Capromab pendetide

Compound Name:Capromab pendetideMolecular Target:Prostate Specific Membrane Antigen (PSMA)Molecular Structure:murine monoclonal IgG1?, indium-111 labeledLicensed Indication:Diagnostic imaging of metastatic prostate cancer in newly diagnosed, high risk patientsManufacturer and/or Distributor:CytogenInitial FDA Approval1996SummaryCapromab pendetide (ProstaScint) is a murine monoclonal IgG1k directed against prostate specific membrane antigen (PSMA) for use as a diagnostic imaging modality. PSMA expression is higher in prostate adenocarcinoma cells than in nonmalignant cells, and it is higher in metastatic lesions than in primary lesions. Capromab pendetide is indicated as an adjunctive imaging tool in newly diagnosed patients suspected to be high-risk for pelvic lymph node metastases, and in post prostatectomy patients with a rising PSA and a negative or equivocal standard metastatic evaluation, in whom there is a high clinical suspicion of occult metastatic disease. Other monoclonal antibodies, directed at extracellular PSMA binding sites, are also under development.

 Capromab is conjugated with Indium-111 within 8 hours of use. Indium-111 is a radioactive isotope (g emission) with a half-life of 2.8 days. Imaging by SPECT will demonstrate sites of metastatic prostatic cancer, although false positives and false negatives are sufficiently frequent that the scans need to be interpreted carefully in light of additional clinical data.

 Adverse reactions include changes in blood pressure and abnormalities of the liver function tests. A minority of patients produces antibodies to capromab (human anti-mouse antibodies, or HAMA), of uncertain clinical significance. Allergic reactions, including anaphylaxis, can occur in patients.References

Prescribing information:

1. Hinkle GH, Burgers JK, Neal CE, Texter JH, Kahn D, Williams RD, et al. Multicenter radioimmunoscintigraphic evaluation of patients with prostate carcinoma using indium-111 capromab pendetide. Cancer. 1998 Aug 15;83(4):739-747.

2. Mouraviev V, Madden JF, Broadwater G, Mayes JM, Burchette JL, Schneider F, et al. Use of 111in-capromab pendetide immunoscintigraphy to image localized prostate cancer foci within the prostate gland. J Urol. 2009 Sep;182(3):938-947.

3. Kelloff GJ, Choyke P, Coffey DS. Challenges in clinical prostate cancer: role of imaging. AJR Am J Roentgenol. 2009 Jun;192(6):1455-1470.

4. Perner S, Hofer MD, Kim R, Shah RB, Li H, Moller P, et al. Prostate-specific membrane antigen expression as a predictor of prostate cancer progression. Hum Pathol. 2007 May;38(5):696-701.

5. Schuster DM, Nieh PT, Jani AB, Amzat R, Bowman FD et al. Anti-3-[(18)F]FACBC positron emission tomography-computerized tomography and (111)In-capromab pendetide single photon emission computerized tomography-computerized tomography for recurrent prostate carcinoma: results of a prospective clinical trial. J Urol. 2014 May;191(5):1446-53.

6. Rizvi T, Deng C, Rehm PK. Indium-111 Capromab Pendetide (ProstaScint(®)) Demonstrates Renal Cell Carcinoma and Aortocaval Nodal Metastases from Prostate Adenocarcinoma. World J Nucl Med. 2015 Sep-Dec;14(3):209-11.