Improved immunoscintigraphy by subcutaneous injection of 99Tc or 111In labelled F(ab')2 fragments of an anti-melanoma monoclonal antibody

Technetium-99m and/or 111In labelled F(ab′)2 fragments of a melanoma associated MoAb 225.28S were injected i.v. in 80 patients affected by stage I to IV malignant melanoma. Seventy five percent of metastatic lesions already documented by other methods were detected by immunoscintigraphy, which was also capable of detecting a certain number of unknown metastases. However, we observed a lower percentage of positive scans in liver, lung and skin because of the poor tumour to background ratio. In some patients, subcutaneous (s.c.) injection allowed us to visualize documented metastases undetected by i.v. administration. An equal amount of non-specific F(ab′)2 fragments (MoAb 4C4) injected s.c. as a negative control showed no positive scans. Clinical studies and Chromatographic patterns of patient serum samples suggest that the s.c. route of administration offers, with respect to the i.v. route, the advantage of reducing vascular background and aspecific accumulation in liver, probably because of retention of possible contaminants by the lymphatic system.