ABSTRACT
This chapter describes clinical experiences with radioimmunotherapy (RAIT) and focuses on three interrelated factors that dictate the therapeutic ratio of RAIT. They are biological mechanisms that determine response in human tumor cells and in normal tissue; dose delivered to these tissues both at the micro and macro levels; and properties of radioimmunoconjugates that alter biodistribution and time-dose relationships in tissues and normal tissues. The chapter discusses possible use of different radioimmunoconjugates and injection schedules that may optimize time-dose patterns delivered to tumors and to normal tissues and improve the therapeutic ratio. It suggests new approaches to clinical RAIT trials that will incorporate and test the insights provided by authors’ analyses. The potential clinical impact of RAIT is being defined through laboratory investigation and phase one and two trials. As a systemic therapy RAIT should have future application for treating metastatic, subclinical disease.
