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Bispecific antibody + di-DTPA-131I is a two-component pretargeted radioimmunotherapy (pRAIT) regimen developed by Nantes University Hospital for the treatment of recurrent medullary thyroid carcinoma (MTC). The regimen consists of a bispecific monoclonal antibody (hMN-14 x m734) and a radiolabeled bivalent hapten (131I-di-DTPA-indium). The bispecific antibody is administered first and targets the carcinoembryonic antigen (CEA) overexpressed on MTC tumor cells, while its second arm remains available to bind the DTPA hapten. Several days later, the iodine-131-labeled di-DTPA hapten is administered; it is rapidly captured by the tumor-bound bispecific antibody, delivering a concentrated dose of therapeutic radiation directly to the malignancy. This pretargeting strategy is designed to improve the therapeutic index by maximizing tumor radiation dose while minimizing systemic exposure and hematologic toxicity compared to conventional radioimmunotherapy.
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