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Effect of Platelet-Derived Growth Factor Receptor-ß Inhibition with STI571 on Radioimmunotherapy

Departments of ¹ Radiation Oncology and ² Pathology and Microbiology, University of Nebraska Medical Center, Omaha, Nebraska; ³ Department of Surgery II, National Hospital Organization, Kumamoto University Medical School, Kumamoto, Japan; and ⁴ Ludwig Institute for Cancer Research and ⁵ Department of Pathology-Oncology, Karolinska Institute, Stockholm, Sweden

Requests for reprints: Janina Baranowska-Kortylewicz, Department of Radiation Oncology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE 68198-6850. Phone: 402-559-8906; Fax: 402-559-9127; E-mail: jbaranow{at}unmc.edu.

Whereas radioimmunotherapy of hematologic malignancies has evolved into a viable treatment option, the responses of solid tumors to radioimmunotherapy are discouraging. The likely cause of this problem is the interstitial hypertension inherent to all solid tumors. Remarkable improvements in tumor responses to radioimmunotherapy were discovered after the inclusion of STI571 in the therapy regimen. A combination of the tumor stroma–reactive STI571, a potent platelet-derived growth factor receptor-ß (PDGFr-ß) antagonist, and the tumor-seeking radiolabeled antibody B72.3 yielded long-lasting growth arrest of the human colorectal adenocarcinoma LS174T grown as s.c. xenografts in athymic mice. The interaction of STI571 with the stromal PDGFr-ß reduced tumor interstitial fluid pressure (P_IF) by >50% and in so doing improved the uptake of B72.3. The attenuation of P_IF also had a positive effect on the homogeneity of antibody distribution. These effects were dose-dependent and under optimized dosing conditions allowed for a 2.45 times increase in the tumor uptake of B72.3 as determined in the biodistribution studies. Single-photon emission computed tomography imaging studies substantiated these results and indicated that the homogeneity of the radioisotope distribution was also much improved when compared with the control mice. The increased uptake of radioimmunotherapy into the tumor resulted in >400% increase in the tumor absorbed radiation doses in STI571 + radioimmunotherapy–treated mice compared with PBS + radioimmunotherapy–treated mice. The improved antibody uptake in response to the attenuation of tumor P_IF was identified as the primary reason for the growth arrest of the STI571 + radioimmunotherapy–treated tumors. Two related causes were also identified: (a) the improved homogeneity of monoclonal antibody distribution in tumor and (b) the increased tumor radiosensitivity resulting from the improved tumor oxygenation.

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