Quantitative distribution of 131I-labelled monoclonal antibodies administered by the intra-ventricular route

Revisiting Cerebrospinal Fluid Flow Direction and Rate in Physiologically Based Pharmacokinetic Model

“…Importantly, bidirectional pulsatile CSF movement allows substances in the CSF to mix and spread in both directions. This is clearly demonstrated in the study reported by Smith et al [59], where 111 In-and 99m Tc-labeled diethylenetriamine pentaacetate (DTPA) were administered to the right LV and lumbar CSF, respectively, of the same patient at almost the same time, and time-dependent distribution from the injection site to the other site was observed in both directions. [ 99m Tc]DTPA concentrations in the right LV after IT administration cannot be explained by its re-entry to CSF across the BCSFB after first being absorbed into systemic circulation given the poor BCSFB penetration of DTPA-chelates [60]; thus, its distribution from lumbar SAS to the LV is a result of the upward movement of [ 99m Tc]DTPA against the traditional CSF flow direction.…”

Chemotherapy in neoplastic meningitis

“…A relatively novel approach is the use of monoclonal antibodies (MAbs) selectively directed against specific tumoral antigens. Most studies utilized monoclonal tumor-specific or tumor-restricted Mabs linked to 131 Iodine for intraventricular or lumbar administration [42,43]. The use of intracavity 131 IMAb has been explored in patients with neoplastic meningitis from different tumors (PNET, lymphoma, leukemia, melanoma, glioma and carcinoma) with progressive disease after conventional therapy.…”