Intraoperative avidination for radionuclide therapy: A prospective new development to accelerate radiotherapy in breast cancer

Giovanni Paganelli, Mahila Ferrari, Laura Ravasi, Marta Cremonesi, Concetta De Cicco, Viviana Galimberti, Gregory Sivolapenko, Alberto Luini, Rita De Santis, Laura Lavinia Travaini, Maurizio Fiorenza, Marco Chinol, Stefano Papi, Claudio Zanna, Paolo Carminati, Umberto Veronesi

Research output: Contribution to journalArticle

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Abstract

Purpose: In a continuous effort to seek for anticancer treatments with minimal side effects, we aimat proving the feasibility of the Intraoperative Avidination for Radionuclide Therapy, a new procedure for partial breast irradiation. Experimental Design: To assess doses of 90Y-DOTA-biotin to target (i.e., breast tumor bed) and nontarget organs, we did simulation studies with 111In-DOTA-biotin in 10 candidates for conservative breast surgery. Immediately after quadrantectomy, patients were injected with 100-mg avidin in the tumor bed. On the following day, patients were given 111In-DOTA-biotin (∼111MBq) i.v. after appropriate chase of biotinylated albumin (20 mg) to remove circulating avidin. Biokinetic studies were done by measuring radioactivity in scheduled blood samples, 48-h urine collection, and through scintigraphic images. The medical internal radiation dose formalism (OLINDA code) enabled dosimetry assessment in target and nontarget organs. Results: Images showed early and long-lasting radioactive biotin uptake in the operated breast. Rapid blood clearance (75% at 24 h) were observed. Absorbed doses, expressed as mean ± SD in Gy/GBq, were as low as 0.15 ± 0.05 in lungs, 0.10 ± 0.02 in heart, 0.06 ± 0.02 in red marrow, 1.30 ± 0.50 in kidneys, 1.50 ± 0.30 in urinary bladder, and 0.06 ± 0.02 in total body, whereas in the targeted area, they increased to 5.5 ± 1.1 Gy/GBq (50% ISOROI) and 4.8 ± 1.0 Gy/GBq (30% ISOROI). Conclusion: Our preliminary results suggest that Intraoperative Avidination for Radionuclide Therapy is a simple and feasible procedure that may improve breast cancer patients' postsurgical management by shortening radiotherapy duration.

Original languageEnglish
JournalClinical Cancer Research
Volume13
Issue number18
DOIs
Publication statusPublished - Sep 15 2007

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Radioisotopes
Breast
Radiotherapy
Avidin
Breast Neoplasms
Urine Specimen Collection
Biotin
Radioactivity
Albumins
Urinary Bladder
Research Design
Therapeutics
Bone Marrow
Radiation
Kidney
Lung
DOTA-biotin
Neoplasms
indium-111-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Intraoperative avidination for radionuclide therapy : A prospective new development to accelerate radiotherapy in breast cancer. / Paganelli, Giovanni; Ferrari, Mahila; Ravasi, Laura; Cremonesi, Marta; De Cicco, Concetta; Galimberti, Viviana; Sivolapenko, Gregory; Luini, Alberto; De Santis, Rita; Travaini, Laura Lavinia; Fiorenza, Maurizio; Chinol, Marco; Papi, Stefano; Zanna, Claudio; Carminati, Paolo; Veronesi, Umberto.

In: Clinical Cancer Research, Vol. 13, No. 18, 15.09.2007.

Research output: Contribution to journalArticle

Paganelli, Giovanni ; Ferrari, Mahila ; Ravasi, Laura ; Cremonesi, Marta ; De Cicco, Concetta ; Galimberti, Viviana ; Sivolapenko, Gregory ; Luini, Alberto ; De Santis, Rita ; Travaini, Laura Lavinia ; Fiorenza, Maurizio ; Chinol, Marco ; Papi, Stefano ; Zanna, Claudio ; Carminati, Paolo ; Veronesi, Umberto. / Intraoperative avidination for radionuclide therapy : A prospective new development to accelerate radiotherapy in breast cancer. In: Clinical Cancer Research. 2007 ; Vol. 13, No. 18.
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abstract = "Purpose: In a continuous effort to seek for anticancer treatments with minimal side effects, we aimat proving the feasibility of the Intraoperative Avidination for Radionuclide Therapy, a new procedure for partial breast irradiation. Experimental Design: To assess doses of 90Y-DOTA-biotin to target (i.e., breast tumor bed) and nontarget organs, we did simulation studies with 111In-DOTA-biotin in 10 candidates for conservative breast surgery. Immediately after quadrantectomy, patients were injected with 100-mg avidin in the tumor bed. On the following day, patients were given 111In-DOTA-biotin (∼111MBq) i.v. after appropriate chase of biotinylated albumin (20 mg) to remove circulating avidin. Biokinetic studies were done by measuring radioactivity in scheduled blood samples, 48-h urine collection, and through scintigraphic images. The medical internal radiation dose formalism (OLINDA code) enabled dosimetry assessment in target and nontarget organs. Results: Images showed early and long-lasting radioactive biotin uptake in the operated breast. Rapid blood clearance (75{\%} at 24 h) were observed. Absorbed doses, expressed as mean ± SD in Gy/GBq, were as low as 0.15 ± 0.05 in lungs, 0.10 ± 0.02 in heart, 0.06 ± 0.02 in red marrow, 1.30 ± 0.50 in kidneys, 1.50 ± 0.30 in urinary bladder, and 0.06 ± 0.02 in total body, whereas in the targeted area, they increased to 5.5 ± 1.1 Gy/GBq (50{\%} ISOROI) and 4.8 ± 1.0 Gy/GBq (30{\%} ISOROI). Conclusion: Our preliminary results suggest that Intraoperative Avidination for Radionuclide Therapy is a simple and feasible procedure that may improve breast cancer patients' postsurgical management by shortening radiotherapy duration.",
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AU - Paganelli, Giovanni

AU - Ferrari, Mahila

AU - Ravasi, Laura

AU - Cremonesi, Marta

AU - De Cicco, Concetta

AU - Galimberti, Viviana

AU - Sivolapenko, Gregory

AU - Luini, Alberto

AU - De Santis, Rita

AU - Travaini, Laura Lavinia

AU - Fiorenza, Maurizio

AU - Chinol, Marco

AU - Papi, Stefano

AU - Zanna, Claudio

AU - Carminati, Paolo

AU - Veronesi, Umberto

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