glycoprotein expressed by prostate epithelial cells.

The diagnostic utility of capromab pendetide has been investigated in 2 distinct patient groups. In patients with untreated prostate cancer at high risk for pelvic lymph node metastases, capromab pendetide imaging had respective sensitivities and specificities of 52 and 96% in 1 study and 62 and 72% in another, as confirmed by pelvic lymph node dissection biopsy results. In patients with suspected occult recurrent or residual disease after prostatectomy, capromab pendetide had respective sensitivities and specificities of 49 and 71% in 1 study and 77 and 35% in another for detection of cancer in the prostate bed. Almost half of these patients also had evidence of lesions outside the prostate fossa (usually in the pelvic and abdominal lymph nodes) according to immunoscintigraphic scans, but too few cases were confirmed to allow an evaluation of capromab pendetide.

Four per cent of patients who received single doses of capromab pendetide experienced adverse events. Elevated bilirubin levels, hypertension and hypotension each affected 1% of patients and elevated liver enzymes and injection site reactions <1% of patients. Detectable human anti-mouse antibodies were reported in 8% of patients after a single dose of capromab pendetide and in 19% of patients after repeat infusions.

Conclusions. Capromab pendetide offers improved sensitivity in the detection of prostate cancer over other noninvasive techniques. When used in conjunction with other techniques, it offers the possibility of defining the extent of localised and metastatic disease, thereby refining patient management.

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References

  1. Troyer JK, Beckett ML, Wright Jr GL. Detection and characterization of the prostate-specific membrane antigen (PSMA) in tissue extracts and body fluids. Int J Cancer 1995 Sep 4; 62: 552–8

    Article  PubMed  CAS  Google Scholar 

  2. Heston WDW. Characterization and glutamyl preferring carboxypeptidase function of prostate specific membrane antigen: a novel folate hydrolase. Urology 1997; 49Suppl. 3A: 104–12

    Article  PubMed  CAS  Google Scholar 

  3. Su SL, Huang I-P, Fair WR, et al. Alternatively spliced variants of prostate-specific membrane antigen RNA: ratio of expression as a potential measurement of progression. Cancer Res 1995 Apr 1; 55: 1441–3

    PubMed  CAS  Google Scholar 

  4. Wright Jr GL, Grob BM, Haley C, et al. Upregulation of prostate-specific membrane antigen after androgen-deprivation therapy. Urology 1996; 48: 326–34

    Article  PubMed  Google Scholar 

  5. Israeli RS, Powell CT, Corr JG, et al. Expression of the prostate-specific membrane antigen. Cancer Res 1994 Apr 1; 54: 1807–11

    PubMed  CAS  Google Scholar 

  6. Israeli RS, Powell CT, Fair WR, et al. Molecular cloning of a complementary DNA encoding a prostate-specific membrane antigen. Cancer Res 1993; 53(2): 227–30

    PubMed  CAS  Google Scholar 

  7. Carter RE, Feldman AR, Coyle JT. Prostate-specific membrane antigen is a hydrolase with substrate and pharmacologic characteristics of a neuropeptidase. Proc Natl Acad Sci U S A 1996 Jan; 93: 749–53

    Article  PubMed  CAS  Google Scholar 

  8. Pinto JT, Suffoletto BP, Berzin TM, et al. Prostate-specific membrane antigen: a novel folate hydrolase in human prostatic carcinoma cells. Clinical Cancer Research 1996 Sep; 2: 1445–51

    PubMed  CAS  Google Scholar 

  9. Horoszewicz JS, Kawinski E, Murphy GP. Monoclonal antibodies to a new antigenic marker in epithelial prostatic cells and serum of prostatic cancer patients. Anticancer Res 1987 Sep-Oct; 7: 927–35

    PubMed  CAS  Google Scholar 

  10. Lopes AD, Davis WL, Rosenstraus MJ, et al. Immunohistochemical and pharmacokinetic characterization of the site-specific immunoconjugate CYT-356 derived from antiprostate monoclonal antibody 7E11-C5. Cancer Res 1990 Oct 1; 50: 6423–9

    PubMed  CAS  Google Scholar 

  11. Wright Jr GL, Haley C, Beckett ML, et al. Expression of prostate-specific membrane antigen in normal, benign, and malignant prostate tissues. Urol Oncol 1995; 1: 18–28

    Article  PubMed  Google Scholar 

  12. Silver DA, Pellicer I, Fair WR, et al. Prostate-specific membrane antigen expression in normal and malignant human tissues. Clin Cancer Res 1997 Jan; 3: 81–5

    PubMed  CAS  Google Scholar 

  13. Cytogen Corporation PNJ. Background dossier for Prosta-Scint® (capromab pendetide). 1997 Jul 10. Data on file

  14. Murphy GP, Tino WT, Holmes EH, et al. Measurement of prostate-specific membrane antigen in the serum with a new antibody. Prostate 1996; 28: 266–71

    Article  PubMed  CAS  Google Scholar 

  15. Murphy GP, Holmes EH, Boynton AL, et al. Comparison of prostate specific antigen, prostate specific membrane antigen, and LNCaP-based enzyme-linked immunosorbent assays in prostatic cancer patients and patients with benign prostatic enlargement. Prostate 1995; 26: 164–8

    Article  PubMed  CAS  Google Scholar 

  16. Murphy G, Ragde H, Kenny G, et al. Comparison of prostate specific membrane antigen, and prostate specific antigen levels in prostatic cancer patients. Anticancer Res 1995; 15: 1473–80

    PubMed  CAS  Google Scholar 

  17. Troyer JK, Beckett ML, Wright Jr GL. Location of prostate-specific membrane antigen in the LNCaP prostate carcinoma cell line. Prostate 1997 Mar 1; 30: 232–42

    Article  PubMed  CAS  Google Scholar 

  18. Troyer JK, Feng Q, Beckett ML, et al. Biochemical characterization and mapping of the 7E11-C5.3 epitope of the prostate-specific membrane antigen. Urol Oncol 1995; 1: 29–37

    Article  PubMed  CAS  Google Scholar 

  19. Barren III RJ, Holmes EH, Boynton AL, et al. Monoclonal antibody 7E11.C5 staining of viable LNCaP cells. Prostate 1997 Jan 1; 30: 65–8

    Article  PubMed  Google Scholar 

  20. Bander NH. Monoclonal antibody 7E11.C5 staining of viable LNCaP cells [letter]. Prostate. In press

  21. Wynant GE, Murphy GP, Horoszewicz JS, et al. Immunoscintigraphy of prostatic cancer: preliminary results with 111In-labeled monoclonal antibody 7E11-C5.3 (CYT-356). Prostate 1991; 18(3): 229–41

    Article  PubMed  CAS  Google Scholar 

  22. Capromab pendetide prescribing information. 1996 Nov 14. Princeton (NJ): Cytogen Corporation

  23. Mardirossian G, Brill AB, Dwyer KM, et al. Radiation absorbed dose from indium-111-CYT-356. J Nucl Med 1996 Sep; 37: 1583–8

    PubMed  CAS  Google Scholar 

  24. Gulfo JV. Clinical utility of monoclonal antibodies in prostate cancer. Prostate Cancer 1994: 77–94

    Google Scholar 

  25. Burgers JK, Hinkle GH, Haseman MK. Monoclonal antibody imaging of recurrent and metastatic prostate cancer. Semin Urol 1995 May; XIII(2): 103–12

    Google Scholar 

  26. Babaian RJ, Sayer J, Podoloff DA, et al. Radioimmunoscintigraphy of pelvic lymph nodes with 111indium-labeled monoclonal antibody CYT-356. J Urol 1994 Dec; 152 (Pt 1): 1952–5

    PubMed  CAS  Google Scholar 

  27. Abdel-Nabi H, Wright GL, Gulfo JV, et al. Monoclonal antibodies and radioimmunoconjugates in the diagnosis and treatment of prostate cancer. Semin Urol 1992; 10(1): 45–54

    PubMed  CAS  Google Scholar 

  28. Gleason DF, Veterans Administration Cooperative Urological Research Group. Histologic grading and clinical staging of prostatic carcinoma. In: Tannenbaum M, editor. Urological pathology: the prostate. Philadelphia: Lea & Febiger, 1977: 171–87

    Google Scholar 

  29. Bander NH. Current status of monoclonal antibodies for imaging and therapy of prostate cancer. Semin Oncol 1994 Oct; 21: 607–12

    PubMed  CAS  Google Scholar 

  30. Chiacchierini RP, Piantadosi S, Partin AW, et al. Logistic regression analysis combining serum PSA, Gleason score and monoclonal antibody scan (ProstaScint) to predict lymph nodal involvement in prostate cancer [abstract no. 797]. J Urol 1997 Apr; 157(4) Suppl.: 202

    Google Scholar 

  31. Kahn D, Haseman M, Libertino J, et al. Indium-111 capromab pendetide (Prostascint) imaging of patients with rising PSA post-prostatectomy [abstract no. 795]. J Urol 1997 Apr; 157(4) Suppl.: 204

    Google Scholar 

  32. Haseman MK, Reed NL, Rosenthal SA. Monoclonal antibody imaging of occult prostate cancer in patients with elevated prostate-specific antigen. Positron emission tomography and biopsy correlation. Clin Nucl Med 1996 Sep; 21: 704–13

    Article  PubMed  CAS  Google Scholar 

  33. Kahn D, Williams RD, Seldin DW, et al. Radioimmunoscintigraphy with 111indium labeled CYT-356 for the detection of occult prostate cancer recurrence. J Urol 1994 Nov; 152 (5 Pt 1): 1490–5

    PubMed  CAS  Google Scholar 

  34. Kahn D, Williams RD, Haseman MK, et al. Radioimmunoscintigraphy with In-111-labeled capromab pendetide predicts prostate cancer response to salvage radiotherapy after failed radical prostatectomy. J Clin Oncol 1998 Jan; 16(1): 284–9

    PubMed  CAS  Google Scholar 

  35. Levran Z, Gonzalez JA, Diokno AC, et al. Are pelvic computed tomography, bone scan and pelvic lymphadenectomy necessary in the staging of prostatic cancer? Br J Urol 1995; 75: 778–81

    Article  PubMed  CAS  Google Scholar 

  36. Stein A, deKernion JB, Smith RB, et al. Prostate specific antigen levels after radical prostatectomy in patients with organ confined and locally extensive prostate cancer. J Urol 1992 Mar; 147: 942–6

    PubMed  CAS  Google Scholar 

  37. Partin AW, Pound CR, Clemens JQ, et al. Serum PSA after anatomic radical prostatectomy: the Johns Hopkins experience after 10 years. Urol Clin North Am 1993 Nov; 20(4): 713–25

    PubMed  CAS  Google Scholar 

  38. Zincke H, Oesterling JE, Blute ML, et al. Long-term (15 years) results after radical prostatectomy for clinically localized (stage T2c or lower) prostate cancer. J Urol 1994 Nov; 152: 1850–7

    PubMed  CAS  Google Scholar 

  39. Zietman AL, Edelstein RA, Coen JJ, et al. Radical prostatectomy for adenocarcinoma of the prostate: the influence of preoperative and pathologic findings on biochemical disease-free outcome. Urology 1994 Jun; 43(6): 828–33

    Article  PubMed  CAS  Google Scholar 

  40. Frydenberg M, Stricker PD, Kaye KW. Prostate cancer diagnosis and management. Lancet 1997 Jun 7; 349: 1681–7

    Article  PubMed  CAS  Google Scholar 

  41. Denis LJ, Murphy GP, Schröder FH. Report of the consensus workshop on screening and global strategy for prostate cancer. Cancer 1995 Mar 1; 75: 1187–207

    Article  PubMed  CAS  Google Scholar 

  42. Catalona WJ, Andriole GL. Tumors of the prostate gland. In: Moosa AR, Schimpff SC, Robson MC, editors. Comprehensive textbook of oncology. Vol. 2. 2nd ed. Baltimore: Williams & Wilkins, 1991: 1088–99

    Google Scholar 

  43. Goldenberg DM, DeLand FH, Bennett SJ, et al. Radioimmuno-detection of prostatic cancer: in vivo use of radioactive antibodies against prostatic acid phosphatase for diagnosis and detection of prostatic cancer by nuclear imaging. JAMA 1983 Aug 5; 250(5): 630–5

    Article  PubMed  CAS  Google Scholar 

  44. Babaian RJ, Murray JL, Lamki LM, et al. Radioimmunological imaging of metastatic prostatic cancer with 111indium-labeled monoclonal antibody PAY 276. J Urol 1987 Mar; 137: 439–43

    PubMed  CAS  Google Scholar 

  45. Babaian RJ, Lamki LM. Radioimmunoscintigraphy of prostate cancer. Semin Nucl Med 1989 Oct; XIX(4): 309–21

    Google Scholar 

  46. Abdel-Nabi HH, Ortman-Nabi JA, See W, et al. Clinical experience with intra lymphatic administration of 111In-labelled monoclonal antibody PAY 276 for the detection of pelvic nodal metastases in prostatic carcinoma. Eur J Nucl Med 1990; 16: 149–56

    Article  PubMed  CAS  Google Scholar 

  47. Meyers FJ, Denardo SJ, Macey D, et al. Development of monoclonal antibody imaging of metastatic prostatic carcinoma. Prostate 1989; 14: 209–20

    Article  PubMed  CAS  Google Scholar 

  48. Neal CE, Baker MR, Texter JH. Prostate imaging with antibodies. Appl Radiol 1992 Apr; 21(4): 39–46

    Google Scholar 

  49. Zuckier LS, DeNardo GL. Trials and tribulations: oncological antibody imaging comes to the fore. Semin Nucl Med 1997 Jan; 27: 10–29

    Article  PubMed  CAS  Google Scholar 

  50. Williams BS, Hinkle GH, Lamatrice RA, et al. Technical consideration for acquiring and processing Indium-111 capromab pendetide images. J Nucl Med Technol 1997 Sep; 25(3): 205–1651.

    PubMed  CAS  Google Scholar 

  51. Liu H, Moy P, Kim S, et al. Monoclonal antibodies to the extracellular domain of prostate-specific membrane antigen also react with tumor vascular endothelium. Cancer Res 1997 Sep 1; 57: 3629–34

    PubMed  CAS  Google Scholar 

  52. Chengazi VU, Feneley MR, Ellison D, et al. Imaging prostate cancer with technetium-99m-7E11-C5.3 (CYT-351). J Nucl Med 1997; 38: 675–82

    PubMed  CAS  Google Scholar 

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Correspondence to Harriet M. Lamb.

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Lamb, H.M., Faulds, D. Capromab Pendetide. Drugs Aging 12, 293–304 (1998). https://doi.org/10.2165/00002512-199812040-00004

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