Radio-Immunoguided Surgery for Large Bowel Cancer
The intra-operative detection of metastatic disease in colorectal cancer depends on tumor-associated antigen and antibodies a- well as detection technology. A hand-held gamma detecting probe is capable of detecting as few as 6×105 labelled cells in vitro.
In a multicentre phase 1-11 study using B72.3 with 1125 105 patients (26 primary, 72 recurrent, 6 no tumor) were enrolled. There was 78% localization - 24/32 primary tumors 126/199 recurrent sites. Occult tumor was detected in 30 sites in 26 patients. There was an impact on management in approximately 1/3 of recurrent cases.
Of 17 patients for complete excision of recurrent tumor, 10 had complete excision and 7 recurred in 1 year. Four with elevated CEA had no tumor found, 2 had widespread metastases (no resection), 1 had bilateral radio uptake and biopsy -negative tumor-free at 3 years.
A current Phase II study is being conducted using MoAle CC49 labelled with 1-2 Mci with primary tumor localization 86% and 97% in second look metastases.
KeywordsPrimary Tumor Localization Large Bowel Cancer Occult Tumor Acute Hypersensitivity Reaction Current Colorectal Cancer
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