Use of I-131 labeled, murine Fab against a high molecular weight antigen of human melanoma: preliminary experience.

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Abstract
High MW antigen (HMWA) is a tumor-associated proteoglycan of human malignant melanoma. 131I labeled Fab fragments of these specific antibodies were used for preliminary feasibility studies for radioimmunodetection and therapy of human subjects who had inoperable metastatic melanoma. Ten patients received tracer doses of 5-13 mCi (185-481 MBq [megabecquerels]) 131I (anti-HMWA) Fab. All patients (8/8) who had melanoma lesions > 1 cm by correlative diagnostic methods had one or more lesions that had localization to tumor of the radiolabeled Fab. In all, 17 of 23 (74%) documented metastases were seen. There were no false positives in this series. Two patients who had avid uptake received potentially radiotherapeutic doses of 142 mCi (5254 MBq) (1 patient) and 181 mCi (6697 MBq) and 193 (7141 MBq) (total: 374 mCi or 13,838 MBq) (1 patient). For both of these patients, whole body imaging studies showed that the localization of the high dose 131I Fab was predominantly in tumor. The patient who received the larger dose showed a > 50% reduction in the size of pelvic and pericaval nodes, with stabilization of disease at the smaller nodal size for a period of 3 mo. On whole body images, the anti-Fab HMWA appears to be more tumor selective than Fab preparations that target the p97 antigen for melanoma, and there is less uptake in liver.

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