The Potential of Astatine-211-MX35-F(ab’)2 in Ovarian Cancer Treatment

The development and characterisation of Astatine-211-MX35-F(ab’)2, a radiolabelled antibody fragment, represents a significant stride in the treatment of ovarian cancer. This therapeutic agent leverages a murine IgG1-class monoclonal antibody, MX35, targeted at a specific cell-surface glycoprotein on OVCAR-3 cells, prevalent in approximately 90% of human epithelial ovarian cancers. Employed through intraperitoneal administration, this molecule delivers therapeutic absorbed doses directly to microscopic tumour clusters, demonstrating effective treatment potential with minimal toxicity. It is currently in open clinical trials in Copenhagen, Denmark, and Gothenburg, Sweden, highlighting its promising application in managing ovarian cancer despite the lack of funding for full drug development.

The Development of Astatine-211-MX35-F(ab’)2

In the quest to find more effective treatments for ovarian cancer, researchers at the Memorial Sloan-Kettering Cancer Center in New York have developed 211At-MX35-F(ab’)2, a pioneering radiolabelled antibody fragment. This novel therapeutic agent is designed to target OVCAR-3 cells, which are known to express a particular cell-surface glycoprotein of 95 kDa. The MX35 antibody, a murine IgG1-class monoclonal antibody, is directed towards this glycoprotein, displaying strong and homogeneous expression on roughly 90% of human epithelial ovarian cancers. This specificity makes 211At-MX35-F(ab’)2 a highly potent tool in the arsenal against ovarian cancer.

Mechanism of Action and Administration

The mechanism of action of Astatine-211-MX35-F(ab’)2 centres around its targeted approach. By focusing on a specific glycoprotein on the surface of OVCAR-3 cells, the antibody ensures that the alpha particle radiation (α) is delivered directly to the cancer cells, sparing the surrounding healthy tissue to a large extent. The intraperitoneal administration of the drug allows for a concentrated delivery to the abdominal cavity, where ovarian cancers typically spread. This method has been shown to achieve therapeutic absorbed doses in microscopic tumour clusters without significant toxicity, as evidenced in Phase I studies. The maximum dose per patient is capped at 200 MBq (approximately 5 mCi), balancing efficacy with safety.

Clinical Application and Trials

The clinical application of 211At-MX35-F(ab’)2 is currently under investigation in open clinical trials conducted in Copenhagen, Denmark, and Gothenburg, Sweden. These trials involve 50 and 300 to 400 patients per year and provide substantial evidence regarding the drug’s effectiveness and safety. The use of 211At-MX35-F(ab’)2 in these trials underscores the potential of this therapeutic agent in managing ovarian cancer, offering hope to patients for whom conventional treatments may have failed or been unsuitable.

Challenges and Future Directions

Although these results are promising in clinical trials, the development of 211At-MX35-F(ab’)2 faces significant hurdles, primarily due to the lack of funding for full-scale drug development. This financial constraint limits the capacity to conduct more extensive research and trials that could pave the way for the widespread adoption of this treatment. Furthermore, as the drug employs a radiolabelled component, there are inherent challenges related to the production, handling, and disposal of radioactive materials.

The future of 211At-MX35-F(ab’)2 in ovarian cancer treatment lies in overcoming these obstacles, potentially through public-private partnerships or increased investment in oncology research. Moreover, continued innovation in targeted therapy and radiopharmaceuticals could further enhance the efficacy and applicability of treatments like 211At-MX35-F(ab’)2.


Astatine-211-MX35-F(ab’)2 represents a beacon of hope in the treatment of ovarian cancer, offering a targeted, practical approach with minimal toxicity. Its development is a testament to the progress in the oncology field, specifically in the use of radiolabelled antibodies. While challenges remain in the path to full-scale development and widespread clinical use, the ongoing trials in Copenhagen and Gothenburg are crucial steps forward. As research continues, Astatine-211-MX35-F(ab’)2 may soon become a staple in the fight against ovarian cancer, demonstrating the power of innovation and targeted therapy in overcoming this formidable disease.

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Tags: Cancer, Targeted Radionuclide Therapy
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