2014, Number 3-4
Immunoscintigraphy and radioimmunotherapy in Cuba: Experiences with labeled monoclonal antibodies for cancer diagnosis and treatment (1993–2013)
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ABSTRACTIntroduction: The availability of monoclonal antibodies in Cuba has facilitated development and application of innovative techniques (immunoscintigraphy and radioimmunotherapy) for cancer diagnosis and treatment.
Objetive: Review immunoscintigraphy and radioimmunotherapy techniques and analyze their use in Cuba, based on the published literature. In this context, we describe the experience of Havana's Clinical Research Center with labeled monoclonal antibodies for cancer diagnosis and treatment during the period 1993–2013.
Evidence acquisition: Basic concepts concerning cancer and monoclonal antibodies were reviewed, as well as relevant international and Cuban data. Forty-nine documents were reviewed, among them 2 textbooks, 34 articles by Cuban authors and 13 by international authors. All works published by the Clinical Research Center from 1993 through 2013 were included. Bibliography was obtained from the library of the Clinical Research Center and Infomed, Cuba's national health telematics network, using the following keywords: monoclonal antibodies, immunoscintigraphy and radioimmunotherapy.
Results: Labeling the antibodies (ior t3, ior t1, ior cea 1, ior egf/r3, ior c5, h-R3, 14F7 and rituximab) with radioactive isotopes was a basic line of research in Cuba and has fostered their use as diagnostic and therapeutic tools. The studies conducted demonstrated the good sensitivity and diagnostic precision of immunoscintigraphy for detecting various types of tumors (head and neck, ovarian, colon, breast, lymphoma, brain).
Obtaining different radioimmune conjugates with radioactive isotopes such as 99mTc and 188Re made it possible to administer radioimmunotherapy to patients with several types of cancer (brain, lymphoma, breast). The objective of 60% of the clinical trials was to determine pharmacokinetics, internal dosimetry and adverse effects of monoclonal antibodies, as well as tumor response; there were few adverse effects, no damage to vital organs, and a positive tumor response in a substantial percentage of patients.
Conclusions: Cuba has experience with production and radiolabeling of monoclonal antibodies, which facilitates use of these agents. Studies in Cuba conducted by the Clinical Research Center over the past 20 years have yielded satisfactory results. Evidence obtained suggests promising potential of monoclonal antibodies and nuclear medicine, with immunoscintigraphy and radioimmunotherapy techniques providing alternatives for cancer diagnosis and treatment in Cuba.
Hiddemann W, Kneba M, Dreyling M, Schmitz N, Lengfelder E, Schmits R, et al. Front-line therapy with rituximab added to the combination of cyclophosphamide, doxorubicin, vincristine the outcome of patients with advanced stage follicular lymphomas as compared to CHOP alone: Results of a prospective randomized study of the German low grade lymphoma study group (GLSG). Blood. 2005 Dec 1;106(12):3725–32.
Torres LA, Coca MA, Batista JF, Casacó A, López G, García I, et al. Biodistribution and internal dosimetry of the 188Re-labelled humanized monoclonal antibody anti-epidermal growth factor receptor, nimotuzumab, in the locoregional treatment of malignant gliomas. Nucl Med Commun. 2008 Jan;29(1):66–75.
Registro Público Cubano de Ensayos Clínicos [Internet]. Havana: National Clinical Trials Coordinating Center (CU); c2014. Código del Registro Público: RPCEC00000016. Use of hR3 MAb and radiotherapy to treat patients with non small cells lung cancer (NSCLC) and brain metastasis; 2013 Nov 8 [cited 2014 Apr 18]; [about 2 p.]. Available from: http://registroclinico.sld.cu. Spanish.