Therapy of solid tumours using targeting agents such as tumour cell-directed monoclonal antibodies (mAbs) has proven to be difficult due to the relatively low fraction of the total dose delivered specifically to the tumour. It has been postulated for some time (Denekamp, 1984) that the tumour blood vessels are more accessible targets for directed therapy. Recent work has shown that agents which interfere with new blood vessel formation (angiogenesis) are capable of inhibiting tumour growth in experimental animals (Kim et al, 1993;O'Reilly et al, 1995O'Reilly et al, , 1997Borgström et al, 1996). The drawback of this approach is that once treatment is stopped, the tumours grow rapidly and eventually prove fatal. Another approach utilized immunotoxins specific for tumour blood vessels. In a model system, an immunotoxin, targeted to major histocompatability complex components induced in blood vessels through genetically altered tumour cells, proved to be therapeutic (Burrows and Thorpe, 1994) and infarction and cure of tumours was observed.For therapy of small metastases, it is desirable to destroy both the tumour blood vessels and the tumour cells. In this work, shortrange, high linear energy transfer (LET) radiation ( 213 Bi) was targeted to blood vessels feeding tumours in the lung. The mAb used, mAb 201B, binds to murine thrombomodulin (TM). TM is expressed selectively and in large amounts on the lumenal surfaces of capillaries and small blood vessels in the lung. mAb 201B injected intravenously (i.v.) localizes quickly and in high concentration in murine lung (Kennel et al, 1990). This system was used previously to target the β-particle emitter 131 I to lungs bearing tumours, resulting in a marginal therapeutic effect (Blumenthal et al, 1992). The localization characteristics of mAb 201B allow targeting of short half-lived isotopes such as the α-particle emitter 213 Bi (t 1 /2 = 45 min), with delivery of a large fraction of the absorbed dose to the lung as a target . The model of experimental lung tumour colonies has been used to test the efficiency of vascular-targeted 213 Bi for radioimmunotherapy. In this system, tumour cells injected i.v. lodge in the lung and form colonies. mAb 201B is then used to deliver 213 Bi to all the lung vessels, including those which feed the tumour colonies. The tissue range of the 213 Bi α-particle is 60-100 µ and thus should produce damage not only to lung vessels, but also to the tumour cells adjacent to the vessels. A preliminary paper has shown that high-dose therapy resulted in tumour cures, but that collateral lung damage occurred (Kennel and Mirzadeh, 1998). Dose-response experiments and radioimmunotherapy with different tumour types were necessary to assess the limits of effectiveness of this approach. We show herein that lung tumour colonies can be significantly reduced by this treatment in five different tumour types with relatively low doses of radioisotope and that tumours which are immunogenic in the host can be cured completely. Summary A model system has been used...