Recent Advances in  Radionuclide Therapies

• Octreotide Therapy
  • Potentially useful in neuroendocrine tumors
  • Tumor must have somatostatin receptor present
  • Both ¹¹¹In and ⁹⁰Y have benn used
  • Some successful remissions have occurred with high doses
• Bexxar Lymphoma Therapy
  • ¹³¹I lableled antibody to NHL cell site
  • 5 mci scan dose first
  • Determine body t1/2
  • Use data from dosimetry study to determine therapy dose
  • Average dose 75 mci ¹³¹I antibody
• Zevalin Lymphoma Therapy
  • ⁹⁰Y labeled antibody to NHL cell site
  • 5 mCi ¹¹¹In scan dose first
  • Perform whole body scans to look for anomalous uptake (bone marrow)
  • Avg. dose 20-32 mCi antibody
• ⁹⁰Y Microsphere Therapy for treating liver metastases from colon cancer
  • ⁹⁰Y labeled resin microspheres- SIR-spheres
  • Requires MAA study and angiogram prior to administration of microspheres
  • Injected dose 20-60 mCi depending upon many factors
    • lobar vs whole liver
    • degree of shunting
    • etc...
• Radiation Synovectomy
  • Purpose: therapy of rheumatic synovitis in knees of patients with rheumatoid arthritis
  • Goal: removal of inflamed joint lining prevention of joint destruction
  • Radiopharmaceutical
    • 270 mCi of ¹⁶⁵Dy FHMA or 10 mCi of ¹⁶⁶Ho FHMA, pure b-emitters
    • t_phys=2.3 hour and 27 hour, respectively
  • Injected into knee joint, requires overnight hospitalization
  • Ideal candidate:
    • patient disabled with chronic knee effusions
    • patient beyond child-bearing years
    • minimal evidence of joint destruction
    • resistance to conventional management > 6 months