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Immunoscintigraphic Detection of the ED-B Domain of Fibronectin, a Marker of Angiogenesis, in Patients with Cancer¹

Servizio di Medicina Nucleare, Ospedale M. Bufalini, 47023 Cesena, Italy [M. S., G. M., P. R.]; Division of Neurosurgery Di.S.C.A.T. Department of Surgery, University of Genoa, Medical School, 16132 Genoa, Italy [G. L. V.]; Philogen S.r.l., 53100 Siena, Italy [L. G., G. N., F. V., A. L.]; Istituto Nazionale per la Ricerca sul Cancro, 16132 Genova, Italy [L. B., P. C., L. Z.]; Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology Zurich, CH-8057 Zurich, Switzerland [D. N.]; and Istituto Oncologico Romagnolo, Forlì, Italy [P. R.]

Purpose: ED-B fibronectin is expressed only during angiogenic processes and in tissues undergoing growth and/or extensive remodeling. We demonstrated previously the possibility to target and selectively deliver therapeutic substances to tumor vasculature in experimental animal models using a human recombinant antibody fragment, L19, specific for the ED-B domain of fibronectin. Here we evaluate the possibility of targeting primary tumors and metastatic lesions in cancer patients through immunoscintigraphy using ¹²³I-labeled dimeric L19 [L19(scFv)₂].

Experimental Design: Twenty patients (34–79 years of age) with lung, colorectal, or brain cancer, whose tumors had been confirmed by imaging techniques and/or histologically, were admitted to the immunoscintigraphic investigation.

Results: The dimeric L19 antibody selectively localized in tumor lesions in aggressive types of lung cancer and colorectal cancer. Because ED-B fibronectin is expressed only during angiogenic processes and in tissues undergoing growth and/or extensive remodeling, L19(scFv)₂ is able to distinguish between quiescent and actively growing lesions. No side effects were observed.

Conclusions: The ability of L19(scFv)₂ to target tumors in patients provides the foundations for new therapeutic applications, in which the L19 antibody is engineered to selectively deliver bioactive molecules to primary tumors as well as to metastases.

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