Radioimmunotherapy of Breast Cancer Metastases with Alpha-Particle-emitter 225Ac: Comparing Efficacy with 213Bi, 90Y

Alpha-particles are suitable to treat cancer micrometastases because of their short range and very high linear energy transfer. Alpha-particle-emitter 213Bi based radioimmunotherapy has shown efficacy in a variety of metastatic animal cancer models, such as breast, ovarian, prostate cancer and leukemia. Its clinical implementation, however, is challenging due to the limited supply of 225Ac, the high technical requirement to prepare radioimmunoconjugate with very short half-life (T1/2=45.6 mins) on site and prohibitive cost. In this study, we investigated the efficacy of the alpha-particle emitter 225Ac, parent of 213Bi, in a mouse model of breast cancer metastases. A single administration of 225Ac (400 nCi) labeled anti-rat HER-2/neu monoclonal antibody (7.16.4) completely eradicated breast cancer lung micrometastases in about 67% of HER-2/neu transgenic mice and led to long-term survival of these mice for up to one year. Treatment with 225Ac-7.16.4 is significantly more effective than 213Bi-7.16.4 (120 µCi) (median survival = 61 days, P=0.001), and 90Y-7.16.4 (120 µCi) (median survival = 50 days, P