Mizanul Hasan

Targeted Alpha Therapy Trial in Bangladesh: Promise for Advanced MUC1 – Expressing Tumors

Introduction: Targeted alpha therapy (TAT) is a new experimental therapy that targets cancer cells and tumor capillary endothelial cells through intravenous injection of an alpha immuneconjugate (AIC). The AIC is formed by labeling the cancer targeting vector (monoclonal antibody) with alpha emitting radioisotopes using a bifunctionalchelator. The monoclonal antibody (MAb) is raised against antigens (e.g. MUC1) over-expressed on the surface of certain cancer cells. There are several centers notably in Europe, the US and Australia that are actively involved in TAT clinical trials of different cancers using a variety of techniques, alpha emitters and MAbs. Observations from their cumulative experience suggest that TAT is safe and effectivebut needs further trials for practical acceptance. Especially critical is the issue of maximum tolerance dose (MTD) which needs to be established for maximum target kill. Bangladesh has the infrastructure to conduct aTAT clinical trial and can significantly add to the growing pool of data for advanced treatment of cancers through collaborative involvement in targeted alpha therapy research. Objective: The aim of the article is to present a general overview of targeted alpha therapy and to discuss the feasibility of a TAT clinical trial in Bangladesh in the context of current cancer management situation in the country. Method: Literature review of significant publications was done to obtain an update of the current status of targeted alpha therapy. Relevant issues of TAT are presented for a theoretical basis of the technology. Next, the methodology of a proposed clinical trial is discussed, together with the practicability of its introduction in Bangladesh. Conclusion: Implementation of TAT clinical trial will help to develop an advanced technology and buildup skilled manpowerin Bangladesh.It will optimize the key parameters of targeted alpha therapy, i e stability and specific activity of the alpha-conjugate and establish the maximum tolerance dose for the AIC. If the clinical trial is successful, it can change the prognosis of many end-stage cancers. Patients in Bangladesh with advanced MUCI expressing tumors of the breast, ovary, pancreas and prostate can have some measure of hope with stability of the disease.

Patient Preparation for 18 F FDG PET-CT scan A Short Communication

18-F fluorodeoxyglucose Positron Emission TomographyComputed Tomography (18F FDG PETCT) scan is an emerging modality of imaging in developing country like us although it is an expensive one. This sophisticated imaging is now available for the general people of Bangladesh, for which a good number of patients used to go to the neighboring countries in previous years. We are proud to say that we are going to stop this trend. Most of the general physicians are eager to be acquainted with this procedure. 18 F FDG PETCT scan play an important role mostly in oncology, less commonly in neurology and cardiology and diagnosis of inflammatory diseases. In oncology, this imaging is useful in diagnosis of primary site of cancer, staging, restaging after treatment, radiation therapy planning and to see the prognosis after chemotherapy and radiotherapy (1). Several factors affect the 18 F FDG PET-CT scan. To get good quality image adequate patient preparation is essential. This article is intended to address the challenges to prepare patients for PETCT scan especially in diabetic patients and other conditions and to disseminate this information to all physicians as well as patients in simple language.

Activities of in vitro laboratory of National Institute of Nuclear Medicine and Allied Sciences

The in vitro laboratory of radioimmunoassay (RIA) Division is designed to provide clinical diagnostic service (e.g. hormone assay) and also to facilitate research works related to radioimmunoassay. The in-vitro laboratory is situated at the 9 floor of block-D of Bangabandhu Sheikh Mujib Medical University (BSMMU). Presently the invitro division of National Institute of Nuclear Medicine and Allied Sciences (NINMAS) has 18 man powers including doctors, radiochemists, officers, technologists and other laboratory staffs. The equipments used for RIA in in vitro laboratory are gamma counter, micropipettes, centrifuge, magnetic separators, vortex mixture, incubator/water bath, stirrers, deep freezer, refrigerator, pH Meter, analytical balance, test tubes and laboratory glassware etc. A large number of samples are analyzed by the RIA Lab each week. In the year 2013 2014 (1 July 2013 – 30 June 2014), a total of 100 assays were done. A total of 25135 samples were assayed by RIA/IRMA in the in vitro lab. Results are reported on every Monday and Thursday of the week. After careful consideration of the local infrastructure, robustness and cost of nuclear and non-nuclear assays, it is likely that RIA methodology will be the main workhorse of routine laboratory diagnostic services of NINMAS.