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131I-hu4G4 is a novel radionuclide drug conjugate (RDC) consisting of the humanized monoclonal IgG1 antibody hu4G4 labeled with the therapeutic radionuclide Iodine-131 (131I). It specifically targets B7-H3 (CD276), a protein highly expressed in various tumors, including glioblastoma multiforme (GBM), but rarely in normal tissues. The mechanism of action involves the delivery of targeted beta-radiation to B7-H3-expressing cancer cells, leading to DNA damage and cell death. Beyond direct cytotoxicity, 131I-hu4G4 induces immunogenic cell death (ICD), characterized by the release of damage-associated molecular patterns (DAMPs) like HMGB1 and calreticulin. This process promotes the infiltration of CD4+ and CD8+ T cells and shifts the polarization of tumor-associated macrophages from an immunosuppressive M2 phenotype to a pro-inflammatory M1 phenotype, effectively converting "cold" tumors into "hot" tumors. It is being investigated for the treatment of glioblastoma, particularly via intracranial administration to bypass the blood-brain barrier.
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