Background: The targeted delivery of bioactive molecules with antibodies specific to tumorassociated antigens represents a promising strategy for improving the efficacy of tumor therapy. The large isoform of tenascin-C, an abundant glycoprotein of the tumor extracellular matrix, is strongly overexpressed in adult tissue undergoing tissue remodeling, including wound healing and neoplasia, and has been implicated in a variety of different cancers while being virtually undetectable in most normal adult tissues. Experimental Design: We have used antibody phage technology to generate good-quality human recombinant antibodies (F16 and P12) specific to the alternatively spliced domains A1 and D of the large isoform of tenascin-C. The tumor-targeting properties of F16 and P12 were assessed by biodistribution studies in tumor xenografts using the antibodies in small immunoprotein (SIP) format. Results: SIP(F16) selectively accumulated at the tumor site with 4.5%ID/g at 24 hours in the U87 glioblastoma model but was rapidly cleared from other organs (tumor-to-organ ratios, f10:1). The accumulation of SIP(P12) in the tumor was lower compared with SIP(F16) and persistent levels of radioactivity were observed in the intestine. Conclusions:These data suggest that the F16 antibody, specific to domain A1of tenascin-C, is a promising building block for the development of antibody-based pharmaceuticals in view of its excellent tumor-targeting performance and the strong expression of the antigen in a variety of primary and metastatic tumors.A promising avenue toward the development of more selective anticancer therapies consists in the targeted delivery of bioactive molecules (antibody constant regions, cytokines, drugs, radionuclides, photosensitizers, procoagulant factors, etc.) to the tumor environment by means of ligands specific to good-quality tumor-associated antigens and endowed with suitable pharmacokinetic properties (1 -7).Antigens that are preferentially expressed in the modified tumor extracellular matrix are, in many respects, ideal targets for tumor-targeting applications (2, 8). Extracellular matrix components are often more abundant and more stable than antigens located on the surface of tumor cells. Furthermore, they typically exhibit a low shedding profile and are well accessible to agents (such as antibody derivatives) coming from the bloodstream. In collaboration with the Zardi group (Genova, Italy), our group has extensively shown the tumortargeting potential of antibodies directed against components of the tumor extracellular matrix using, as an example, the L19 human monoclonal antibody (9), specific to the extradomain B of fibronectin (EDB), a marker of angiogenesis (10 -12). The L19 antibody was shown to efficiently target tumor neovasculature and stromal structures in animal models of cancer (13) The EDB domain of fibronectin is a good-quality marker of angiogenesis, which is overexpressed in a variety of solid tumors (renal cell carcinoma, colorectal carcinoma, hepatocellular carcinoma, high-g...