在去除肿瘤和标准辅助放射治疗和化疗之后，目前缺乏针对胶质母细胞瘤的批准使用的维持疗法。将注射到切除腔内的以177Lu标记的6A10-Fab片段瞄准肿瘤相关型碳酸酐酶XII的局部放射免疫治疗（iRIT）为改善肿瘤控制提供了一种新的有希望的策略。三名胶质母细胞瘤患者在完成标准治疗后病情稳定，出于同情的原因接受了iRIT治疗。在将注射器埋入切除腔的皮下注射腔内之后，通过[99mTc]Tc-DTPA进行渗漏测试以排除渗漏到其他脑区的可能性。IRIT治疗方案包括对每个患者连续三个月进行三次注射，注射总活性的25%、50%和25%。剂量学方案包括血液采样和腹部SPECT/CT以计算骨髓和肾脏作为潜在风险器官的剂量。所有三名患者在应用[99mTc]Tc-DTPA后没有发生渗漏问题。两名患者接受了三个完整周期的iRIT治疗（总活性分别为592 MBq和1228 MBq）。一名患者在第二周期治疗后经组织学证实出现肿瘤进展（总活性为526 MBq）。未观察到与治疗相关的重要毒性或不良事件。剂量计算未显示达到危险器官的上限剂量。根据个案分析，[177Lu]Lu-6A10-Fab的iRIT似乎是可行和安全的，没有治疗相关的副作用。一项证实性的多中心Ⅰ期临床试验最近已经开放并正在招募病例。 Copyright © 2023. Springer-Verlag GmbH Germany, part of Springer Nature.

Following resection and standard adjuvant radio- and chemotherapy, approved maintenance therapies for glioblastoma are lacking. Intracavitary radioimmunotherapy (iRIT) with 177Lu-labeled 6A10-Fab fragments targeting tumor-associated carbonic anhydrase XII and injected into the resection cavity offers a novel and promising strategy for improved tumor control.Three glioblastoma patients underwent tumor resection followed by standard radio- and chemotherapy. These patients with stable disease following completion of standard therapy underwent iRIT on compassionate grounds. After surgical implantation of a subcutaneous injection reservoir with a catheter into the resection cavity, a leakage test with [99mTc]Tc-DTPA was performed to rule out leakage into other cerebral compartments. IRIT comprised three consecutive applications over three months for each patient, with 25%, 50%, 25% of the total activity injected. A dosimetry protocol was included with blood sampling and SPECT/CT of the abdomen to calculate doses for the bone marrow and kidneys as potential organs at risk.All three patients presented without relevant leakage after application of [99mTc]Tc-DTPA. Two patients underwent three full cycles of iRIT (592 MBq and 1228 MBq total activity). One patient showed histologically proven tumor progression after the second cycle (526 MBq total activity). No relevant therapy-associated toxicities or adverse events were observed. Dosimetry did not reveal absorbed doses above upper dose limits for organs at risk.In first individual cases, iRIT with [177Lu]Lu-6A10-Fab appears to be feasible and safe, without therapy-related side effects. A confirmatory multicenter phase-I-trial was recently opened and is currently recruiting.© 2023. Springer-Verlag GmbH Germany, part of Springer Nature.