Comparing monoclonal antibodies and small peptidic hormones for local targeting of malignant gliomas.

Comparing monoclonal antibodies and small peptidic hormones for local targeting of malignant gliomas.
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比较单克隆抗体和小肽激素局部靶向恶性神经胶质瘤的效果。

DOI:
10.1007/978-3-7091-6090-9_14
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发表时间:
2003
期刊:
Acta neurochirurgica. Supplement
影响因子:
--
通讯作者:
H. Maecke
H. Maecke
中科院分区:
--
文献类型:
--
作者:
A. Merlo;J. Mueller‐Brand;H. Maecke

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单克隆抗体、F(ab ')2片段和肽载体已被临床测试用于恶性神经胶质瘤的全身和局部治疗。由于这些脑内源性肿瘤的特征在于正常脑实质的无情肿瘤细胞浸润,靶向剂需要扩散性质以到达沿沿着血管裂隙和轴突通路迁移的侵入肿瘤细胞簇。与仅导致疾病有限稳定的大分子相比,通过在全身注射后使用小肽激素受体,例如修饰的奥曲肽,肿瘤摄取显著改善。更重要的是,通过使用这些小的药物样放射性缀合物,发现直接瘤内注射后的生物分布是上级的。在大肿瘤中观察到快速和广泛的分布,在未切除的肿瘤中心注射2-3 ml后,甚至在双半球病变中穿过胼胝体。与手术减积后腔内注射相比,直接瘤内注射后分布更广泛。与正常脑组织的极其紧密的结构相比,肿瘤的间质压力梯度增加和间质空间的更大和混乱的结构可能解释这种意想不到的生物分布模式。肽类激素载体可能成为将放射性药物递送到人类侵袭性胶质瘤中的有用试剂。
Monoclonal antibodies, F(ab')2 fragments and peptidic vectors have been clinically tested for systemic and locoregional treatment of malignant gliomas. Since these brain-intrinsic neoplasms are characterized by relentless tumor cell infiltration of normal brain parenchyma, targeting agents require diffusive properties in order to reach invading tumor cell clusters that migrate along vascular clefts and axonal pathways. Tumor uptake was significantly improved by using small peptidic hormone receptors, e.g. modified octreotide, following systemic injections as compared to macromolecules which only led to limited stabilization of the disease. More importantly, biodistribution was found to be superior following direct intratumoral injection by using these small drug-like radioconjugates. Rapid and extensive distribution within 30 minutes was observed in large tumors, even crossing the corpus callosum in bihemispheric lesions following injection of 2-3 ml of the radiopharmakon injected into the center of non-resected tumors. Distribution was far more extensive after direct intratumoral injection as compared to intracavitary injection after surgical debulking. Increased interstitial pressure gradients and the much larger and chaotic structure of the interstitial space of a tumor compared to the extremely tight architecture of normal brain tissue might explain this unexpected biodistribution pattern. Peptidic hormone vectors might become useful agents to deliver radiopharmaceuticals into human invasive gliomas.
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