Skip to main content
NCBI home page
Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1991 Mar;54(3):260–265. doi: 10.1136/jnnp.54.3.260

Carcinomatous meningitis: antibody-guided therapy with I-131 HMFG1.

R P Moseley 1, J C Benjamin 1, R D Ashpole 1, N M Sullivan 1, J A Bullimore 1, H B Coakham 1, J T Kemshead 1
PMCID: PMC1014397  PMID: 2030355

Abstract

Seven patients with carcinomatous meningitis were administered intrathecal I-131 labelled monoclonal antibody HMFG1. Clinical responses were seen in two patients, with a long term survivor at 32 months. Aseptic meningitis occurred in 4/7 patients, but more serious toxicity was observed in the form of seizures (2/7 patients) and myelosuppression (3/7 patients). Partial obliteration of the subarachnoid space was identified as a potential problem in patients with advanced disease.

Full text

PDF
260

Images in this article

261Image
on p.261

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aisner J., Ostrow S., Govindan S., Wiernik P. H. Leptomeningeal carcinomatosis in small cell carcinoma of the lung. Med Pediatr Oncol. 1981;9(1):47–59. doi: 10.1002/mpo.2950090108. [DOI] [PubMed] [Google Scholar]
  2. Aroney R. S., Dalley D. N., Chan W. K., Bell D. R., Levi J. A. Meningeal carcinomatosis in small cell carcinoma of the lung. Am J Med. 1981 Jul;71(1):26–32. doi: 10.1016/0002-9343(81)90254-0. [DOI] [PubMed] [Google Scholar]
  3. Balducci L., Little D. D., Khansur T., Steinberg M. H. Carcinomatous meningitis in small cell lung cancer. Am J Med Sci. 1984 Jan-Feb;287(1):31–33. doi: 10.1097/00000441-198401000-00007. [DOI] [PubMed] [Google Scholar]
  4. Behnke J., Mach J. P., Buchegger F., Carrel S., Delaloye B., De Tribolet N. In vivo localisation of radiolabelled monoclonal antibody in human gliomas. Br J Neurosurg. 1988;2(2):193–197. doi: 10.3109/02688698808992669. [DOI] [PubMed] [Google Scholar]
  5. Benjamin J. C., Moss T., Moseley R. P., Maxwell R., Coakham H. B. Cerebral distribution of immunoconjugate after treatment for neoplastic meningitis using an intrathecal radiolabeled monoclonal antibody. Neurosurgery. 1989 Aug;25(2):253–258. doi: 10.1097/00006123-198908000-00015. [DOI] [PubMed] [Google Scholar]
  6. Bourdon M. A., Wikstrand C. J., Furthmayr H., Matthews T. J., Bigner D. D. Human glioma-mesenchymal extracellular matrix antigen defined by monoclonal antibody. Cancer Res. 1983 Jun;43(6):2796–2805. [PubMed] [Google Scholar]
  7. Buchegger F., Mach J. P., Leonnard P., Carrel S. Selective tumor localization of radiolabeled anti-human melanoma monoclonal antibody fragment demonstrated in the nude mouse model. Cancer. 1986 Aug 1;58(3):655–662. doi: 10.1002/1097-0142(19860801)58:3<655::aid-cncr2820580310>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  8. Carrasquillo J. A., Krohn K. A., Beaumier P., McGuffin R. W., Brown J. P., Hellström K. E., Hellström I., Larson S. M. Diagnosis of and therapy for solid tumors with radiolabeled antibodies and immune fragments. Cancer Treat Rep. 1984 Jan;68(1):317–328. [PubMed] [Google Scholar]
  9. Cooper J. F., Harbert J. C. Endotoxin as a cause of aseptic meningitis after radionuclide cisternography. J Nucl Med. 1975 Sep;16(9):809–813. [PubMed] [Google Scholar]
  10. Duttera M. J., Bleyer W. A., Pomeroy T. C., Leventhal C. M., Leventhal B. G. Irradiation, methotrexate toxicity, and the treatment of meningeal leukaemia. Lancet. 1973 Sep 29;2(7831):703–707. doi: 10.1016/s0140-6736(73)92539-7. [DOI] [PubMed] [Google Scholar]
  11. Embleton M. J., Rowland G. F., Simmonds R. G., Jacobs E., Marsden C. H., Baldwin R. W. Selective cytotoxicity against human tumour cells by a vindesine-monoclonal antibody conjugate. Br J Cancer. 1983 Jan;47(1):43–49. doi: 10.1038/bjc.1983.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Epenetos A. A., Munro A. J., Stewart S., Rampling R., Lambert H. E., McKenzie C. G., Soutter P., Rahemtulla A., Hooker G., Sivolapenko G. B. Antibody-guided irradiation of advanced ovarian cancer with intraperitoneally administered radiolabeled monoclonal antibodies. J Clin Oncol. 1987 Dec;5(12):1890–1899. doi: 10.1200/JCO.1987.5.12.1890. [DOI] [PubMed] [Google Scholar]
  13. Fraker P. J., Speck J. C., Jr Protein and cell membrane iodinations with a sparingly soluble chloroamide, 1,3,4,6-tetrachloro-3a,6a-diphrenylglycoluril. Biochem Biophys Res Commun. 1978 Feb 28;80(4):849–857. doi: 10.1016/0006-291x(78)91322-0. [DOI] [PubMed] [Google Scholar]
  14. Gatter K. C., Alcock C., Heryet A., Mason D. Y. Clinical importance of analysing malignant tumours of uncertain origin with immunohistological techniques. Lancet. 1985 Jun 8;1(8441):1302–1305. doi: 10.1016/s0140-6736(85)92794-1. [DOI] [PubMed] [Google Scholar]
  15. Giannone L., Greco F. A., Hainsworth J. D. Combination intraventricular chemotherapy for meningeal neoplasia. J Clin Oncol. 1986 Jan;4(1):68–73. doi: 10.1200/JCO.1986.4.1.68. [DOI] [PubMed] [Google Scholar]
  16. Gold L. H., Kieffer S. A., D'Angio G. J., Fallon V. T., Long D. M. Current status of intrathecal radiogold in the treatment of medulloblastoma. Acta Radiol Ther Phys Biol. 1972 Aug;11(4):329–340. doi: 10.3109/02841867209130756. [DOI] [PubMed] [Google Scholar]
  17. Jansen F. K., Blythman H. E., Carrière D., Casellas P., Gros O., Gros P., Laurent J. C., Paolucci F., Pau B., Poncelet P. Immunotoxins: hybrid molecules combining high specificity and potent cytotoxicity. Immunol Rev. 1982;62:185–216. doi: 10.1111/j.1600-065x.1982.tb00394.x. [DOI] [PubMed] [Google Scholar]
  18. Jones D. H., Goldman A., Gordon I., Pritchard J., Gregory B. J., Kemshead J. T. Therapeutic application of a radiolabelled monoclonal antibody in nude mice xenografted with human neuroblastoma: tumoricidal effects and distribution studies. Int J Cancer. 1985 Jun 15;35(6):715–720. doi: 10.1002/ijc.2910350604. [DOI] [PubMed] [Google Scholar]
  19. Kemshead J. T., Coakham H. B. The use of monoclonal antibodies for the diagnosis of intracranial malignancies and the small round cell tumours of childhood. J Pathol. 1983 Nov;141(3):249–257. doi: 10.1002/path.1711410306. [DOI] [PubMed] [Google Scholar]
  20. Larson S. M., Carrasquillo J. A., Krohn K. A., Brown J. P., McGuffin R. W., Ferens J. M., Graham M. M., Hill L. D., Beaumier P. L., Hellström K. E. Localization of 131I-labeled p97-specific Fab fragments in human melanoma as a basis for radiotherapy. J Clin Invest. 1983 Dec;72(6):2101–2114. doi: 10.1172/JCI111175. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Lashford L. S., Davies A. G., Richardson R. B., Bourne S. P., Bullimore J. A., Eckert H., Kemshead J. T., Coakham H. B. A pilot study of 131I monoclonal antibodies in the therapy of leptomeningeal tumors. Cancer. 1988 Mar 1;61(5):857–868. doi: 10.1002/1097-0142(19880301)61:5<857::aid-cncr2820610502>3.0.co;2-s. [DOI] [PubMed] [Google Scholar]
  22. Lee Y. S., Bullard D. E., Zalutsky M. R., Coleman R. E., Wikstrand C. J., Friedman H. S., Colapinto E. V., Bigner D. D. Therapeutic efficacy of antiglioma mesenchymal extracellular matrix 131I-radiolabeled murine monoclonal antibody in a human glioma xenograft model. Cancer Res. 1988 Feb 1;48(3):559–566. [PubMed] [Google Scholar]
  23. Lee Y., Bullard D. E., Humphrey P. A., Colapinto E. V., Friedman H. S., Zalutsky M. R., Coleman R. E., Bigner D. D. Treatment of intracranial human glioma xenografts with 131I-labeled anti-tenascin monoclonal antibody 81C6. Cancer Res. 1988 May 15;48(10):2904–2910. [PubMed] [Google Scholar]
  24. Lindmo T., Boven E., Cuttitta F., Fedorko J., Bunn P. A., Jr Determination of the immunoreactive fraction of radiolabeled monoclonal antibodies by linear extrapolation to binding at infinite antigen excess. J Immunol Methods. 1984 Aug 3;72(1):77–89. doi: 10.1016/0022-1759(84)90435-6. [DOI] [PubMed] [Google Scholar]
  25. Lindmo T., Bunn P. A., Jr Determination of the true immunoreactive fraction of monoclonal antibodies after radiolabeling. Methods Enzymol. 1986;121:678–691. doi: 10.1016/0076-6879(86)21067-8. [DOI] [PubMed] [Google Scholar]
  26. Little J. R., Dale A. J., Okazaki H. Meningeal carcinomatosis. Clinical manifestations. Arch Neurol. 1974 Feb;30(2):138–143. doi: 10.1001/archneur.1974.00490320026003. [DOI] [PubMed] [Google Scholar]
  27. MEISSNER G. F. Carcinoma of the stomach with meningeal carcinosis; report of four cases. Cancer. 1953 Mar;6(2):313–318. doi: 10.1002/1097-0142(195303)6:2<313::aid-cncr2820060214>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  28. McKelvey E. M. Meningeal involvement with metastatic carcinoma of the breast treated with intrathecal methotrexate. Cancer. 1968 Sep;22(3):576–580. doi: 10.1002/1097-0142(196809)22:3<576::aid-cncr2820220313>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  29. Messert B., Rieder M. J. RISA cisternography. Study of spinal fluid changes associated with intrathecal RISA injection. Neurology. 1972 Aug;22(8):789–792. doi: 10.1212/wnl.22.8.789. [DOI] [PubMed] [Google Scholar]
  30. Metz O., Stoll W., Plenert W. Meningosis prophylaxis with intrathecal 198Au-colloid and methotrexate in childhood acute lymphocytic leukemia. Cancer. 1982 Jan 15;49(2):224–228. doi: 10.1002/1097-0142(19820115)49:2<224::aid-cncr2820490205>3.0.co;2-o. [DOI] [PubMed] [Google Scholar]
  31. Moseley R. P., Oge K., Shafqat S., Moseley C. M., Sullivan N. M., Badley R. A., Burchell J., Taylor-Papadimitriou J., Coakham H. B. HMFG1 antigen: a new marker for carcinomatous meningitis. Int J Cancer. 1989 Sep 15;44(3):440–444. doi: 10.1002/ijc.2910440310. [DOI] [PubMed] [Google Scholar]
  32. Olson M. E., Chernik N. L., Posner J. B. Infiltration of the leptomeninges by systemic cancer. A clinical and pathologic study. Arch Neurol. 1974 Feb;30(2):122–137. doi: 10.1001/archneur.1974.00490320010002. [DOI] [PubMed] [Google Scholar]
  33. Ongerboer de Visser B. W., Somers R., Nooyen W. H., van Heerde P., Hart A. A., McVie J. G. Intraventricular methotrexate therapy of leptomeningeal metastasis from breast carcinoma. Neurology. 1983 Dec;33(12):1565–1572. doi: 10.1212/wnl.33.12.1565. [DOI] [PubMed] [Google Scholar]
  34. Pectasides D., Stewart S., Courtenay-Luck N., Rampling R., Munro A. J., Krausz T., Dhokia B., Snook D., Hooker G., Durbin H. Antibody-guided irradiation of malignant pleural and pericardial effusions. Br J Cancer. 1986 Jun;53(6):727–732. doi: 10.1038/bjc.1986.125. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Posner J. B. Management of central nervous system metastases. Semin Oncol. 1977 Mar;4(1):81–91. [PubMed] [Google Scholar]
  36. Schabet M., Kloeter I., Adam T., Heidemann E., Wiethölter H. Diagnosis and treatment of meningeal carcinomatosis in ten patients with breast cancer. Eur Neurol. 1986;25(6):403–411. doi: 10.1159/000116043. [DOI] [PubMed] [Google Scholar]
  37. Shapiro W. R., Posner J. B., Ushio Y., Chemik N. L., Young D. F. Treatment of meningeal neoplasms. Cancer Treat Rep. 1977 Jul;61(4):733–743. [PubMed] [Google Scholar]
  38. Smith S., Thomas R. M., Steere H. A., Beatty H. E., Dawson K. B., Peckham M. J. Therapeutic irradiation of the central nervous system using intrathecal 90Y--DTA. Br J Radiol. 1976 Feb;49(578):141–147. doi: 10.1259/0007-1285-49-578-141. [DOI] [PubMed] [Google Scholar]
  39. Taylor-Papadimitriou J., Peterson J. A., Arklie J., Burchell J., Ceriani R. L., Bodmer W. F. Monoclonal antibodies to epithelium-specific components of the human milk fat globule membrane: production and reaction with cells in culture. Int J Cancer. 1981 Jul 15;28(1):17–21. doi: 10.1002/ijc.2910280104. [DOI] [PubMed] [Google Scholar]
  40. Thorpe P. E., Brown A. N., Bremner J. A., Jr, Foxwell B. M., Stirpe F. An immunotoxin composed of monoclonal anti-Thy 1.1 antibody and a ribosome-inactivating protein from Saponaria officinalis: potent antitumor effects in vitro and in vivo. J Natl Cancer Inst. 1985 Jul;75(1):151–159. [PubMed] [Google Scholar]
  41. Wang J. J., Pratt C. B. Intrathecal arabinosyl cytosine in meningeal leukemia. Cancer. 1970 Mar;25(3):531–534. doi: 10.1002/1097-0142(197003)25:3<531::aid-cncr2820250306>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  42. Ward B. G., Cruickshank D. J. Circulating tumor-associated antigen detected by the monoclonal antibody HMFG2 in human epithelial ovarian cancer. Int J Cancer. 1987 Jan 15;39(1):30–33. doi: 10.1002/ijc.2910390107. [DOI] [PubMed] [Google Scholar]
  43. Wasserstrom W. R., Glass J. P., Posner J. B. Diagnosis and treatment of leptomeningeal metastases from solid tumors: experience with 90 patients. Cancer. 1982 Feb 15;49(4):759–772. doi: 10.1002/1097-0142(19820215)49:4<759::aid-cncr2820490427>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  44. Wikstrand C. J., Grahmann F. C., McComb R. D., Bigner D. D. Antigenic heterogeneity of human anaplastic gliomas and glioma-derived cell lines defined by monoclonal antibodies. J Neuropathol Exp Neurol. 1985 May;44(3):229–241. doi: 10.1097/00005072-198505000-00002. [DOI] [PubMed] [Google Scholar]
  45. Yap H. Y., Yap B. S., Rasmussen S., Levens M. E., Hortobagyi G. N., Blumenschein G. R. Treatment for meningeal carcinomatosis in breast cancer. Cancer. 1982 Jul 15;50(2):219–222. doi: 10.1002/1097-0142(19820715)50:2<219::aid-cncr2820500209>3.0.co;2-7. [DOI] [PubMed] [Google Scholar]
  46. Yap H. Y., Yap B. S., Tashima C. K., DiStefano A., Blumenschein G. R. Meningeal carcinomatosis in breast cancer. Cancer. 1978 Jul;42(1):283–286. doi: 10.1002/1097-0142(197807)42:1<283::aid-cncr2820420142>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  47. Zalutsky M. R., Knapp R. C., Bast R. C., Jr Influence of circulating antigen on blood pool activity of a radioiodinated monoclonal antibody. Int J Rad Appl Instrum B. 1988;15(4):431–437. doi: 10.1016/0883-2897(88)90014-1. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Neurology, Neurosurgery, and Psychiatry are provided here courtesy of BMJ Publishing Group

RESOURCES