101
|
Pandit-Taskar N. Targeted Radioimmunotherapy and Theranostics with Alpha Emitters. J Med Imaging Radiat Sci 2019; 50:S41-S44. [PMID: 31451417 DOI: 10.1016/j.jmir.2019.07.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 07/12/2019] [Accepted: 07/16/2019] [Indexed: 11/29/2022]
Abstract
Radiolabeled antibodies allow for selective targeting of the cancer cells within a tumor. Both beta- and alpha-emitting radioisotopes can be linked to the antibodies for delivery of radiation to the cells. The choice of the radionuclide would depend on the biological characteristics of the antibody including its biodistribution and biological half-life. Alpha-emitting isotopes deliver high energy to target sites within short range and therefore less radiation to adjacent normal tissues. Whole antibodies have long biological clearance times that may be limiting due to radiation levels to blood and marrow. Novel strategies, such as development of smaller antibody fragments such as minibodies and diabodies, which have faster biological clearance, engineered bispecific antibodies, and multistep targeting that uses pretargeting and bioorthogonal click chemistry methods, appear promising. Several novel targets are being investigated in early-phase studies. This review provides a brief summary and current status of radioimmunotargeted agents in oncology.
Collapse
Affiliation(s)
- Neeta Pandit-Taskar
- Department of Radiology, Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
| |
Collapse
|
102
|
Puttemans J, Lahoutte T, D'Huyvetter M, Devoogdt N. Beyond the Barrier: Targeted Radionuclide Therapy in Brain Tumors and Metastases. Pharmaceutics 2019; 11:pharmaceutics11080376. [PMID: 31374991 PMCID: PMC6723032 DOI: 10.3390/pharmaceutics11080376] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 07/12/2019] [Accepted: 07/17/2019] [Indexed: 01/10/2023] Open
Abstract
Brain tumors are notoriously difficult to treat. The blood-brain barrier provides a sanctuary site where residual and metastatic cancer cells can evade most therapeutic modalities. The delicate nature of the brain further complicates the decision of eliminating as much tumorous tissue as possible while protecting healthy tissue. Despite recent advances in immunotherapy, radiotherapy and systemic treatments, prognosis of newly diagnosed patients remains dismal, and recurrence is still a universal problem. Several strategies are now under preclinical and clinical investigation to optimize delivery and maximize the cytotoxic potential of pharmaceuticals with regards to brain tumors. This review provides an overview of targeted radionuclide therapy approaches for the treatment of primary brain tumors and brain metastases, with an emphasis on biological targeting moieties that specifically target key biomarkers involved in cancer development.
Collapse
Affiliation(s)
- Janik Puttemans
- In Vivo Cellular and Molecular Imaging Lab, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium.
| | - Tony Lahoutte
- In Vivo Cellular and Molecular Imaging Lab, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
- Nuclear Medicine Department, UZ Brussel, Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Matthias D'Huyvetter
- In Vivo Cellular and Molecular Imaging Lab, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| | - Nick Devoogdt
- In Vivo Cellular and Molecular Imaging Lab, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090 Brussels, Belgium
| |
Collapse
|
103
|
Bailly C, Vidal A, Bonnemaire C, Kraeber-Bodéré F, Chérel M, Pallardy A, Rousseau C, Garcion E, Lacoeuille F, Hindré F, Valable S, Bernaudin M, Bodet-Milin C, Bourgeois M. Potential for Nuclear Medicine Therapy for Glioblastoma Treatment. Front Pharmacol 2019; 10:772. [PMID: 31354487 PMCID: PMC6637301 DOI: 10.3389/fphar.2019.00772] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/14/2019] [Indexed: 12/17/2022] Open
Abstract
Glioblastoma is the most common malignant adult brain tumor and has a very poor patient prognosis. The mean survival for highly proliferative glioblastoma is only 10 to 14 months despite an aggressive current therapeutic approach known as Stupp's protocol, which consists of debulking surgery followed by radiotherapy and chemotherapy. Despite several clinical trials using anti-angiogenic targeted therapies, glioblastoma medical care remains without major progress in the last decade. Recent progress in nuclear medicine, has been mainly driven by advances in biotechnologies such as radioimmunotherapy, radiopeptide therapy, and radionanoparticles, and these bring a new promising arsenal for glioblastoma therapy. For therapeutic purposes, nuclear medicine practitioners classically use β- particle emitters like 131I, 90Y, 186/188Re, or 177Lu. In the glioblastoma field, these radioisotopes are coupled with nanoparticles, monoclonal antibodies, or peptides. These radiopharmaceutical compounds have resulted in a stabilization and/or improvement of the neurological status with only transient side effects. In nuclear medicine, the glioblastoma-localized and targeted internal radiotherapy proof-of-concept stage has been successfully demonstrated using β- emitting isotopes. Similarly, α particle emitters like 213Bi, 211At, or 225Ac appear to be an innovative and interesting alternative. Indeed, α particles deliver a high proportion of their energy inside or at close proximity to the targeted cells (within a few micrometers from the emission point versus several millimeters for β- particles). This physical property is based on particle-matter interaction differences and results in α particles being highly efficient in killing tumor cells with minimal irradiation of healthy tissues and permits targeting of isolated tumor cells. The first clinical trials confirmed this idea and showed good therapeutic efficacy and less side effects, thus opening a new and promising era for glioblastoma medical care using α therapy. The objective of this literature review is focused on the developing field of nuclear medicine and aims to describe the various parameters such as targets, vectors, isotopes, or injection route (systemic and local) in relation to the clinical and preclinical results in glioblastoma pathology.
Collapse
Affiliation(s)
- Clément Bailly
- Nuclear Medicine, Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France.,CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | | | | | - Françoise Kraeber-Bodéré
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Nuclear Medecine, Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France
| | - Michel Chérel
- CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Institut de Cancérologie de l'Ouest (ICO), Angers, France
| | - Amandine Pallardy
- Nuclear Medicine, Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France
| | | | - Emmanuel Garcion
- Team 17-Design and Application of Innovative Local Treatments in Glioblastoma, INSERM U1232 Centre de Recherche en Cancérologie et Immunologie Nantes Angers (CRCINA), Nantes, France
| | - Franck Lacoeuille
- Team 17-Design and Application of Innovative Local Treatments in Glioblastoma, INSERM U1232 Centre de Recherche en Cancérologie et Immunologie Nantes Angers (CRCINA), Nantes, France.,Nuclear Medicine, Centre Hospitalier Universitaire d'Angers, Angers, France
| | - François Hindré
- Team 17-Design and Application of Innovative Local Treatments in Glioblastoma, INSERM U1232 Centre de Recherche en Cancérologie et Immunologie Nantes Angers (CRCINA), Nantes, France
| | | | | | - Caroline Bodet-Milin
- Nuclear Medicine, Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France.,CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France
| | - Mickaël Bourgeois
- Nuclear Medicine, Centre Hospitalier Universitaire (CHU) de Nantes, Nantes, France.,CRCINA, INSERM, CNRS, Université d'Angers, Université de Nantes, Nantes, France.,Arronax, Saint-Herblain, France
| |
Collapse
|
104
|
Feuerecker B, Michalik M, Hundshammer C, Schwaiger M, Bruchertseifer F, Morgenstern A, Seidl C. Assessment of 213Bi-anti-EGFR MAb treatment efficacy in malignant cancer cells with [1- 13C]pyruvate and [ 18F]FDG. Sci Rep 2019; 9:8294. [PMID: 31165773 PMCID: PMC6549183 DOI: 10.1038/s41598-019-44484-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 05/13/2019] [Indexed: 12/02/2022] Open
Abstract
Evaluation of response to therapy is among the key objectives of oncology. A new method to evaluate this response includes magnetic resonance spectroscopy (MRS) with hyperpolarized 13C-labelled metabolites, which holds promise to provide new insights in terms of both therapeutic efficacy and tumor cell metabolism. Human EJ28Luc urothelial carcinoma and LN18 glioma cells were treated with lethal activity concentrations of a 213Bi-anti-EGFR immunoconjugate. Treatment efficacy was controlled via analysis of DNA double-strand breaks (immunofluorescence γH2AX staining) and clonogenic survival of cells. To investigate changes in metabolism of treated cells vs controls we analyzed conversion of hyperpolarized [1-13C]pyruvate to [1-13C]lactate via MRS as well as viability of cells, lactate formation and lactate dehydrogenase activity in the cellular supernatants and [18F]FDG uptake in treated cells vs controls, respectively. Treatment of malignant cancer cells with 213Bi-anti-EGFR-MAb induced intense DNA double-strand breaks, resulting in cell death as monitored via clonogenic survival. Moreover, treatment of EJ28Luc bladder cancer cells resulted in decreased cell viability, [18F]FDG-uptake and an increased lactate export. In both EJ28Luc and LN18 carcinoma cells treatment with 213Bi-anti-EGFR-MAb triggered a significant increase in lactate/pyruvate ratios, as measured with hyperpolarized [1-13C]pyruvate. Treatment with 213Bi-anti-EGFR-MAb resulted in an effective induction of cell death in EJ28Luc and LN18 cells. Lactate/pyruvate ratios of hyperpolarized [1-13C]pyruvate proved to detect early treatment response effects, holding promise for future clinical applications in early therapy monitoring.
Collapse
Affiliation(s)
- Benedikt Feuerecker
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany. .,German Cancer Consortium (DKTK), partner site Munich and German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Michael Michalik
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany
| | - Christian Hundshammer
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany.,Department of Chemistry, Technical University of Munich, Garching, Germany.,Munich School of Bioengineering, Technical University of Munich, Garching, Germany
| | - Markus Schwaiger
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany
| | - Frank Bruchertseifer
- European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - Alfred Morgenstern
- European Commission, Joint Research Centre, Directorate for Nuclear Safety and Security, Karlsruhe, Germany
| | - Christof Seidl
- Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Nuclear Medicine, Munich, Germany.,Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Department of Obstetrics and Gynecology, Munich, Germany
| |
Collapse
|
105
|
Ferrier MG, Radchenko V, Wilbur DS. Radiochemical aspects of alpha emitting radionuclides for medical application. RADIOCHIM ACTA 2019. [DOI: 10.1515/ract-2019-0005] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Abstract
The use of α-emitting radionuclides in targeted alpha therapy (TAT) holds great potential for treatment of human diseases, such as cancer, due to the short pathlength and high potency of the α particle, which can localize damage to targeted cells while minimizing effects to healthy surrounding tissues. In this review several potential α-emitting radionuclides having emission properties applicable to TAT are discussed from a radiochemical point of view. Overviews of production, radiochemical separation and chelation aspects relative to developing TAT radiopharmaceuticals are provided for the α-emitting radionuclides (and their generator systems) 211At, 224Ra/212Pb/212Bi, 225Ac/213Bi, 227Th/223Ra, 230U/226Th, 149Tb and 255Fm.
Collapse
Affiliation(s)
- Maryline G. Ferrier
- Department of Radiation Oncology, Radiochemistry Division , University of Washington , Seattle, WA , USA
| | - Valery Radchenko
- Life Sciences Division, TRIUMF , Vancouver, BC , Canada
- Department of Chemistry , University of British Columbia , Vancouver, BC , Canada
| | - D. Scott Wilbur
- Department of Radiation Oncology, Radiochemistry Division , University of Washington , Seattle, WA , USA
| |
Collapse
|
106
|
Safety and Outcome Measures of First-in-Human Intraperitoneal α Radioimmunotherapy With 212Pb-TCMC-Trastuzumab. Am J Clin Oncol 2019; 41:716-721. [PMID: 27906723 PMCID: PMC5449266 DOI: 10.1097/coc.0000000000000353] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
PURPOSE One-year monitoring of patients receiving intraperitoneal (IP) Pb-TCMC-trastuzumab to provide long-term safety and outcome data. A secondary objective was to study 7 tumor markers for correlation with outcome. METHODS Eighteen patients with relapsed intra-abdominal human epidermal growth factor receptor-2 expressing peritoneal metastases were treated with a single IP infusion of Pb-TCMC-trastuzumab, delivered <4 h after 4 mg/kg IV trastuzumab. Seven tumor markers were studied for correlation with outcome. RESULTS Six dose levels (7.4, 9.6, 12.6, 16.3, 21.1, 27.4 MBq/m) were well tolerated with early possibly agent-related adverse events being mild, transient, and not dose dependent. These included asymptomatic, abnormal laboratory values. No late renal, liver, cardiac, or other toxicity was noted up to 1 year. There were no clinical signs or symptoms of an immune response to Pb-TCMC-trastuzumab, and assays to detect an immune response to this conjugate were negative for all tested. Tumor marker studies in ovarian cancer patients showed a trend of decreasing Cancer antigen 72-4 (CA 72-4) aka tumor-associated glycoprotein 72 (TAG-72) and tumor growth with increasing administered radioactivity. Other tumor markers, including carbohydrate antigen (CA125), human epididymis protein 4 (HE-4), serum amyloid A (SAA), mesothelin, interleukin-6 (IL-6), and carcinoembryonic antigen (CEA) did not correlate with imaging outcome. CONCLUSIONS IP Pb-TCMC-trastuzumab up to 27 MBq/m seems safe for patients with peritoneal carcinomatosis who have failed standard therapies. Serum TAG-72 levels better correlated to imaging changes in ovarian cancer patients than the more common tumor marker, CA125.
Collapse
|
107
|
Ladjohounlou R, Lozza C, Pichard A, Constanzo J, Karam J, Le Fur P, Deshayes E, Boudousq V, Paillas S, Busson M, Le Blay M, Jarlier M, Marcatili S, Bardiès M, Bruchertseifer F, Morgenstern A, Torgue J, Navarro-Teulon I, Pouget JP. Drugs That Modify Cholesterol Metabolism Alter the p38/JNK-Mediated Targeted and Nontargeted Response to Alpha and Auger Radioimmunotherapy. Clin Cancer Res 2019; 25:4775-4790. [PMID: 31061069 DOI: 10.1158/1078-0432.ccr-18-3295] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 03/18/2019] [Accepted: 05/01/2019] [Indexed: 11/16/2022]
Abstract
PURPOSE For the development of new anticancer therapeutic radiopharmaceuticals, including alpha particle emitters, it is important to determine the contribution of targeted effects in irradiated cells, and also of nontargeted effects in nonirradiated neighboring cells, because they may affect the therapeutic efficacy and contribute to side effects. EXPERIMENTAL DESIGN Here, we investigated the contribution of nontargeted cytotoxic and genotoxic effects in vitro and in vivo (in xenografted mice) during alpha (212Pb/212Bi, 213Bi) and Auger (125I) radioimmunotherapy (RIT). RESULTS Between 67% and 94% (alpha RIT) and 8% and 15% (Auger RIT) of cancer cells were killed by targeted effects, whereas 7% to 36% (alpha RIT) and 27% to 29% (Auger RIT) of cells were killed by nontargeted effects. We then demonstrated that the nontargeted cell response to alpha and Auger RIT was partly driven by lipid raft-mediated activation of p38 kinase and JNK. Reactive oxygen species also played a significant role in these nontargeted effects, as demonstrated by NF-κB activation and the inhibitory effects of antioxidant enzymes and radical scavengers. Compared with RIT alone, the use of RIT with ASMase inhibitor (imipramine) or with a lipid raft disruptor (e.g., methyl-beta-cyclodextrin or filipin) led to an increase in clonogenic cell survival in vitro and to larger tumors and less tissue DNA damage in vivo. These results were supported by an inhibitory effect of pravastatin on Auger RIT. CONCLUSIONS Cell membrane-mediated nontargeted effects play a significant role during Auger and alpha RIT, and drugs that modulate cholesterol level, such as statins, could interfere with RIT efficacy.
Collapse
Affiliation(s)
- Riad Ladjohounlou
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Catherine Lozza
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Alexandre Pichard
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Julie Constanzo
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Jihad Karam
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Pierre Le Fur
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Emmanuel Deshayes
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Vincent Boudousq
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Salomé Paillas
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Muriel Busson
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Marion Le Blay
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Marta Jarlier
- Institut Régional du Cancer de Montpellier, Université de Montpellier, Montpellier, France
| | - Sara Marcatili
- UMR 1037 INSERM/UPS, Centre de Recherche en Cancérologie de Toulouse, Toulouse, France
| | - Manuel Bardiès
- UMR 1037 INSERM/UPS, Centre de Recherche en Cancérologie de Toulouse, Toulouse, France
| | - Frank Bruchertseifer
- Directorate for Nuclear Safety and Security, European Commission - Joint Research Centre, Karlsruhe, Germany
| | - Alfred Morgenstern
- Directorate for Nuclear Safety and Security, European Commission - Joint Research Centre, Karlsruhe, Germany
| | | | - Isabelle Navarro-Teulon
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France
| | - Jean-Pierre Pouget
- IRCM, Institut de Recherche en Cancérologie de Montpellier, INSERM U1194, Université de Montpellier, Institut Régional du Cancer de Montpellier, Montpellier, France.
| |
Collapse
|
108
|
Bennett K, Bone SE, Akin AC, Birnbaum ER, Blake AV, Brugh M, Daly SR, Engle JW, Fassbender ME, Ferrier MG, Kozimor SA, Lilley LM, Martinez CA, Mocko V, Nortier FM, Stein BW, Thiemann SL, Vermeulen C. Large-Scale Production of 119mTe and 119Sb for Radiopharmaceutical Applications. ACS CENTRAL SCIENCE 2019; 5:494-505. [PMID: 30937377 PMCID: PMC6439462 DOI: 10.1021/acscentsci.8b00869] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Indexed: 06/09/2023]
Abstract
Radionuclides find widespread use in medical technologies for treating and diagnosing disease. Among successful and emerging radiotherapeutics, 119Sb has unique potential in targeted therapeutic applications for low-energy electron-emitting isotopes. Unfortunately, developing 119Sb-based drugs has been slow in comparison to other radionuclides, primarily due to limited accessibility. Herein is a production method that overcomes this challenge and expands the available time for large-scale distribution and use. Our approach exploits high flux and fluence from high-energy proton sources to produce longer lived 119mTe. This parent isotope slowly decays to 119Sb, which in turn provides access to 119Sb for longer time periods (in comparison to direct 119Sb production routes). We contribute the target design, irradiation conditions, and a rapid procedure for isolating the 119mTe/119Sb pair. To guide process development and to understand why the procedure was successful, we characterized the Te/Sb separation using Te and Sb K-edge X-ray absorption spectroscopy. The procedure provides low-volume aqueous solutions that have high 119mTe-and consequently 119Sb-specific activity in a chemically pure form. This procedure has been demonstrated at large-scale (production-sized, Ci quantities), and the product has potential to meet stringent Food and Drug Administration requirements for a 119mTe/119Sb active pharmaceutical ingredient.
Collapse
Affiliation(s)
- Kevin
T. Bennett
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Sharon E. Bone
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Andrew C. Akin
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Eva R. Birnbaum
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Anastasia V. Blake
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
- University
of Iowa, Iowa City, Iowa 52242-1294, United States
| | - Mark Brugh
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Scott R. Daly
- University
of Iowa, Iowa City, Iowa 52242-1294, United States
| | - Jonathan W. Engle
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
- University
of Wisconsin, Madison, Wisconsin 53705, United States
| | | | | | - Stosh A. Kozimor
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Laura M. Lilley
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | | | - Veronika Mocko
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | | | - Benjamin W. Stein
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | - Sara L. Thiemann
- Los
Alamos National Laboratory, Los Alamos, New Mexico 87545, United States
| | | |
Collapse
|
109
|
Fujiki K, Kanayama Y, Yano S, Sato N, Yokokita T, Ahmadi P, Watanabe Y, Haba H, Tanaka K. 211At-labeled immunoconjugate via a one-pot three-component double click strategy: practical access to α-emission cancer radiotherapeutics. Chem Sci 2018; 10:1936-1944. [PMID: 30881623 PMCID: PMC6385556 DOI: 10.1039/c8sc04747b] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/19/2018] [Indexed: 01/04/2023] Open
Abstract
α-Emission radiotherapeutics has potential to be one of most effective cancer therapeutics. Herein, we report a facile synthesis of an 211At-labeled immunoconjugate for use as an α-emission molecular targeting therapy. We synthesized a tetrazine probe modified with closo-decaborate(2-), a prosthetic group that forms a bioavailable stable complex with 211At. Our one-pot three-component double-click labeling method was used to attach decaborate to trastuzumab (anti-HER2 antibody) using decaborate-tetrazine and TCO-aldehyde probes without reducing the antibody binding affinity. Labeling the decaborate-attached trastuzumab with 211At produced in the cyclotron at the RIKEN Nishina Center, at which highly radioactive 211At can be produced, readily furnished the 211At-labeled trastuzumab with a maximum specific activity of 15 MBq μg-1 and retention of the native binding affinity. Intratumor injection of the 211At-labeled trastuzumab in BALB/c nude mice implanted with HER2-expressing epidermoid cancer cells yielded efficient accumulation at the targeted tumor site as well as effective suppression of tumor growth.
Collapse
Affiliation(s)
- Katsumasa Fujiki
- Biofunctional Synthetic Chemistry Laboratory , RIKEN Cluster for Pioneering Research , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan . .,GlycoTargeting Research Laboratory , RIKEN Baton Zone Program , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan
| | - Yousuke Kanayama
- Laboratory for Pathophysiological and Health Science , RIKEN Center for Biosystems Dynamics Research , 6-7-3 Minatojima-minamimachi, Chuo-ku , Kobe , Hyogo 650-0047 , Japan
| | - Shinya Yano
- Nuclear Chemistry Research Team , RIKEN Nishina Center for Accelerator-Based Science , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan
| | - Nozomi Sato
- Nuclear Chemistry Research Team , RIKEN Nishina Center for Accelerator-Based Science , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan
| | - Takuya Yokokita
- Nuclear Chemistry Research Team , RIKEN Nishina Center for Accelerator-Based Science , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan
| | - Peni Ahmadi
- Biofunctional Synthetic Chemistry Laboratory , RIKEN Cluster for Pioneering Research , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan .
| | - Yasuyoshi Watanabe
- Laboratory for Pathophysiological and Health Science , RIKEN Center for Biosystems Dynamics Research , 6-7-3 Minatojima-minamimachi, Chuo-ku , Kobe , Hyogo 650-0047 , Japan
| | - Hiromitsu Haba
- Nuclear Chemistry Research Team , RIKEN Nishina Center for Accelerator-Based Science , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan
| | - Katsunori Tanaka
- Biofunctional Synthetic Chemistry Laboratory , RIKEN Cluster for Pioneering Research , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan . .,GlycoTargeting Research Laboratory , RIKEN Baton Zone Program , 2-1 Hirosawa , Wako , Saitama 351-0198 , Japan.,Biofunctional Chemistry Laboratory , A. Butlerov Institute of Chemistry , Kazan Federal University , 18 Kremlyovskaya Street , Kazan 420008 , Russia
| |
Collapse
|
110
|
Kumar NN, Pizzo ME, Nehra G, Wilken-Resman B, Boroumand S, Thorne RG. Passive Immunotherapies for Central Nervous System Disorders: Current Delivery Challenges and New Approaches. Bioconjug Chem 2018; 29:3937-3966. [PMID: 30265523 PMCID: PMC7234797 DOI: 10.1021/acs.bioconjchem.8b00548] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Passive immunotherapy, i.e., the administration of exogenous antibodies that recognize a specific target antigen, has gained significant momentum as a potential treatment strategy for several central nervous system (CNS) disorders, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and brain cancer, among others. Advances in antibody engineering to create therapeutic antibody fragments or antibody conjugates have introduced new strategies that may also be applied to treat CNS disorders. However, drug delivery to the CNS for antibodies and other macromolecules has thus far proven challenging, due in large part to the blood-brain barrier and blood-cerebrospinal fluid barriers that greatly restrict transport of peripherally administered molecules from the systemic circulation into the CNS. Here, we summarize the various passive immunotherapy approaches under study for the treatment of CNS disorders, with a primary focus on disease-specific and target site-specific challenges to drug delivery and new, cutting edge methods.
Collapse
Affiliation(s)
- Niyanta N. Kumar
- Pharmaceutical Sciences Division, University of
Wisconsin-Madison School of Pharmacy
| | - Michelle E. Pizzo
- Pharmaceutical Sciences Division, University of
Wisconsin-Madison School of Pharmacy
- Clinical Neuroengineering Training Program, University of
Wisconsin-Madison, Madison, Wisconsin 53705, United States
| | - Geetika Nehra
- Pharmaceutical Sciences Division, University of
Wisconsin-Madison School of Pharmacy
| | - Brynna Wilken-Resman
- Pharmaceutical Sciences Division, University of
Wisconsin-Madison School of Pharmacy
| | - Sam Boroumand
- Pharmaceutical Sciences Division, University of
Wisconsin-Madison School of Pharmacy
| | - Robert G. Thorne
- Pharmaceutical Sciences Division, University of
Wisconsin-Madison School of Pharmacy
- Clinical Neuroengineering Training Program, University of
Wisconsin-Madison, Madison, Wisconsin 53705, United States
- Neuroscience Training Program & Center for
Neuroscience, University of Wisconsin-Madison, Madison, Wisconsin 53705, United
States
- Cellular and Molecular Pathology Graduate Training Program,
University of Wisconsin-Madison, Madison, Wisconsin 53705, United States
| |
Collapse
|
111
|
Nawrocki T, Tritt TC, Neti PVSV, Rosen AS, Dondapati AR, Howell RW. Design and testing of a microcontroller that enables alpha particle irradiators to deliver complex dose rate patterns. Phys Med Biol 2018; 63:245022. [PMID: 30524061 PMCID: PMC8528213 DOI: 10.1088/1361-6560/aaf269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There is increasing interest in using alpha particle emitting radionuclides for cancer therapy because of their unique cytotoxic properties which are advantageous for eradicating tumor cells. The high linear energy transfer (LET) of alpha particles produces a correspondingly high density of ionizations along their track. Alpha particle emitting radiopharmaceuticals deposit this energy in tissues over prolonged periods with complex dose rate patterns that depend on the physical half-life of the radionuclide, and the biological uptake and clearance half-times in tumor and normal tissues. We have previously shown that the dose rate increase half-time that arises as a consequence of these biokinetics can have a profound effect on the radiotoxicity of low-LET radiation. The microcontroller hardware and software described here offer a unique way to deliver these complex dose rate patterns with a broad-beam alpha particle irradiator, thereby enabling experiments to study the radiobiology of complex dose rate patterns of alpha particles. Complex dose rate patterns were created by precise manipulation of the timing of opening and closing of the electromechanical shutters of an α-particle irradiator. An Arduino Uno and custom circuitry was implemented to control the shutters. The software that controls the circuits and shutters has a user-friendly Graphic User Interface (GUI). Alpha particle detectors were used to validate the programmed dose rate profiles. Circuit diagrams and downloadable software are provided to facilitate adoption of this technology by other radiobiology laboratories.
Collapse
Affiliation(s)
- Tomer Nawrocki
- Division of Radiation Research, Department of Radiology, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, United States of America
| | | | | | | | | | | |
Collapse
|
112
|
Basaco T, Pektor S, Bermudez JM, Meneses N, Heller M, Galván JA, Boligán KF, Schürch S, von Gunten S, Türler A, Miederer M. Evaluation of Radiolabeled Girentuximab In Vitro and In Vivo. Pharmaceuticals (Basel) 2018; 11:E132. [PMID: 30487460 PMCID: PMC6316122 DOI: 10.3390/ph11040132] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 11/21/2018] [Accepted: 11/26/2018] [Indexed: 11/16/2022] Open
Abstract
Girentuximab (cG250) targets carbonic anhydrase IX (CAIX), a protein which is expressed on the surface of most renal cancer cells (RCCs). cG250 labeled with 177Lu has been used in clinical trials for radioimmunotherapy (RIT) of RCCs. In this work, an extensive characterization of the immunoconjugates allowed optimization of the labeling conditions with 177Lu while maintaining immunoreactivity of cG250, which was then investigated in in vitro and in vivo experiments. cG250 was conjugated with S-2-(4-isothiocyanatobenzyl)-1,4,7,10-tetraazacyclododecane tetraacetic acid (DOTA(SCN)) by using incubation times between 30 and 90 min and characterized by mass spectrometry. Immunoconjugates with five to ten DOTA(SCN) molecules per cG250 molecule were obtained. Conjugates with ratios less than six DOTA(SCN)/cG250 had higher in vitro antigen affinity, both pre- and postlabeling with 177Lu. Radiochemical stability increased, in the presence of sodium ascorbate, which prevents radiolysis. The immunoreactivity of the radiolabeled cG250 tested by specific binding to SK-RC-52 cells decreased when the DOTA content per conjugate increased. The in vivo tumor uptake was < 10% ID/g and independent of the total amount of protein in the range between 5 and 100 µg cG250 per animal. Low tumor uptake was found to be due to significant necrotic areas and heterogeneous CAIX expression. In addition, low vascularity indicated relatively poor accessibility of the CAIX target.
Collapse
Affiliation(s)
- Tais Basaco
- Department of Chemistry and Biochemistry, University of Bern, 3012 Bern, Switzerland.
- Laboratory of Radiochemistry, Paul Scherrer Institute (PSI), 5232 Villigen PSI, Switzerland.
| | - Stefanie Pektor
- Clinic for Nuclear Medicine, University Medical Center Mainz, 55131 Mainz, Germany.
| | - Josue M Bermudez
- Department of Chemistry and Biochemistry, University of Bern, 3012 Bern, Switzerland.
| | - Niurka Meneses
- Department of Chemistry and Biochemistry, University of Bern, 3012 Bern, Switzerland.
| | - Manfred Heller
- Department for Biomedical Research (DBMR), University of Bern, 3010 Bern, Switzerland.
| | - José A Galván
- Institute of Pathology, University of Bern, 3010 Bern, Switzerland.
| | - Kayluz F Boligán
- Institute of Pharmacology (PKI), University of Bern, 3010 Bern, Switzerland.
| | - Stefan Schürch
- Department of Chemistry and Biochemistry, University of Bern, 3012 Bern, Switzerland.
| | - Stephan von Gunten
- Institute of Pharmacology (PKI), University of Bern, 3010 Bern, Switzerland.
| | - Andreas Türler
- Department of Chemistry and Biochemistry, University of Bern, 3012 Bern, Switzerland.
| | - Matthias Miederer
- Clinic for Nuclear Medicine, University Medical Center Mainz, 55131 Mainz, Germany.
| |
Collapse
|
113
|
Soares AD, Paixão L, Facure A. Determination of the dose rate constant through Monte Carlo simulations with voxel phantoms. Med Phys 2018; 45:5283-5292. [DOI: 10.1002/mp.13181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 08/23/2018] [Accepted: 08/31/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Abner D. Soares
- Instituto de Radioproteção e Dosimetria Avenida Salvador Allende, 9 22780‐160 Rio de Janeiro RJ Brazil
| | - Lucas Paixão
- Dep. de Anatomia e Imagem/Faculdade de Medicina Universidade Federal de Minas Gerais 30130‐100 Belo Horizonte MG Brazil
| | - Alessandro Facure
- Comissão Nacional de Energia Nuclear Rua General Severiano 90, sala 402 22294‐900 Rio de Janeiro RJ Brazil
| |
Collapse
|
114
|
Li Y, Hamlin DK, Chyan MK, Wong R, Dorman EF, Emery RC, Woodle DR, Manger RL, Nartea M, Kenoyer AL, Orozco JJ, Green DJ, Press OW, Storb R, Sandmaier BM, Wilbur DS. cGMP production of astatine-211-labeled anti-CD45 antibodies for use in allogeneic hematopoietic cell transplantation for treatment of advanced hematopoietic malignancies. PLoS One 2018; 13:e0205135. [PMID: 30335787 PMCID: PMC6193629 DOI: 10.1371/journal.pone.0205135] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 09/19/2018] [Indexed: 11/28/2022] Open
Abstract
The objective of this study was to translate reaction conditions and quality control methods used for production of an astatine-211(211At)-labeled anti-CD45 monoclonal antibody (MAb) conjugate, 211At-BC8-B10, from the laboratory setting to cGMP production. Five separate materials were produced in the preparation of 211At-BC8-B10: (1) p-isothiocyanato-phenethyl-closo-decaborate(2-) (B10-NCS), (2) anti-CD45 MAb, BC8, (3) BC8-B10 MAb conjugate, (4) [211At]NaAt, and (5) 211At-BC8-B10. The 211At-labeling reagent, B10-NCS, was synthesized as previously reported. BC8 was produced, then conjugated with B10-NCS under cGMP conditions to form BC8-B10. [211At]NaAt was produced by α-irradiation of Bi targets, followed by isolation of the 211At using a “wet chemistry” method. The clinical product, 211At-BC8-B10, was prepared by reacting [211At]NaAt with BC8-B10 in NH4OAc buffer (pH 5.5) for 2 min at room temperature, followed by size-exclusion chromatography purification. Quality control tests conducted on the 211At-BC8-B10 included evaluations for purity and identity, as well as pyrogen and sterility tests. Stability of the 211At-BC8-B10 in 25 mg/mL sodium ascorbate solution was evaluated at 1, 2, 4, 6 and 21 h post isolation. For qualification, three consecutive 211At-BC8-B10 clinical preparations were successfully conducted in the cGMP suite, and an additional cGMP clinical preparation was carried out to validate each step required to deliver 211At-BC8-B10 to a patient. These cGMP preparations provided 0.80–1.28 Gbq (21.5–34.5 mCi) of 211At-BC8-B10 with radiochemical purity of >97%. The preparations were found to be sterile and have a pyrogen level <0.50 EU/mL. Cell binding was retained by the 211At-BC8-B10. 211At-BC8-B10 in ascorbic acid solution demonstrated a radiochemical stability of >95% for up to 21 h at room temperature. The experiments conducted have defined conditions for translation of 211At-BC8-B10 production from the laboratory to cGMP suite. This study has allowed the initiation of a phase I/II clinical trial using 211At-BC8-B10 (NCT03128034).
Collapse
Affiliation(s)
- Yawen Li
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
| | - Donald K. Hamlin
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
| | - Ming-Kuan Chyan
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
| | - Roger Wong
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
| | - Eric F. Dorman
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
| | - Robert C. Emery
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
| | - Douglas R. Woodle
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Ronald L. Manger
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Margaret Nartea
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Aimee L. Kenoyer
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Johnnie J. Orozco
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Damian J. Green
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Oliver W. Press
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Rainer Storb
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - Brenda M. Sandmaier
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
| | - D. Scott Wilbur
- Department of Radiation Oncology, University of Washington, Seattle, Washington, United States of America
- * E-mail:
| |
Collapse
|
115
|
Abstract
α-Particle irradiation of cancerous tissue is increasingly recognized as a potent therapeutic option. We briefly review the physics, radiobiology, and dosimetry of α-particle emitters, as well as the distinguishing features that make them unique for radiopharmaceutical therapy. We also review the emerging clinical role of α-particle therapy in managing cancer and recent studies on in vitro and preclinical α-particle therapy delivered by antibodies, other small molecules, and nanometer-sized particles. In addition to their unique radiopharmaceutical characteristics, the increased availability and improved radiochemistry of α-particle radionuclides have contributed to the growing recent interest in α-particle radiotherapy. Targeted therapy strategies have presented novel possibilities for the use of α-particles in the treatment of cancer. Clinical experience has already demonstrated the safe and effective use of α-particle emitters as potent tumor-selective drugs for the treatment of leukemia and metastatic disease.
Collapse
Affiliation(s)
- Michael R McDevitt
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- Department of Radiology, Weill Cornell Medical College, New York, NY 10065, USA
| | - George Sgouros
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA
| | - Stavroula Sofou
- Department of Chemical and Biomolecular Engineering, Johns Hopkins University, Baltimore, Maryland 21218, USA
| |
Collapse
|
116
|
Holzwarth U, Ojea Jimenez I, Calzolai L. A random walk approach to estimate the confinement of α-particle emitters in nanoparticles for targeted radionuclide therapy. EJNMMI Radiopharm Chem 2018; 3:9. [PMID: 29888318 PMCID: PMC5976682 DOI: 10.1186/s41181-018-0042-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/28/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Targeted radionuclide therapy is a highly efficient but still underused treatment modality for various types of cancers that uses so far mainly readily available β-emitting radionuclides. By using α-particle emitters several shortcomings due to hypoxia, cell proliferation and in the selected treatment of small volumes such as micrometastasis could be overcome. To enable efficient targeting longer-lived α-particle emitters are required. These are the starting point of decay chains emitting several α-particles delivering extremely high radiation doses into small treatment volumes. However, as a consequence of the α-decay the daughter nuclides receive high recoil energies that cannot be managed by chemical radiolabelling techniques. By safe encapsulation of all α-emitters in the decay chain in properly sized nanocarriers their release may be avoided. RESULTS The encapsulation of small core nanoparticles loaded with the radionuclide in a shell structure that safely confines the recoiling daughter nuclides promises good tumour targeting, penetration and uptake, provided these nanostructures can be kept small enough. A model for spherical nanoparticles is proposed that allows an estimate of the fraction of recoiling α-particle emitters that may escape from the nanoparticles as a function of their size. The model treats the recoil ranges of the daughter nuclides as approximately equidistant steps with arbitrary orientation in a three-dimensional random walk model. CONCLUSIONS The presented model allows an estimate of the fraction of α-particles that are emitted from outside the nanoparticle when its size is reduced below the radius that guarantees complete confinement of all radioactive daughter nuclides. Smaller nanoparticle size with reduced retention of daughter radionuclides might be tolerated when the effects can be compensated by fast internalisation of the nanoparticles by the target cells.
Collapse
Affiliation(s)
- Uwe Holzwarth
- European Commission, Joint Research Centre, Via Enrico Fermi 2749, 21027 Ispra, VA Italy
| | - Isaac Ojea Jimenez
- European Commission, Joint Research Centre, Via Enrico Fermi 2749, 21027 Ispra, VA Italy
| | - Luigi Calzolai
- European Commission, Joint Research Centre, Via Enrico Fermi 2749, 21027 Ispra, VA Italy
| |
Collapse
|
117
|
Kayano D, Kinuya S. Current Consensus on I-131 MIBG Therapy. Nucl Med Mol Imaging 2018; 52:254-265. [PMID: 30100938 DOI: 10.1007/s13139-018-0523-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 03/27/2018] [Accepted: 04/12/2018] [Indexed: 12/24/2022] Open
Abstract
Metaiodobenzylguanidine (MIBG) is structurally similar to the neurotransmitter norepinephrine and specifically targets neuroendocrine cells including some neuroendocrine tumors. Iodine-131 (I-131)-labeled MIBG (I-131 MIBG) therapy for neuroendocrine tumors has been performed for more than a quarter-century. The indications of I-131 MIBG therapy include treatment-resistant neuroblastoma (NB), unresectable or metastatic pheochromocytoma (PC) and paraganglioma (PG), unresectable or metastatic carcinoid tumors, and unresectable or metastatic medullary thyroid cancer (MTC). I-131 MIBG therapy is one of the considerable effective treatments in patients with advanced NB, PC, and PG. On the other hand, I-131 MIBG therapy is an alternative method after more effective novel therapies are used such as radiolabeled somatostatin analogs and tyrosine kinase inhibitors in patients with advanced carcinoid tumors and MTC. No-carrier-aided (NCA) I-131 MIBG has more favorable potential compared to the conventional I-131 MIBG. Astatine-211-labeled meta-astatobenzylguanidine (At-211 MABG) has massive potential in patients with neuroendocrine tumors. Further studies about the therapeutic protocols of I-131 MIBG including NCA I-131 MIBG in the clinical setting and At-211 MABG in both the preclinical and clinical settings are needed.
Collapse
Affiliation(s)
- Daiki Kayano
- 1Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641 Japan.,2Department of Nuclear Medicine, Fukushima Medical University Hospital, 1 Hikariga-oka, Fukushima, 960-1295 Japan
| | - Seigo Kinuya
- 1Department of Nuclear Medicine, Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, 920-8641 Japan
| |
Collapse
|
118
|
Prolonged survival in secondary glioblastoma following local injection of targeted alpha therapy with 213Bi-substance P analogue. Eur J Nucl Med Mol Imaging 2018; 45:1636-1644. [PMID: 29713762 PMCID: PMC6061489 DOI: 10.1007/s00259-018-4015-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 04/09/2018] [Indexed: 12/14/2022]
Abstract
Background Glioblastoma multiforme (GBM), the most common malignant brain tumor, mainly manifests as a primary de novo and less frequently as a secondary glial neoplasm. GBM has been demonstrated to overexpress the NK-1 receptor and substance P can be used as a ligand for targeted therapy. Alpha emitters, e.g. 213Bi, that deposit their high energy within a short range allow the selective irradiation of tumor cells while sparing adjacent neuronal structures. Material and methods Among 50 glioma patients of different subtypes that have to date been treated with targeted alpha therapy at the Medical University Warsaw, we report here the data on nine patients with secondary GBM. Following surgery, chemo- and radiotherapy, recurrent GBM was treated by intracavitary injection of 1–6 doses of 0.9–2.3 GBq 213Bi- DOTA-[Thi8,Met(O2)11]-substance P (213Bi-DOTA-SP) in 2-month intervals. 68Ga-DOTA-[Thi8,Met(O2)11]-substance P (68Ga-DOTA-SP) was co-injected with the therapeutic doses to assess biodistribution using PET/CT. Therapeutic response was monitored with MRI. Results Treatment with activities ranging from 1.4 to 9.7 (median 5.8) GBq 213Bi- DOTA-SP was well tolerated with only mild transient adverse reactions, mainly headaches due to a transient perfocal edema reaction. The median progression free survival and overall survival time following the initiation of alpha therapy was 5.8 and 16.4 months, respectively. The median overall survival time from the first diagnosis was 52.3 months. Two out of nine patients are still alive 39 and 51 months, respectively, after the initiation of the therapy. Conclusions Targeted alpha therapy of secondary GBM with 213Bi-DOTA-SP is safe and well tolerated and may evolve as a promising novel therapeutic option for secondary GBM.
Collapse
|
119
|
Majkowska-Pilip A, Rius M, Bruchertseifer F, Apostolidis C, Weis M, Bonelli M, Laurenza M, Królicki L, Morgenstern A. In vitro evaluation of 225 Ac-DOTA-substance P for targeted alpha therapy of glioblastoma multiforme. Chem Biol Drug Des 2018; 92:1344-1356. [PMID: 29611298 DOI: 10.1111/cbdd.13199] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 02/21/2018] [Accepted: 03/07/2018] [Indexed: 12/25/2022]
Abstract
Glioblastoma multiforme (GBM) is the most malignant form of brain tumors with dismal prognosis despite treatment by surgery combined with radiotherapy and chemotherapy. The neuropeptide Substance P (SP) is the physiological ligand of the neurokinin-1 receptor, which is highly expressed in glioblastoma cells. Thus, SP represents a potential ligand for targeted alpha therapy. In this study, a protocol for the synthesis of SP labeled with the alpha emitter 225 Ac was developed and binding affinity properties were determined. The effects of 225 Ac-DOTA-SP were investigated on human glioblastoma cell lines (T98G, U87MG, U138MG) as well as GBM stem cells. A significant dose-dependent reduction in cell viability was detected up to 6 days after treatment. Also, colony-forming capacity was inhibited at the lower doses tested. In comparison, treatment with the conventional agent temozolomide showed higher cell viability and colony-forming capacity. 225 Ac-DOTA-SP treatment caused induction of late apoptosis pathways. Cells were arrested to G2/M-phase upon treatment. Increasing doses and treatment time caused additional S-phase arrest. Similar results were obtained using human glioblastoma stem cells, known to show radioresistance. Our data suggest that 225 Ac-DOTA-SP is a promising compound for treatment of GBM.
Collapse
Affiliation(s)
- Agnieszka Majkowska-Pilip
- Directorate for Nuclear Safety and Security, Joint Research Centre, European Commission, Karlsruhe, Germany.,Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology, Warsaw, Poland
| | - Maria Rius
- Directorate for Nuclear Safety and Security, Joint Research Centre, European Commission, Karlsruhe, Germany
| | - Frank Bruchertseifer
- Directorate for Nuclear Safety and Security, Joint Research Centre, European Commission, Karlsruhe, Germany
| | - Christos Apostolidis
- Directorate for Nuclear Safety and Security, Joint Research Centre, European Commission, Karlsruhe, Germany
| | - Mirjam Weis
- Directorate for Nuclear Safety and Security, Joint Research Centre, European Commission, Karlsruhe, Germany
| | - Milton Bonelli
- Department of Physiology and Pharmacology, University of Rome "Sapienza", Rome, Italy
| | - Marta Laurenza
- Department of Physiology and Pharmacology, University of Rome "Sapienza", Rome, Italy
| | - Leszek Królicki
- Department of Nuclear Medicine, Medical University Warsaw, Warsaw, Poland
| | - Alfred Morgenstern
- Directorate for Nuclear Safety and Security, Joint Research Centre, European Commission, Karlsruhe, Germany
| |
Collapse
|
120
|
Guo N, Pottier F, Aupiais J, Alliot C, Montavon G, Champion J. Evidence for the Heaviest Expected Halide Species in Aqueous Solution, At–, by Electromobility Measurements. Inorg Chem 2018; 57:4926-4933. [DOI: 10.1021/acs.inorgchem.7b03003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Ning Guo
- SUBATECH, UMR CNRS, 6457 IMT Atlantique/IN2P3/Université de Nantes, 4 rue Alfred Kastler, BP 20722, 44307 Nantes Cedex 3, France
| | - Fabien Pottier
- SUBATECH, UMR CNRS, 6457 IMT Atlantique/IN2P3/Université de Nantes, 4 rue Alfred Kastler, BP 20722, 44307 Nantes Cedex 3, France
| | | | - Cyrille Alliot
- GIP ARRONAX, 1 rue Aronnax, CS 10112, 44817 Saint-Herblain Cedex, France
- INSERM 892, CNRS 6299, CRCNA, 8 quai Moncousu, BP 70721, 44007 Nantes Cedex, France
| | - Gilles Montavon
- SUBATECH, UMR CNRS, 6457 IMT Atlantique/IN2P3/Université de Nantes, 4 rue Alfred Kastler, BP 20722, 44307 Nantes Cedex 3, France
| | - Julie Champion
- SUBATECH, UMR CNRS, 6457 IMT Atlantique/IN2P3/Université de Nantes, 4 rue Alfred Kastler, BP 20722, 44307 Nantes Cedex 3, France
| |
Collapse
|
121
|
Sattiraju A, Solingapuram Sai KK, Xuan A, Pandya DN, Almaguel FG, Wadas TJ, Herpai DM, Debinski W, Mintz A. IL13RA2 targeted alpha particle therapy against glioblastomas. Oncotarget 2018; 8:42997-43007. [PMID: 28562337 PMCID: PMC5522122 DOI: 10.18632/oncotarget.17792] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 04/15/2017] [Indexed: 12/22/2022] Open
Abstract
Glioblastoma (GBM) is the most aggressive primary malignant brain cancer that invariably results in a dismal prognosis. Chemotherapy and radiotherapy have not been completely effective as standard treatment options for patients due to recurrent disease. We and others have therefore developed molecular strategies to specifically target interleukin 13 receptor alpha 2 (IL13RA2), a GBM restricted receptor expressed abundantly on over 75% of GBM patients. In this work, we evaluated the potential of Pep-1L, a novel IL13RA2 targeted peptide, as a platform to deliver targeted lethal therapies to GBM. To demonstrate GBM-specificity, we radiolabeled Pep-1L with Copper-64 and performed in vitro cell binding studies, which demonstrated specific binding that was blocked by unlabeled Pep-1L. Furthermore, we demonstrated real-time GBM localization of [64Cu]Pep-1L to orthotopic GBMs using small animal PET imaging. Based on these targeting data, we performed an initial in vivo safety and therapeutic study using Pep-1L conjugated to Actinium-225, an alpha particle emitter that has been shown to potently and irreversibly kill targeted cells. We infused [225Ac]Pep-1L into orthotopic GBMs using convection-enhanced delivery and found no significant adverse events at injected doses. Furthermore, our initial data also demonstrated significantly greater overall, median and mean survival in treated mice when compared to those in control groups (p < 0.05). GBM tissue extracted from mice treated with [225Ac]Pep-1L showed double stranded DNA breaks, lower Ki67 expression and greater propidium iodide internalization, indicating anti-GBM therapeutic effects of [225Ac]Pep-1L. Based on our results, Pep-1L warrants further investigation as a potential targeted platform to deliver anti-cancer agents.
Collapse
Affiliation(s)
- Anirudh Sattiraju
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.,Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Winston-Salem, NC 27157, USA
| | - Kiran Kumar Solingapuram Sai
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.,Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Winston-Salem, NC 27157, USA
| | - Ang Xuan
- Department of Nuclear Medicine and Radiology, The People's Hospital of Zhengzhou University, Zhengzhou, Henan 450003, China
| | - Darpan N Pandya
- Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Winston-Salem, NC 27157, USA
| | - Frankis G Almaguel
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Thaddeus J Wadas
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.,Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Denise M Herpai
- Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Winston-Salem, NC 27157, USA.,Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Waldemar Debinski
- Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Winston-Salem, NC 27157, USA.,Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Akiva Mintz
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.,Brain Tumor Center of Excellence, Wake Forest University Comprehensive Cancer Center, Winston-Salem, NC 27157, USA
| |
Collapse
|
122
|
Miller BW. Radiation Imagers for Quantitative, Single-particle Digital Autoradiography of Alpha- and Beta-particle Emitters. Semin Nucl Med 2018; 48:367-376. [PMID: 29852946 DOI: 10.1053/j.semnuclmed.2018.02.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Promising therapies are being developed or are in early-stage clinical trials that employ the use of alpha- and beta-emitting radionuclides to cure hematologic malignancies. However, these targeted radionuclide therapies have not yet met their expected potential for cancer treatment. A primary reason is lack of biodistribution, dosimetry, and dose-response information at cellular levels, which are directly related to optimal targeting, achieving a requisite therapeutic dose, and assessing the safety profile in normal organs and tissues. The current set of imaging tools, such as film autoradiography, scintigraphy, and SPECT/CT, available to researchers and clinicians do not allow the effective assessment of radiation absorbed dose distributions at cellular levels because resolutions are poor, measurement and analytical times are long, and the spatial resolutions are low-generally resulting in poor signal-to-noise ratios. Recently, new radiation digital autoradiography imaging tools have been developed that promise to address these challenges. They include scintillation-, gaseous-, and semiconductor-based radiation-detection technologies that localize the emission location of charged particles on an event-by-event basis at resolutions up to 20 µm FWHM for alpha and beta emitters. These imaging systems allow radionuclide activity concentrations to be quantified to unprecedented levels (mBq/µg) and provide real-time imaging and simultaneous imaging capabilities of both high- and low-activity samples without dynamic range limitations that plague traditional autoradiography. Additionally, large-area imagers are available (>20 × 20 cm2) to accommodate high-throughput imaging studies. This article reviews the various detector classes and their associated performance trade-offs to provide researchers with an overview of the current technologies available for selecting an optimal detector configuration to meet imaging requirement needs.
Collapse
Affiliation(s)
- Brian W Miller
- College of Optical Sciences, The University of Arizona, Tucson, AZ.
| |
Collapse
|
123
|
Experimental and computational evidence of halogen bonds involving astatine. Nat Chem 2018; 10:428-434. [PMID: 29556053 DOI: 10.1038/s41557-018-0011-1] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 01/18/2018] [Indexed: 01/04/2023]
Abstract
The importance of halogen bonds-highly directional interactions between an electron-deficient σ-hole moiety in a halogenated compound and an acceptor such as a Lewis base-is being increasingly recognized in a wide variety of fields from biomedicinal chemistry to materials science. The heaviest halogens are known to form stronger halogen bonds, implying that if this trend continues down the periodic table, astatine should exhibit the highest halogen-bond donating ability. This may be mitigated, however, by the relativistic effects undergone by heavy elements, as illustrated by the metallic character of astatine. Here, the occurrence of halogen-bonding interactions involving astatine is experimentally evidenced. The complexation constants of astatine monoiodide with a series of organic ligands in cyclohexane solution were derived from distribution coefficient measurements and supported by relativistic quantum mechanical calculations. Taken together, the results show that astatine indeed behaves as a halogen-bond donor-a stronger one than iodine-owing to its much more electrophilic σ-hole.
Collapse
|
124
|
Poty S, Francesconi LC, McDevitt MR, Morris MJ, Lewis JS. α-Emitters for Radiotherapy: From Basic Radiochemistry to Clinical Studies-Part 1. J Nucl Med 2018; 59:878-884. [PMID: 29545378 DOI: 10.2967/jnumed.116.186338] [Citation(s) in RCA: 115] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 02/03/2018] [Indexed: 12/11/2022] Open
Abstract
With a short particle range and high linear energy transfer, α-emitting radionuclides demonstrate high cell-killing efficiencies. Even with the existence of numerous radionuclides that decay by α-particle emission, only a few of these can reasonably be exploited for therapeutic purposes. Factors including radioisotope availability and physical characteristics (e.g., half-life) can limit their widespread dissemination. The first part of this review will explore the diversity, basic radiochemistry, restrictions, and hurdles of α-emitters.
Collapse
Affiliation(s)
- Sophie Poty
- Department of Radiology and Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lynn C Francesconi
- Department of Chemistry, Hunter College, New York, New York.,Graduate Center of City University of New York, New York, New York
| | - Michael R McDevitt
- Department of Radiology and Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Michael J Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Jason S Lewis
- Department of Radiology and Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York .,Departments of Radiology and Pharmacology, Weill Cornell Medical College, New York, New York
| |
Collapse
|
125
|
Liu W, Ma H, Tang Y, Chen Q, Peng S, Yang J, Liao J, Yang Y, Li Q, Liu N. One-step labelling of a novel small-molecule peptide with astatine-211: preliminary evaluation in vitro and in vivo. J Radioanal Nucl Chem 2018. [DOI: 10.1007/s10967-018-5780-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
|
126
|
Poty S, Francesconi LC, McDevitt MR, Morris MJ, Lewis JS. α-Emitters for Radiotherapy: From Basic Radiochemistry to Clinical Studies-Part 2. J Nucl Med 2018; 59:1020-1027. [PMID: 29496984 DOI: 10.2967/jnumed.117.204651] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 02/03/2018] [Indexed: 12/30/2022] Open
Abstract
The use of radioactive sources to deliver cytotoxic ionizing radiation to disease sites dates back to the early 20th century, with the discovery of radium and its physiologic effects. α-emitters are of particular interest in the field of clinical oncology for radiotherapy applications. The first part of this review explored the basic radiochemistry, high cell-killing potency, and availability of α-emitting radionuclides, together with hurdles such as radiolabeling methods and daughter redistribution. The second part of this review will give an overview of the most promising and current uses of α-emitters in preclinical and clinical studies.
Collapse
Affiliation(s)
- Sophie Poty
- Department of Radiology and Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Lynn C Francesconi
- Department of Chemistry, Hunter College, New York, New York.,Graduate Center of City University of New York, New York, New York
| | - Michael R McDevitt
- Department of Radiology and Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Radiology, Weill Cornell Medical College, New York, New York
| | - Michael J Morris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; and
| | - Jason S Lewis
- Department of Radiology and Program in Molecular Pharmacology, Memorial Sloan Kettering Cancer Center, New York, New York .,Departments of Radiology and Pharmacology, Weill Cornell Medical College, New York, New York
| |
Collapse
|
127
|
Meyer GJ. Astatine. J Labelled Comp Radiopharm 2018; 61:154-164. [PMID: 29080397 DOI: 10.1002/jlcr.3573] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 09/14/2017] [Accepted: 09/29/2017] [Indexed: 12/20/2022]
Abstract
This educational review describes and summarizes the historic discovery of element 85, the experiments leading to its physical and chemical characterization and comparison with its lighter homologue iodine. The half-lives of its longest living isotopes 210 At and 211 At with 8.3 and 7.22 hours respectively together with their alpha decay characteristics made these isotopes interesting for radiation biological research. However, the lack of stable isotopes of astatine presents a strong challenge for all characterizations. Nevertheless, the decay characteristics especially of 211 At stimulated several research groups to develop labelling strategies for the preparation of astatinated radiopharmaceuticals for targeted alpha radiation therapy. Because of the distinct differences in the chemical behaviour of astatine, when compared with iodine, these approaches are quite challenging. Accordingly, quite different labelling strategies have been tested, namely nucleophilic and electrophilic substitution reactions as well as complex forming strategies. Classic and new developments for the preparation of these compounds are reviewed.
Collapse
Affiliation(s)
- Geerd-J Meyer
- Klinik für Nuklearmedizin/Radiopharmazeutische Chemie, Medizinische Hochschule Hannover, Hannover, Germany
| |
Collapse
|
128
|
Crawford JR, Robertson AKH, Yang H, Rodríguez-Rodríguez C, Esquinas PL, Kunz P, Blinder S, Sossi V, Schaffer P, Ruth TJ. Evaluation of209At as a theranostic isotope for209At-radiopharmaceutical development using high-energy SPECT. ACTA ACUST UNITED AC 2018; 63:045025. [DOI: 10.1088/1361-6560/aaaa95] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
129
|
Yamamoto S, Kamada K, Yoshikawa A. Ultrahigh resolution radiation imaging system using an optical fiber structure scintillator plate. Sci Rep 2018; 8:3194. [PMID: 29453459 PMCID: PMC5816672 DOI: 10.1038/s41598-018-21500-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 02/06/2018] [Indexed: 11/09/2022] Open
Abstract
High resolution imaging of radiation is required for such radioisotope distribution measurements as alpha particle detection in nuclear facilities or high energy physics experiments. For this purpose, we developed an ultrahigh resolution radiation imaging system using an optical fiber structure scintillator plate. We used a ~1-μm diameter fiber structured GdAlO3:Ce (GAP) /α-Al2O3 scintillator plate to reduce the light spread. The fiber structured scintillator plate was optically coupled to a tapered optical fiber plate to magnify the image and combined with a lens-based high sensitivity CCD camera. We observed the images of alpha particles with a spatial resolution of ~25 μm. For the beta particles, the images had various shapes, and the trajectories of the electrons were clearly observed in the images. For the gamma photons, the images also had various shapes, and the trajectories of the secondary electrons were observed in some of the images. These results show that combining an optical fiber structure scintillator plate with a tapered optical fiber plate and a high sensitivity CCD camera achieved ultrahigh resolution and is a promising method to observe the images of the interactions of radiation in a scintillator.
Collapse
Affiliation(s)
- Seiichi Yamamoto
- Radiological and Medical Laboratory Sciences, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Kei Kamada
- New Industry Creation Hatchery Center (NICHe), Tohoku University, Sendai, Japan
| | - Akira Yoshikawa
- New Industry Creation Hatchery Center (NICHe), Tohoku University, Sendai, Japan
| |
Collapse
|
130
|
Abstract
The phenomenal advances in pharmaceutical sciences over the last few decades have led to the development of new therapeutics like peptides, proteins, RNAs, DNAs and highly potent small molecules. Fruitful applications of these therapeutics have been challenged by several anatomical and physiological barriers that limit adequate drug disposition at the site-of-action and by off-target drug distribution to undesired tissues, which together result in the reduced effectiveness and increased side effects of therapeutic agents. As such, the development of drug delivery and targeting systems has been recognised as a cornerstone for future drug development. Research in pharmaceutical sciences is now devoted to tackling delivery challenges through engineering delivery systems that move beyond conventional dosage forms and regimens into state-of-the-art targeted drug delivery tailored toward specific therapeutic needs. Modern drug delivery systems comprise passive and active targeting approaches. While passive targeting relies on the natural course of distribution of drugs or drug carriers in the body, as governed by their physicochemical properties, active targeting often exploits targeting moieties that home preferentially into target tissues. Here, we provide an overview of theories of and approaches to passive and active drug delivery. As the design of drug delivery is dependent on the unique structure of target tissues and organs, we present our discussion in an organ-specific manner with the aim to inspire the development of new strategies for curing disease with high accuracy and efficiency.
Collapse
Affiliation(s)
- Mohammad Alsaggar
- a Department of Pharmaceutical Technology, College of Pharmacy , Jordon University of Science and Technology , Irbid , Jordan
| | - Dexi Liu
- b Department of Pharmaceutical and Biomedical Sciences, College of Pharmacy , University of Georgia , Athens , GA , USA
| |
Collapse
|
131
|
Marcu L, Bezak E, Allen BJ. Global comparison of targeted alpha vs targeted beta therapy for cancer: In vitro, in vivo and clinical trials. Crit Rev Oncol Hematol 2018; 123:7-20. [PMID: 29482781 DOI: 10.1016/j.critrevonc.2018.01.001] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 11/11/2017] [Accepted: 01/09/2018] [Indexed: 12/20/2022] Open
Abstract
Targeted therapy for cancer is a rapidly expanding and successful approach to the management of many intractable cancers. However, many immunotherapies fail in the longer term and there continues to be a need for improved targeted cancer cell toxicity, which can be achieved by radiolabelling the targeting vector with a radioisotope. Such constructs are successful in using a gamma ray emitter for imaging. However, traditionally, a beta emitter is used for therapeutic applications. The new approach is to use the short range and highly cytotoxic alpha radiation from alpha emitters to achieve improved efficacy and therapeutic gain. This paper sets out to review all experimental and theoretical comparisons of efficacy and therapeutic gain for alpha and beta emitters labelling the same targeting vector. The overall conclusion is that targeted alpha therapy is superior to targeted beta therapy, such that the use of alpha therapy in clinical settings should be expanded.
Collapse
Affiliation(s)
- Loredana Marcu
- Department of Physics, Faculty of Science, 1 Universitatii street, University of Oradea, 410087, Romania; Sansom Institute for Health Research and the School of Health Sciences, University of South Australia, GPO Box 247, Adelaide SA 5001, Australia
| | - Eva Bezak
- Sansom Institute for Health Research and the School of Health Sciences, University of South Australia, GPO Box 247, Adelaide SA 5001, Australia; Department of Physics, University of Adelaide, Adelaide, SA 5005, Australia
| | - Barry J Allen
- School of Medicine, University of Western Sydney, Locked Bag 1797, Penrith NSW 2751, Australia.
| |
Collapse
|
132
|
Choi J, Vaidyanathan G, Koumarianou E, Kang CM, Zalutsky MR. Astatine-211 labeled anti-HER2 5F7 single domain antibody fragment conjugates: radiolabeling and preliminary evaluation. Nucl Med Biol 2018; 56:10-20. [PMID: 29031230 PMCID: PMC5732883 DOI: 10.1016/j.nucmedbio.2017.09.003] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 08/28/2017] [Accepted: 09/14/2017] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Derived from heavy chain only camelid antibodies, ~15-kDa single-domain antibody fragments (sdAbs) are an attractive platform for developing molecularly specific imaging probes and targeted radiotherapeutics. The rapid tumor accumulation and normal tissue clearance of sdAbs might be ideal for use with 211At, a 7.2-h half-life α-emitter, if appropriate labeling chemistry can be devised to trap 211At in cancer cells after sdAb binding. This study evaluated two reagents, [211At]SAGMB and iso-[211At]SAGMB, for this purpose. METHODS [211At]SAGMB and iso-[211At]SAGMB, and their radioiodinated analogues [131I]SGMIB and iso-[131I]SGMIB, were synthesized by halodestannylation and reacted with the anti-HER2 sdAb 5F7. Radiochemical purity, immunoreactivity and binding affinity were determined. Paired-label internalization assays on HER2-expressing BT474M1 breast carcinoma cells directly compared [131I]SGMIB-5F7/[211At]SAGMB-5F7 and iso-[131I]SGMIB-5F7/iso-[211At]SAGMB-5F7 tandems. The biodistribution of the two tandems was evaluated in SCID mice with subcutaneous BT474M1 xenografts. RESULTS Radiochemical yields for Boc2-iso-[211At]SAGMB and Boc2-[211At]SAGMB synthesis, and efficiencies for coupling of iso-[211At]SAGMB and [211At]SAGMB to 5F7 were similar, with radiochemical purities of [211At]SAGMB-5F7 and iso-[211At]SAGMB-5F7 >98%. iso-[211At]SAGMB-5F7 and [211At]SAGMB-5F7 had immunoreactive fractions >80% and HER2 binding affinities of less than 5 nM. Internalization assays demonstrated high intracellular trapping of radioactivity, with little difference observed between corresponding 211At- and 131I-labeled 5F7 conjugates. Higher BT474M1 intracellular retention was observed from 1-6 h for the iso-conjugates (iso-[211At]SAGMB-5F7, 74.3 ± 2.8%, vs. [211At]SAGMB-5F7, 63.7 ± 0.4% at 2 h) with the opposite behavior observed at 24 h. Peak tumor uptake for iso-[211At]SAGMB-5F7 was 23.4 ± 2.2% ID/g at 4 h, slightly lower than its radioiodinated counterpart, but significantly higher than observed with [211At]SAGMB-5F7. Except in kidneys and lungs, tumor-to-normal organ ratios for iso-[211At]SAGMB-5F7 were greater than 10:1 by 2 h, and significantly higher than those for [211At]SAGMB-5F7. CONCLUSION These 211At-labeled sdAb conjugates, particularly iso-[211At]SAGMB-5F7, warrant further evaluation for targeted α-particle radiotherapy of HER2-expressing cancers.
Collapse
Affiliation(s)
- Jaeyeon Choi
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, 27710, USA
| | - Ganesan Vaidyanathan
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, 27710, USA
| | - Eftychia Koumarianou
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, 27710, USA
| | - Choong Mo Kang
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, 27710, USA
| | - Michael R Zalutsky
- Department of Radiology, Duke University Medical Center, Durham, North Carolina, 27710, USA.
| |
Collapse
|
133
|
Falzone N, Ackerman NL, Rosales LDLF, Bernal MA, Liu X, Peeters SGJA, Soto MS, Corroyer-Dulmont A, Bernaudin M, Grimoin E, Touzani O, Sibson NR, Vallis KA. Dosimetric evaluation of radionuclides for VCAM-1-targeted radionuclide therapy of early brain metastases. Theranostics 2018; 8:292-303. [PMID: 29290808 PMCID: PMC5743475 DOI: 10.7150/thno.22217] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 10/02/2017] [Indexed: 11/13/2022] Open
Abstract
Brain metastases develop frequently in patients with breast cancer, and present a pressing therapeutic challenge. Expression of vascular cell adhesion molecule 1 (VCAM-1) is upregulated on brain endothelial cells during the early stages of metastasis and provides a target for the detection and treatment of early brain metastases. The aim of this study was to use a model of early brain metastasis to evaluate the efficacy of α-emitting radionuclides, 149Tb, 211At, 212Pb, 213Bi and 225Ac; β-emitting radionuclides, 90Y, 161Tb and 177Lu; and Auger electron (AE)-emitters 67Ga, 89Zr, 111In and 124I, for targeted radionuclide therapy (TRT). METHODS Histologic sections and two photon microscopy of mouse brain parenchyma were used to inform a cylindrical vessel geometry using the Geant4 general purpose Monte Carlo (MC) toolkit with the Geant4-DNA low energy physics models. Energy deposition was evaluated as a radial function and the resulting phase spaces were superimposed on a DNA model to estimate double-strand break (DSB) yields for representative β- and α-emitters, 177Lu and 212Pb. Relative biological effectiveness (RBE) values were determined by only evaluating DNA damage due to physical interactions. RESULTS 177Lu produced 2.69 ± 0.08 DSB per GbpGy, without significant variation from the lumen of the vessel to a radius of 100 µm. The DSB yield of 212Pb included two local maxima produced by the 6.1 MeV and 8.8 MeV α-emissions from decay products, 212Bi and 212Po, with yields of 7.64 ± 0.12 and 9.15 ± 0.24 per GbpGy, respectively. Given its higher DSB yield 212Pb may be more effective for short range targeting of early micrometastatic lesions than 177Lu. CONCLUSION MC simulation of a model of early brain metastases provides invaluable insight into the potential efficacy of α-, β- and AE-emitting radionuclides for TRT. 212Pb, which has the attributes of a theranostic radionuclide since it can be used for SPECT imaging, showed a favorable dose profile and RBE.
Collapse
Affiliation(s)
- Nadia Falzone
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Nicole L. Ackerman
- Department of Physics and Astronomy, Agnes Scott College, Decatur, GA, United States of America
| | | | - Mario A. Bernal
- Departamento de Física Aplicada, Instituto de Física "Gleb Wataghin", UNICAMP, Campinas, Brazil
| | - Xiaoxuan Liu
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Sarah GJA Peeters
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Manuel Sarmiento Soto
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Aurélien Corroyer-Dulmont
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
- Normandie Univ, UNICAEN, CEA, CNRS, ISTCT/CERVOxy group, Caen, France
| | - Myriam Bernaudin
- Normandie Univ, UNICAEN, CEA, CNRS, ISTCT/CERVOxy group, Caen, France
| | - Elisa Grimoin
- Normandie Univ, UNICAEN, CEA, CNRS, ISTCT/CERVOxy group, Caen, France
| | - Omar Touzani
- Normandie Univ, UNICAEN, CEA, CNRS, ISTCT/CERVOxy group, Caen, France
| | - Nicola R. Sibson
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| | - Katherine A. Vallis
- CR-UK/MRC Oxford Institute for Radiation Oncology, Department of Oncology, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
134
|
Acheampong DO, Adokoh CK, Asante DB, Asiamah EA, Barnie PA, Bonsu DOM, Kyei F. Immunotherapy for acute myeloid leukemia (AML): a potent alternative therapy. Biomed Pharmacother 2017; 97:225-232. [PMID: 29091870 DOI: 10.1016/j.biopha.2017.10.100] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 10/11/2017] [Accepted: 10/21/2017] [Indexed: 12/20/2022] Open
Abstract
The standard therapy of AML for many years has been chemotherapy with or without stem transplantation. However, there has not been any tangible improvement in this treatment beyond induction through chemotherapy and consolidation with allogeneic stem cell transplantation or chemotherapy. Residual AML cells which later cause relapse mostly persist even after rigorous standard therapy. It is imperative therefore to find an alternative therapy that can take care of the residual AML cells. With a better understanding of how the immune system works to destroy tumor cells and inhibit their growth, another therapeutic option immunotherapy has emerged to address the difficulties associated with the standard therapy. Identification of leukemia-associated antigens (LAA) and the fact that T and NK cells can be activated to exert cytotoxicity on AML cells have further introduced diverse immunotherapeutic development strategies. This review discusses the merits of current immunotherapeutic strategies such as the use of antibodies, adoptive T cells and alloreactive NK cell, and vaccination as against the standard therapy of AML.
Collapse
Affiliation(s)
| | - Christian K Adokoh
- Department of Forensic Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Du-Bois Asante
- Department of Forensic Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Ernest A Asiamah
- Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Prince A Barnie
- Department of Forensic Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Dan O M Bonsu
- Department of Forensic Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Foster Kyei
- Department of Molecular Biology and Biotechnology, University of Cape Coast, Ghana
| |
Collapse
|
135
|
Milenic DE, Baidoo KE, Kim YS, Barkley R, Brechbiel MW. Comparative studies on the therapeutic benefit of targeted α-particle radiation therapy for the treatment of disseminated intraperitoneal disease. Dalton Trans 2017; 46:14591-14601. [PMID: 28675216 PMCID: PMC5664163 DOI: 10.1039/c7dt01819c] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Identification of the appropriate combination of radionuclide, target and targeting vehicle is critical for successful radioimmunotherapy. For the treatment of disseminated peritoneal diseases such as pancreatic or ovarian cancer, α-emitting radionuclides have been proposed for targeted radiation therapy. This laboratory has taken a systematic approach investigating targeted α-radiation therapy, allowing comparisons to now be made between 211At, 227Th, 213Bi and 212Pb. Herein, trastuzumab radiolabeled with 211At and 227Th was evaluated for therapeutic efficacy in the LS-174T i.p. tumor model. A dose escalation study was conducted with each radioimmunoconjugate (RIC). Therapeutic benefit was realized with 211At-trastuzumab with doses of 20, 30 and 40 μCi. At doses >40 μCi, toxicity was observed with greater weight loss and 2-fold higher decrease in the platelet counts. Following a second study comparing the effect of 20, 30 and 40 μCi of 211At-trastuzumab, 30 μCi was selected as the dose for future studies. A parallel study was performed evaluating 0.25, 0.5, 1.0, 2.0 and 5.0 μCi of 227Th-trastuzumab. The 0.5 and 1.0 μCi injected dose resulted in a therapeutic response; a lower degree of weight loss was experienced by the mice in the 0.5 μCi cohort. When the data is normalized for comparing 211At, 227Th, 213Bi and 212Pb, the choice of radionuclide for RIT is perhaps not entirely based on simple therapeutic efficacy, other factors may play a role in choosing the "right" radionuclide.
Collapse
Affiliation(s)
- Diane E Milenic
- Radioimmune & Inorganic Chemistry Section, Radiation Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda MD, USA.
| | | | | | | | | |
Collapse
|
136
|
Séhédic D, Chourpa I, Tétaud C, Griveau A, Loussouarn C, Avril S, Legendre C, Lepareur N, Wion D, Hindré F, Davodeau F, Garcion E. Locoregional Confinement and Major Clinical Benefit of 188Re-Loaded CXCR4-Targeted Nanocarriers in an Orthotopic Human to Mouse Model of Glioblastoma. Am J Cancer Res 2017; 7:4517-4536. [PMID: 29158842 PMCID: PMC5695146 DOI: 10.7150/thno.19403] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 09/11/2017] [Indexed: 02/02/2023] Open
Abstract
PURPOSE Gold standard beam radiation for glioblastoma (GBM) treatment is challenged by resistance phenomena occurring in cellular populations well prepared to survive or to repair damage caused by radiation. Among signals that have been linked with radio-resistance, the SDF1/CXCR4 axis, associated with cancer stem-like cell, may be an opportune target. To avoid the problem of systemic toxicity and blood-brain barrier crossing, the relevance and efficacy of an original system of local brain internal radiation therapy combining a radiopharmaceutical with an immuno-nanoparticle was investigated. EXPERIMENT DESIGN The nanocarrier combined lipophilic thiobenzoate complexes of rhenium-188 loaded in the core of a lipid nanocapsule (LNC188Re) with a function-blocking antibody, 12G5 directed at the CXCR4, on its surface. The efficiency of 12G5-LNC188Re was investigated in an orthotopic and xenogenic GBM model of CXCR4-positive U87MG cells implanted in the striatum of Scid mice. RESULTS We demonstrated that 12G5-LNC188Re single infusion treatment by convection-enhanced delivery resulted in a major clinical improvement in median survival that was accompanied by locoregional effects on tumor development including hypovascularization and stimulation of the recruitment of bone marrow derived CD11b- or CD68-positive cells as confirmed by immunohistochemistry analysis. Interestingly, thorough analysis by spectral imaging in a chimeric U87MG GBM model containing CXCR4-positive/red fluorescent protein (RFP)-positive- and CXCR4-negative/RFP-negative-GBM cells revealed greater confinement of DiD-labeled 12G5-LNCs than control IgG2a-LNCs in RFP compartments. Main conclusion: These findings on locoregional impact and targeting of disseminated cancer cells in tumor margins suggest that intracerebral active targeting of nanocarriers loaded with radiopharmaceuticals may have considerable benefits in clinical applications.
Collapse
|
137
|
Gan HK, van den Bent M, Lassman AB, Reardon DA, Scott AM. Antibody-drug conjugates in glioblastoma therapy: the right drugs to the right cells. Nat Rev Clin Oncol 2017; 14:695-707. [PMID: 28675164 DOI: 10.1038/nrclinonc.2017.95] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Glioblastomas are high-grade brain tumours with a poor prognosis and, currently, few available therapeutic options. This lack of effective treatments has been linked to diverse factors, including target selection, tumour heterogeneity and poor penetrance of therapeutic agents through the blood-brain barrier and into tumours. Therapies using monoclonal antibodies, alone or linked to cytotoxic payloads, have proved beneficial for patients with different solid tumours; these approaches are currently being explored in patients with glioblastoma. In this Review, we summarise clinical data regarding antibody-drug conjugates (ADCs) against a variety of targets in glioblastoma, and compare the efficacy and toxicity of targeting EGFR with ADCs versus naked antibodies in order to illustrate key aspects of the use of ADCs in this malignancy. Finally, we discuss the complex challenges related to the biology and mutational changes of glioblastoma that can affect the use of ADC-based therapies in patients with this disease, and highlight potential strategies to improve efficacy.
Collapse
Affiliation(s)
- Hui K Gan
- Austin Health and Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, Victoria 3084, Australia.,La Trobe University School of Cancer Medicine, 145 Studley Road, Heidelberg, Victoria 3084, Australia.,Department of Medicine, University of Melbourne, 145 Studley Road, Heidelberg, Victoria 3084, Australia
| | - Martin van den Bent
- Brain Tumour Centre, Erasmus MC Cancer Institute, Groene Hilledijk 301, 3075 EA Rotterdam, Netherlands
| | - Andrew B Lassman
- Department of Neurology & Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, 161 Fort Washington Avenue, New York, New York 10032, USA
| | - David A Reardon
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Dana 2134, Boston, Massachusetts 02215, USA
| | - Andrew M Scott
- Austin Health and Olivia Newton-John Cancer Research Institute, 145 Studley Road, Heidelberg, Victoria 3084, Australia.,La Trobe University School of Cancer Medicine, 145 Studley Road, Heidelberg, Victoria 3084, Australia.,Department of Medicine, University of Melbourne, 145 Studley Road, Heidelberg, Victoria 3084, Australia
| |
Collapse
|
138
|
Raghavan R, Howell RW, Zalutsky MR. A model for optimizing delivery of targeted radionuclide therapies into resection cavity margins for the treatment of primary brain cancers. Biomed Phys Eng Express 2017; 3:035005. [PMID: 29081990 PMCID: PMC5658137 DOI: 10.1088/2057-1976/aa6db9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Radionuclides conjugated to molecules that bind specifically to cancer cells are of great interest as a means to increase the specificity of radiotherapy. Currently, the methods to disseminate these targeted radiotherapeutics have been either systemic delivery or by bolus injection into the tumor or tumor resection cavity. Herein we model a potentially more efficient method of delivery, namely pressure-driven fluid flow, called convection-enhanced delivery (CED), where a device infuses the molecules in solution (or suspension) directly into the tissue of interest. In particular, we focus on the setting of primary brain cancer after debulking surgery, where the tissue margins surrounding the surgical resection cavity are infiltrated with tumor cells and the most frequent sites of tumor recurrence. We develop the combination of fluid flow, chemical kinetics, and radiation dose models needed to examine such protocols. We focus on Auger electron-emitting radionuclides (e.g. 67Ga, 77Br, 111In, 125I, 123I, 193mPt, 195mPt) whose short range makes them ideal for targeted therapy in this setting of small foci of tumor spread within normal tissue. By solving these model equations, we confirm that a CED protocol is promising in allowing sufficient absorbed dose to destroy cancer cells with minimal absorbed dose to normal cells at clinically feasible activity levels. We also show that Auger emitters are ideal for this purpose while the longer range alpha particle emitters fail to meet criteria for effective therapy (as neither would energetic beta particle emitters). The model is used with simplified assumptions on the geometry and homogeneity of brain tissue to allow semi-analytic solutions to be displayed, and with the purpose of a first examination of this new delivery protocol proposed for radionuclide therapy. However, we emphasize that it is immediately extensible to personalized therapy treatment planning as we have previously shown for conventional CED, at the price of requiring a fully numerical computerized approach.
Collapse
Affiliation(s)
- Raghu Raghavan
- Therataxis, LLC, JHU Eastern Complex, Suite B305, 1101 E. 33rd St., Baltimore MD 21218, United States of America
| | - Roger W Howell
- Division of Radiation Research, Department of Radiology, New Jersey Medical School Cancer Center. Rutgers, The State Univeristy of New Jersey, 205 S. Orange Ave, Newark, NJ 07103, United States of America
| | - Michael R Zalutsky
- Department of Radiology, Duke University Medical Center, 311 Research Drive, Durham, NC27710, United States of America
| |
Collapse
|
139
|
Targeted radionuclide therapy with astatine-211: Oxidative dehalogenation of astatobenzoate conjugates. Sci Rep 2017; 7:2579. [PMID: 28566709 PMCID: PMC5451414 DOI: 10.1038/s41598-017-02614-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 04/13/2017] [Indexed: 11/09/2022] Open
Abstract
211At is a most promising radionuclide for targeted alpha therapy. However, its limited availability and poorly known basic chemistry hamper its use. Based on the analogy with iodine, labelling is performed via astatobenzoate conjugates, but in vivo deastatination occurs, particularly when the conjugates are internalized in cells. Actually, the chemical or biological mechanism responsible for deastatination is unknown. In this work, we show that the C−At “organometalloid” bond can be cleaved by oxidative dehalogenation induced by oxidants such as permanganates, peroxides or hydroxyl radicals. Quantum mechanical calculations demonstrate that astatobenzoates are more sensitive to oxidation than iodobenzoates, and the oxidative deastatination rate is estimated to be about 6 × 106 faster at 37 °C than the oxidative deiodination one. Therefore, we attribute the “internal” deastatination mechanism to oxidative dehalogenation in biological compartments, in particular lysosomes.
Collapse
|
140
|
Lyczko M, Pruszynski M, Majkowska-Pilip A, Lyczko K, Was B, Meczynska-Wielgosz S, Kruszewski M, Szkliniarz K, Jastrzebski J, Stolarz A, Bilewicz A. 211At labeled substance P (5-11) as potential radiopharmaceutical for glioma treatment. Nucl Med Biol 2017; 53:1-8. [PMID: 28683361 DOI: 10.1016/j.nucmedbio.2017.05.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/18/2017] [Accepted: 05/21/2017] [Indexed: 02/03/2023]
Abstract
INTRODUCTION The purposes of the present work were to label substance P (5-11) with 211At using a rhodium(III) complex with a bifunctional ligand-2-(1,5,9,13-tetrathiacyclohexadecan-3-yloxy)acetic acid ([16aneS4]-COOH) and to assess the in vitro stability and toxicity of the obtained radiobioconjugate. METHODS Two approaches were evaluated to obtain 131I/211At-Rh[16aneS4]-SP5-11 radiobioconjugates, based on 2-step and 1-step syntheses. In the first method 131I/211At-Rh[16aneS4]-COOH complexes were obtained that required further coupling to a biomolecule. In the second approach, the bioconjugate [16aneS4]-SP5-11 was synthesized and further labeled with 131I and 211At through the utilization of a Rh(III) metal cation bridge. The synthesized compounds were analyzed by HPLC, TLC and paper electrophoresis. RESULTS The 131I/211At-Rh[16aneS4]-COOH complexes were obtained in high yield and possessed good stability in PBS and CSF. Preliminary studies on coupling of 131I-Rh[16aneS4]-COOH to substance P (5-11) in 2-step synthesis showed that this procedure was too long with respect to 211At half-life, prompting us to improve it by finally using a 1-step synthesis. This strategy not only shortened the labeling time, but also increased final yield of 131I/211At-Rh[16aneS4]-SP5-11 radiobioconjugates. The stability of both compounds in PBS and CSF was high. Toxicity studies with the 211At-Rh[16aneS4]-SP5-11 demonstrated that radiobioconjugate significantly reduced T98G cell viability in a dose dependent manner reaching 20% of survival at the highest radioactivity 1200kBq/mL. CONCLUSIONS The radiobioconjugate 211At-Rh[16aneS4]-SP5-11 revealed its potential in killing glioma T98G cells during in vitro studies; therefore further animal studies to are required to determine its in vivo stability and treatment potential in normal and xenografted mice.
Collapse
Affiliation(s)
- Monika Lyczko
- Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland.
| | - Marek Pruszynski
- Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland
| | - Agnieszka Majkowska-Pilip
- Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland
| | - Krzysztof Lyczko
- Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland
| | - Bogdan Was
- Institute of Nuclear Physics, Polish Academy of Sciences, 31-342 Cracow, Poland
| | - Sylwia Meczynska-Wielgosz
- Centre For Radiobiology and Biological Dosimetry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland
| | - Marcin Kruszewski
- Centre For Radiobiology and Biological Dosimetry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland; Faculty of Medicine, University of Information Technology and Management in Rzeszów, 35-225 Rzeszów, Poland; Department of Molecular Biology and Translational Research, Institute of Rural Health, 20-090 Lublin, Poland
| | | | | | - Anna Stolarz
- Heavy Ion Laboratory, University of Warsaw, 02-093 Warsaw, Poland
| | - Aleksander Bilewicz
- Centre of Radiochemistry and Nuclear Chemistry, Institute of Nuclear Chemistry and Technology, 03-195 Warsaw, Poland
| |
Collapse
|
141
|
Bourgeois M, Bailly C, Frindel M, Guerard F, Chérel M, Faivre-Chauvet A, Kraeber-Bodéré F, Bodet-Milin C. Radioimmunoconjugates for treating cancer: recent advances and current opportunities. Expert Opin Biol Ther 2017; 17:813-819. [DOI: 10.1080/14712598.2017.1322577] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Mickaël Bourgeois
- Department of Nuclear Medicine, University Hospital, 44093 Nantes, France
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
- Department of radiopharmacy, ARRONAX Cyclotron, Saint Herblain, France
| | - Clément Bailly
- Department of Nuclear Medicine, University Hospital, 44093 Nantes, France
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
| | - Mathieu Frindel
- Department of Nuclear Medicine, Institut de Cancérologie de l’Ouest (ICO) – Site Gauducheau, Saint Herblain, France
| | - François Guerard
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
| | - Michel Chérel
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
- Department of Nuclear Medicine, Institut de Cancérologie de l’Ouest (ICO) – Site Gauducheau, Saint Herblain, France
| | - Alain Faivre-Chauvet
- Department of Nuclear Medicine, University Hospital, 44093 Nantes, France
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
| | - Françoise Kraeber-Bodéré
- Department of Nuclear Medicine, University Hospital, 44093 Nantes, France
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
- Department of Nuclear Medicine, Institut de Cancérologie de l’Ouest (ICO) – Site Gauducheau, Saint Herblain, France
| | - Caroline Bodet-Milin
- Department of Nuclear Medicine, University Hospital, 44093 Nantes, France
- Nantes-Angers Cancer Research Center (CRCNA), University of Nantes, Nantes, France
- Department of Nuclear Medicine, Institut de Cancérologie de l’Ouest (ICO) – Site Gauducheau, Saint Herblain, France
| |
Collapse
|
142
|
Crawford JR, Kunz P, Yang H, Schaffer P, Ruth TJ. 211 Rn/ 211 At and 209 At production with intense mass separated Fr ion beams for preclinical 211 At-based α-therapy research. Appl Radiat Isot 2017; 122:222-228. [DOI: 10.1016/j.apradiso.2017.01.035] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/06/2017] [Accepted: 01/24/2017] [Indexed: 11/16/2022]
|
143
|
An automated flow system incorporating in-line acid dissolution of bismuth metal from a cyclotron irradiated target assembly for use in the isolation of astatine-211. Appl Radiat Isot 2017; 122:202-210. [DOI: 10.1016/j.apradiso.2017.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/22/2017] [Accepted: 02/01/2017] [Indexed: 11/19/2022]
|
144
|
Pozzi OR, Zalutsky MR. Radiopharmaceutical chemistry of targeted radiotherapeutics, part 4: Strategies for 211At labeling at high activities and radiation doses of 211At α-particles. Nucl Med Biol 2017; 46:43-49. [PMID: 28013121 PMCID: PMC5285439 DOI: 10.1016/j.nucmedbio.2016.11.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 11/11/2016] [Accepted: 11/28/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Alpha particles are radiation of high energy and short range, properties that can lead to radiolysis-mediated complications in labeling chemistry at the high radioactivity levels required for clinical application. In previous papers in this series, we have shown that radiation dose has a profound effect on the astatine species that are present in the labeling reaction and their suitability for the synthesis of N-succinimidyl 3-[211At]astatobenzoate. The purpose of this study was to evaluate the effects of adding N-chlorosuccinimide (NCS) to the methanol solution used for initial isolation of 211At after distillation, a process referred to as 211At stabilization, on 211At chemistry after exposure to high radiation doses. METHODS High performance liquid chromatography was used to evaluate the distribution of 211At species present in methanol in the 500-65,000Gy radiation dose range and the synthesis of SAB from N-succinimidyl 3-(tri-n-butylstannyl)benzoate in the 500-120,000Gy radiation dose range using different 211At timeactivity combinations under conditions with/without 211At stabilization. RESULTS In the absence of NCS stabilization, a reduced form of astatine, At(2), increased with increasing radiation dose, accounting for about half the total activity by about 15,000Gy, while with stabilization, At(2) accounted for <10% of 211At activity even at doses >60,000Gy. SAB yields without stabilization rapidly declined with increasing dose, falling to ~20% at about 5000Gy while with stabilization, yields >80% were obtained with 211At solutions stored for more than 23h and receiving radiation doses >100,000Gy. CONCLUSIONS Adding NCS to the methanol solution used for initial isolation of 211At is a promising strategy for countering the deleterious effects of radiolysis on 211At chemistry. ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE This strategy could facilitate the ability to perform 211At labeling at sites remote from its production and at the high activity levels required for clinical applications.
Collapse
Affiliation(s)
- Oscar R Pozzi
- Department of Radiology, Duke University Medical Center, Durham, NC, 27710, USA.
| | - Michael R Zalutsky
- Department of Radiology, Duke University Medical Center, Durham, NC, 27710, USA.
| |
Collapse
|
145
|
Crawford JR, Yang H, Kunz P, Wilbur DS, Schaffer P, Ruth TJ. Development of a preclinical 211Rn/ 211At generator system for targeted alpha therapy research with 211At. Nucl Med Biol 2017; 48:31-35. [PMID: 28193502 DOI: 10.1016/j.nucmedbio.2017.01.011] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 11/16/2016] [Accepted: 01/25/2017] [Indexed: 01/28/2023]
Abstract
INTRODUCTION The availability of 211At for targeted alpha therapy research can be increased by the 211Rn/211At generator system, whereby 211At is produced by 211Rn electron capture decay. This study demonstrated the feasibility of using generator-produced 211At to label monoclonal antibody (BC8, anti-human CD45) for preclinical use, following isolation from the 207Po contamination also produced by these generators (by 211Rn α-decay). METHODS 211Rn was produced by 211Fr electron capture decay following mass separated ion beam implantation and chemically isolated in liquid alkane hydrocarbon (dodecane). 211At produced by the resulting 211Rn source was extracted in strong base (2N NaOH) and purified by granular Te columns. BC8-B10 (antibody conjugated with closo-decaborate(2-)) was labeled with generator-produced 211At and purified by PD-10 columns. RESULTS Aqueous solutions extracted from the generator were found to contain 211At and 207Po, isolated from 211Rn. High radionuclidic purity was obtained for 211At eluted from Te columns, from which BC8-B10 monoclonal antibody was successfully labeled. If not removed, 207Po was found to significantly contaminate the final 211At-BC8-B10 product. High yield efficiencies (decay-corrected, n=3) were achieved for 211At extraction from the generator (86%±7%), Te column purification (70%±10%), and antibody labeling (76%±2%). CONCLUSIONS The experimental 211Rn/211At generator was shown to be well-suited for preclinical 211At-based research. ADVANCES IN KNOWLEDGE We believe that these experiments have furthered the knowledge-base for expanding accessibility to 211At using the 211Rn/211At generator system. IMPLICATIONS FOR PATIENT CARE As established by this work, the 211Rn/211At generator has the capability of facilitating preclinical evaluations of 211At-based therapies.
Collapse
Affiliation(s)
- Jason R Crawford
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada; Department of Physics and Astronomy, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada.
| | - Hua Yang
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - Peter Kunz
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - D Scott Wilbur
- Department of Radiation Oncology, University of Washington (Box 355016), 616 N.E. Northlake Place, Seattle, WA 98105, USA
| | - Paul Schaffer
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada
| | - Thomas J Ruth
- TRIUMF, 4004 Wesbrook Mall, Vancouver, British Columbia V6T 2A3, Canada; Department of Physics and Astronomy, University of Victoria, 3800 Finnerty Road, Victoria, British Columbia V8P 5C2, Canada
| |
Collapse
|
146
|
Aghevlian S, Boyle AJ, Reilly RM. Radioimmunotherapy of cancer with high linear energy transfer (LET) radiation delivered by radionuclides emitting α-particles or Auger electrons. Adv Drug Deliv Rev 2017; 109:102-118. [PMID: 26705852 DOI: 10.1016/j.addr.2015.12.003] [Citation(s) in RCA: 99] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 11/26/2015] [Accepted: 12/06/2015] [Indexed: 12/31/2022]
Abstract
Radioimmunotherapy (RIT) aims to selectively deliver radionuclides emitting α-particles, β-particles or Auger electrons to tumors by conjugation to monoclonal antibodies (mAbs) that recognize tumor-associated antigens/receptors. The approach has been most successful for treatment of non-Hodgkin's B-cell lymphoma but challenges have been encountered in extending these promising results to the treatment of solid malignancies. These challenges include the low potency of β-particle emitters such as 131I, 177Lu or 90Y which have been commonly conjugated to the mAbs, due to their low linear energy transfer (LET=0.1-1.0keV/μm). Furthermore, since the β-particles have a 2-10mm range, there has been dose-limiting non-specific toxicity to hematopoietic stem cells in the bone marrow (BM) due to the cross-fire effect. Conjugation of mAbs to α-particle-emitters (e.g. 225Ac, 213Bi, 212Pb or 211At) or Auger electron-emitters (e.g. 111In, 67Ga, 123I or 125I) would increase the potency of RIT due to their high LET (50-230keV/μm and 4 to 26keV/μm, respectively). In addition, α-particles have a range in tissues of 28-100μm and Auger electrons are nanometer in range which greatly reduces or eliminates the cross-fire effect compared to β-particles, potentially reducing their non-specific toxicity to the BM. In this review, we describe the results of preclinical and clinical studies of RIT of cancer using radioimmunoconjugates emitting α-particles or Auger electrons, and discuss the potential of these high LET forms of radiation to improve the outcome of cancer patients.
Collapse
Affiliation(s)
- Sadaf Aghevlian
- Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON, Canada
| | - Amanda J Boyle
- Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON, Canada
| | - Raymond M Reilly
- Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada; Toronto General Research Institute and Joint Department of Medical Imaging, University Health Network, Toronto, ON, Canada.
| |
Collapse
|
147
|
Ceder J, Elgqvist J. Targeting Prostate Cancer Stem Cells with Alpha-Particle Therapy. Front Oncol 2017; 6:273. [PMID: 28119854 PMCID: PMC5220245 DOI: 10.3389/fonc.2016.00273] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 12/22/2016] [Indexed: 01/16/2023] Open
Abstract
Modern molecular and radiopharmaceutical development has brought the promise of tumor-selective delivery of antibody-drug conjugates to tumor cells for the diagnosis and treatment of primary and disseminated tumor disease. The classical mode of discourse regarding targeted therapy has been that the antigen targeted must be highly and homogenously expressed in the tumor cell population, and at the same time exhibit low expression in healthy tissue. However, there is increasing evidence that the reason cancer patients are not cured by current protocols is that there exist subpopulations of cancer cells that are resistant to conventional therapy including radioresistance and that these cells express other target antigens than the bulk of the tumor cells. These types of cells are often referred to as cancer stem cells (CSCs). The CSCs are tumorigenic and have the ability to give rise to all types of cells found in a cancerous disease through the processes of self-renewal and differentiation. If the CSCs are not eradicated, the cancer is likely to recur after therapy. Due to some of the characteristics of alpha particles, such as short path length and high density of energy depositions per distance traveled in tissue, they are especially well suited for use in targeted therapies against microscopic cancerous disease. The characteristics of alpha particles further make it possible to minimize the irradiation of non-targeted surrounding healthy tissue, but most importantly, make it possible to deliver high-absorbed doses locally and therefore eradicating small tumor cell clusters on the submillimeter level, or even single tumor cells. When alpha particles pass through a cell, they cause severe damage to the cell membrane, cytoplasm, and nucleus, including double-strand breaks of DNA that are very difficult to repair for the cell. This means that very few hits to a cell by alpha particles are needed in order to cause cell death, enabling killing of cells, such as CSCs, exhibiting cellular resistance mechanisms to conventional therapy. This paper presents and evaluates the possibility of using alpha-particle emitting radionuclides in the treatment of prostate cancer (PCa) and discusses the parameters that have to be considered as well as pros and cons of targeted alpha-particle therapy in the treatment of PCa. By targeting and eradicating the CSCs responsible of tumor recurrence in patients who no longer respond to conventional therapies, including androgen deprivation and castration, it may be possible to cure the disease, or prolong survival significantly.
Collapse
Affiliation(s)
- Jens Ceder
- Department of Translational Medicine, Lund University, Skåne University Hospital , Malmö , Sweden
| | - Jörgen Elgqvist
- Department of Physics, University of Gothenburg, Gothenburg, Sweden; Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden
| |
Collapse
|
148
|
Dziawer L, Koźmiński P, Męczyńska-Wielgosz S, Pruszyński M, Łyczko M, Wąs B, Celichowski G, Grobelny J, Jastrzębski J, Bilewicz A. Gold nanoparticle bioconjugates labelled with 211At for targeted alpha therapy. RSC Adv 2017. [DOI: 10.1039/c7ra06376h] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Gold nanoparticles labeled with 211At are very effective in radionuclide therapy.
Collapse
Affiliation(s)
- L. Dziawer
- Institute of Nuclear Chemistry and Technology
- 03-195 Warsaw
- Poland
| | - P. Koźmiński
- Institute of Nuclear Chemistry and Technology
- 03-195 Warsaw
- Poland
| | | | - M. Pruszyński
- Institute of Nuclear Chemistry and Technology
- 03-195 Warsaw
- Poland
| | - M. Łyczko
- Institute of Nuclear Chemistry and Technology
- 03-195 Warsaw
- Poland
| | - B. Wąs
- Institute of Nuclear Physics
- Polish Academy of Sciences
- 31-342 Cracow
- Poland
| | | | - J. Grobelny
- Faculty of Chemistry
- University of Lodz
- 90-236 Lodz
- Poland
| | - J. Jastrzębski
- Heavy Ion Laboratory
- University of Warsaw
- 02-093 Warszawa
- Poland
| | - A. Bilewicz
- Institute of Nuclear Chemistry and Technology
- 03-195 Warsaw
- Poland
| |
Collapse
|
149
|
Developing a dedicated comprehensive α-radionuclide therapy program: should this be the vision of the atomic energy programs in the next decade? Nucl Med Commun 2016; 38:103-105. [PMID: 27906780 DOI: 10.1097/mnm.0000000000000626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
150
|
Kwekkeboom DJ, Krenning EP. Peptide Receptor Radionuclide Therapy in the Treatment of Neuroendocrine Tumors. Hematol Oncol Clin North Am 2016; 30:179-91. [PMID: 26614376 DOI: 10.1016/j.hoc.2015.09.009] [Citation(s) in RCA: 96] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Peptide receptor radionuclide therapy (PRRT) is a promising new treatment modality for inoperable or metastasized gastroenteropancreatic neuroendocrine tumors patients. Most studies report objective response rates in 15% to 35% of patients. Progression-free (PFS) and overall survival (OS) compare favorably with that for somatostatin analogues, chemotherapy, or newer, "targeted" therapies. Prospective, randomized data regarding the potential PFS and OS benefit of PRRT compared with standard therapies is anticipated.
Collapse
Affiliation(s)
- Dik J Kwekkeboom
- Department of Nuclear Medicine, Erasmus MC, University Medical Center, s-Gravendijkwal 230, Rotterdam 3015CE, The Netherlands.
| | - Eric P Krenning
- Department of Nuclear Medicine, Erasmus MC, University Medical Center, s-Gravendijkwal 230, Rotterdam 3015CE, The Netherlands
| |
Collapse
|