Intracavitary radioimmunotherapy of high-grade gliomas: present status and future developments

Hans-Jürgen Reulen, Eric Suero Molina, Reinhard Zeidler, Franz Josef Gildehaus, Guido Böning, Astrid Gosewisch, Walter Stummer

Research output: Contribution to journalReview articlepeer-review

11 Citations (Scopus)


There is a distinct need for new and second-line therapies to delay or prevent local tumor regrowth after current standard of care therapy. Intracavitary radioimmunotherapy, in combination with radiotherapy, is discussed in the present review as a therapeutic strategy of high potential. We performed a systematic literature search following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The available body of literature on intracavitary radioimmunotherapy (iRIT) in glioblastoma and anaplastic astrocytomas is presented. Several past and current phase I and II clinical trials, using mostly an anti-tenascin monoclonal antibody labeled with I-131, have shown median overall survival of 19–25 months in glioblastoma, while adverse events remain low. Tenascin, followed by EGFR and variants, or smaller peptides have been used as targets, and most clinical studies were performed with I-131 or Y-90 as radionuclides while only recently Re-188, I-125, and Bi-213 were applied. The pharmacokinetics of iRIT, as well as the challenges encountered with this therapy, is comprehensively discussed. This promising approach deserves further exploration in future studies by incorporating several innovative modifications.

Original languageEnglish
Pages (from-to)1109-1124
Number of pages16
JournalActa Neurochirurgica
Issue number6
Publication statusPublished - 1 Jun 2019
Externally publishedYes


  • Glioblastomas
  • High-grade gliomas
  • Intracavitary radioimmunotherapy
  • Locoregional therapy
  • Malignant gliomas


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