Monte Carlo Calculation of Radioimmunotherapy with⁹⁰Y-,¹⁷⁷Lu-,¹³¹I-,¹²⁴I-, and¹⁸⁸Re-Nanoobjects: Choice of the Best Radionuclide for Solid Tumour Treatment by Using TCP and NTCP Concepts

Abstract

Radioimmunotherapy has shown that the use of monoclonal antibodies combined with a radioisotope like 131I or 90Y still remains ineffective for solid and radioresistant tumour treatment. Previous simulations have revealed that an increase in the number of 90Y labelled to each antibody or nanoobject could be a solution to improve treatment output. It now seems important to assess the treatment output and toxicity when radionuclides such as 90Y, 177Lu, 131I, 124I, and 188Re are used. Tumour control probability (TCP) and normal tissue complication probability (NTCP) curves versus the number of radionuclides per nanoobject were computed with MCNPX to evaluate treatment efficacy for solid tumours and to predict the incidence of surrounding side effects. Analyses were carried out for two solid tumour sizes of 0.5 and 1.0 cm radius and for nanoobject (i.e., a radiolabelled antibody) distributed uniformly or nonuniformly throughout a solid tumour (e.g., Non-small-cell-lung cancer (NSCLC)). 90Y and 188Re are the best candidates for solid tumour treatment when only one radionuclide is coupled to one carrier. Furthermore, regardless of the radionuclide properties, high values of TCP can be reached without toxicity if the number of radionuclides per nanoobject increases.

Gold Nanoparticles as a Potent Radiosensitizer: A Transdisciplinary Approach from Physics to Patient

“…One of the current challenges is to maximize the differential response between tumor and healthy tissues. The likelihood for a tumor to be controlled is called the tumor control probability (TCP), while the one for the healthy tissue side-effect is called normal tissue complication probability (NTCP) [11]. These probabilities are represented by a sigmoid function according to the dose, as illustrated in Figure 1.…”

Translational radionanomedicine: a clinical perspective

“…Firstly, nanoparticles for internal radiotherapy can be labeled with multiple radionuclides, which can make it harder to estimate radiation dosimetry. Recent reports suggest that the combination of different types of beta-emitters could be effective for internal radiotherapy according to the tumor size and uptake of nanoparticles (90,91). Various therapeutic radionuclides with different beta-ray energy such as 90 Y and 177 Lu can be combined for a personalized optimal ratio according to the tumor properties (90).…”

Monoclonal Antibodies Radiolabeling with Rhenium-188 for Radioimmunotherapy

“…Quantitative measurements of the distribution of an iodine-131 labeled antibody to carcinoembryonic antigen carried out in relation to time by Begent et al [ 9 ] have demonstrated that the maximum tumor uptake of radiolabeled IgG injected into humans occurs within 8 hours after administration. Moreover, Lucas et al [ 10 ] and Xiao et al [ 11 ] demonstrated that rhenium-188 is the best candidate for solid tumors treatment such as for non-small-cell lung cancer (NSCLC).…”