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Therapeutic Nuclear Medicine pp 557–567Cite as

Targeted Alpha Particle Therapy of Peritoneal Carcinomas

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Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

Abstract

Peritoneal carcinomatosis is the most common secondary cancerous disease to affect the peritoneal cavity. It is a frequent consequence of primary cancers especially of the gastrointestinal tract and of the ovary. Prognosis of peritoneal spread of a primary carcinoma is poor because effective treatment strategies do not exist. The primary therapeutic option is cytoreductive surgery in combination with adjuvant intraperitoneal chemotherapy. However, treatment related complications and still poor survival rates suggest that alternative treatment strategies should be investigated. To improve the therapeutic outcome targeted radionuclide therapy seems a promising option. However, the overall efficacy of targeted therapy with β-emitters did not turn out to be satisfactory. Because α-particles very efficiently eradicate single tumour cells or small tumour cell nodules they represent a promising option for treatment of disseminated tumour cells and micrometastatic disease characteristic for peritoneal carcinomatosis. Actually the α-emitters 225Ac, 213Bi, 212Bi and 211At coupled to carrier molecules that specifically target tumour cells have successfully been used in experimental studies for treatment of ovarian, colon, pancreatic, breast or gastric cancer. A first clinical phase I study has been initiated to evaluate the therapeutic potential of 211At-MX35 F(ab’)2, targeting the sodium-dependent phosphate transport protein 2b which is overexpressed in more than 90% of human ovarian epithelial cancers. The results of the study suggest that intraperitoneal 211At-radioimmunotherapy of ovarian cancer patients will be efficient without significant toxicity. Therefore, in spite of current problems concerning world-wide availability, α-emitters could become indispensable with regard to optimization of strategies for tumour therapy in the future. 

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  1. Department of Nuclear Medicine, Technische Universität München, Ismaninger Strasse 22, 81675, Munich, Germany

    Christof Seidl & Reingard Senekowitsch-Schmidtke

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  1. Christof Seidl
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  2. Reingard Senekowitsch-Schmidtke
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Correspondence to Christof Seidl .

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  1. THERANOSTICS Center for Molecular, Radiotherapy and Molecular Imaging, ENETS Center of Excellence, Bad Berka, Germany

    Richard P. Baum

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Seidl, C., Senekowitsch-Schmidtke, R. (2012). Targeted Alpha Particle Therapy of Peritoneal Carcinomas. In: Baum, R. (eds) Therapeutic Nuclear Medicine. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/174_2012_678

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