1
|
Pereira MP, Tejería ME, Zeni M, Gambini JP, Duarte P, Rey A, Giglio J. Radiosynthesis and validation of [ 18 F]Fluoroestradiol in a Synthra plus research platform for use in routine clinical practice. J Labelled Comp Radiopharm 2022; 65:292-297. [PMID: 35996821 DOI: 10.1002/jlcr.3998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 08/11/2022] [Accepted: 08/17/2022] [Indexed: 11/06/2022]
Abstract
In this practitioner protocol, the optimization of the radiochemical synthesis of [18 F]fluoroestradiol (FES) on the Synthra RNplus research automated platform is described in detail and a QC summary of three validation productions is presented. In comparison to published synthesis methods developed on other platforms, the yield was considerably improved (40-45% ndc). The other important improvement is the reduction of the required concentration of H2 SO4 avoiding the production of high concentrations of acidic vapors that can deteriorate the module. Purification was achieved by solid phase extraction and the required adaptation of an external heating plate to the module to evaporate the ethanol is also described. The product was obtained with high radiochemical purity and fulfilled all the requirements of current Good Manufacturing Practice (cGMP). The final product is formulated as a sterile, pyrogen-free solution suitable for human injection. To the best of our knowledge this is the first report of FES production using this type of module.
Collapse
Affiliation(s)
- María Pía Pereira
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay.,Área Radioquímica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | - María Emilia Tejería
- Área Radioquímica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | - Maia Zeni
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay.,Área Radioquímica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | | | - Pablo Duarte
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
| | - Ana Rey
- Área Radioquímica, Facultad de Química, Universidad de la República, Montevideo, Uruguay
| | - Javier Giglio
- Centro Uruguayo de Imagenología Molecular (CUDIM), Montevideo, Uruguay
| |
Collapse
|
2
|
Katzenellenbogen JA. The quest for improving the management of breast cancer by functional imaging: The discovery and development of 16α-[ 18F]fluoroestradiol (FES), a PET radiotracer for the estrogen receptor, a historical review. Nucl Med Biol 2021; 92:24-37. [PMID: 32229068 PMCID: PMC7442693 DOI: 10.1016/j.nucmedbio.2020.02.007] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/16/2020] [Indexed: 12/21/2022]
Abstract
INTRODUCTION 16α-[18F]Fluoroestradiol (FES), a PET radiotracer for the estrogen receptor (ER) in breast cancer, was the first receptor-targeted PET radiotracer for oncology and is continuing to prove its value in clinical research, antiestrogen development, and breast cancer care. The story of its conception, design, evaluation and use in clinical studies parallels the evolution of the whole field of receptor-targeted radiotracers, one greatly influenced by the research and intellectual contributions of William C. Eckelman. METHODS AND RESULTS The development of methods for efficient production of fluorine-18, for conversion of [18F]fluoride ion into chemically reactive form, and for its rapid and efficient incorporation into suitable estrogen precursor molecules at high molar activity, were all methodological underpinnings required for the preparation of FES. FES binds to ER with very high affinity, and its in vivo uptake by ER-dependent target tissues in animal models was efficient and selective, findings that preceded its use for PET imaging in patients with breast cancer. ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE Comparisons between ER levels measured by FES-PET imaging of breast tumors with tissue-specimen ER quantification by IHC and other methods show that imaging provided improved prediction of benefit from endocrine therapies. Serial imaging of ER by FES-PET, before and after dosing patients with antiestrogens, is used to determine the efficacious dose for established antiestrogens and to facilitate clinical development of new ER antagonists. Beyond FES imaging, PET-based hormone challenge tests, which evaluate the functional status of ER by monitoring rapid changes in tumor metabolic or transcriptional activity after a brief estrogen challenge, provide highly sensitive and selective predictions of whether or not there will be a favorable response to endocrine therapies. There is sufficient interest in the clinical applications of FES that FDA approval is being sought for its wider use in breast cancer. CONCLUSIONS FES was the first PET probe for a receptor in cancer, and its development and clinical applications in breast cancer parallel the conceptual evolution of the whole field of receptor-binding radiotracers.
Collapse
Affiliation(s)
- John A Katzenellenbogen
- Department of Chemistry, University of Illinois at Urbana-Champaign, Urbana, IL 61801, United States of America.
| |
Collapse
|
3
|
Saxena P, Mahmood T, Dixit M, Gambhir S, Ahsan F. An Exposition of 11C and 18F Radiotracers Synthesis for PET Imaging. Curr Radiopharm 2020; 14:92-100. [PMID: 33261547 DOI: 10.2174/1874471013666201201095631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 09/13/2020] [Accepted: 10/02/2020] [Indexed: 11/22/2022]
Abstract
The development of new radiolabeled Positron emission tomography tracers has been extensively utilized to access the increasing diversity in the research process and to facilitate the development in research methodology, clinical usage of drug discovery and patient care. Recent advances in radiochemistry, as well as the latest techniques in automated radio-synthesizer, have encouraged and challenged the radiochemists to produce the routinely developed radiotracers. Various radionuclides like 18F, 11C, 15O, 13N 99mTc, 131I, 124I and 64Cu are used for incorporating into different chemical scaffolds; among them, 18F and 11C tagged radiotracers are mostly explored such as 11C-Methionine, 11C-Choline, 18F-FDG, 18F-FLT, and 18F-FES. This review is focused on the development of radiochemistry routes to synthesize different radiotracers of 11C and 18F for clinical studies.
Collapse
Affiliation(s)
- Priya Saxena
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, Uttar Pradesh, India
| | - Tarique Mahmood
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, Uttar Pradesh, India
| | - Manish Dixit
- Department of Nuclear Medicine, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Sanjay Gambhir
- Department of Nuclear Medicine, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Farogh Ahsan
- Department of Pharmacology, Faculty of Pharmacy, Integral University, Lucknow, Uttar Pradesh, India
| |
Collapse
|
4
|
Automated synthesis of the 16α-[18F]fluoroestradiol ([18F]FES): minimization of precursor amount and resulting benefits. RADIOCHIM ACTA 2020. [DOI: 10.1515/ract-2020-0058] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Abstract
The 16α-[18F]Fluoroestradiol ([18F]FES) is an established PET radiotracer for estrogen positive (ER+) breast cancer. Although the radiosynthesis is well-described, the majority of the published methods suffer from modest or irreproducible yields and time-intensive purification procedures. In view of the considerable clinical applications, development of a more efficient and faster synthesis of [18F]FES still remains a task of a significant practical importance. [18F]FES was produced by a direct nucleophilic radiofluorination of 3-O-methoxymethyl-16,17-O-sulfuryl-16-epiestriol (MMSE), followed by acidic hydrolysis using HCl/CH3CN. [18F]Fluoride retained on a QMA carb cartridge (46 mg) was eluted by solution of 1.2 mg of tetrabutylammonium tosylate (TBAOTs) in EtOH. After fluorination reaction (0.3 mg MMSE, 1 ml of CH3CN/100 °C, 5 min) [18F]FES was isolated by single-cartridge SPE purification using OASIS WAX 3cc, elution accomplished with aqueous ethanol of different concentrations. On а GE TRACERlab FX N Pro automated module [18F]FES (formulated in normal saline with 5% EtOH) was obtained in 33 ± 3% yield (n = 5, non-decay corrected) within 32 min. Reduction of precursor amount, exclusion of azeotropic drying step and simplification of purification make the suggested method readily adaptable to various automated synthesizers and offers significant cost decrease.
Collapse
|
5
|
Katzenellenbogen JA. PET Imaging Agents (FES, FFNP, and FDHT) for Estrogen, Androgen, and Progesterone Receptors to Improve Management of Breast and Prostate Cancers by Functional Imaging. Cancers (Basel) 2020; 12:E2020. [PMID: 32718075 PMCID: PMC7465097 DOI: 10.3390/cancers12082020] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 06/30/2020] [Accepted: 07/17/2020] [Indexed: 12/20/2022] Open
Abstract
Many breast and prostate cancers are driven by the action of steroid hormones on their cognate receptors in primary tumors and in metastases, and endocrine therapies that inhibit hormone production or block the action of these receptors provide clinical benefit to many but not all of these cancer patients. Because it is difficult to predict which individuals will be helped by endocrine therapies and which will not, positron emission tomography (PET) imaging of estrogen receptor (ER) and progesterone receptor (PgR) in breast cancer, and androgen receptor (AR) in prostate cancer can provide useful, often functional, information on the likelihood of endocrine therapy response in individual patients. This review covers our development of three PET imaging agents, 16α-[18F]fluoroestradiol (FES) for ER, 21-[18F]fluoro-furanyl-nor-progesterone (FFNP) for PgR, and 16β-[18F]fluoro-5α-dihydrotestosterone (FDHT) for AR, and the evolution of their clinical use. For these agents, the pathway from concept through development tracks with an emerging understanding of critical performance criteria that is needed for successful PET imaging of these low-abundance receptor targets. Progress in the ongoing evaluation of what they can add to the clinical management of breast and prostate cancers reflects our increased understanding of these diseases and of optimal strategies for predicting the success of clinical endocrine therapies.
Collapse
Affiliation(s)
- John A Katzenellenbogen
- Department of Chemistry and Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA
| |
Collapse
|
6
|
Lin FI, Gonzalez EM, Kummar S, Do K, Shih J, Adler S, Kurdziel KA, Ton A, Turkbey B, Jacobs PM, Bhattacharyya S, Chen AP, Collins JM, Doroshow JH, Choyke PL, Lindenberg ML. Utility of 18F-fluoroestradiol ( 18F-FES) PET/CT imaging as a pharmacodynamic marker in patients with refractory estrogen receptor-positive solid tumors receiving Z-endoxifen therapy. Eur J Nucl Med Mol Imaging 2017; 44:500-508. [PMID: 27872957 PMCID: PMC7886184 DOI: 10.1007/s00259-016-3561-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 10/25/2016] [Indexed: 01/13/2023]
Abstract
BACKGROUND Z-endoxifen is the most potent of the metabolites of tamoxifen, and has the potential to be more effective than tamoxifen because it bypasses potential drug resistance mechanisms attributable to patient variability in the expression of the hepatic microsomal enzyme CYP2D6. 18F-FES is a positron emission tomography (PET) imaging agent which selectively binds to estrogen receptor alpha (ER-α) and has been used for non-invasive in vivo assessment of ER activity in tumors. This study utilizes 18F-FES PET imaging as a pharmacodynamic biomarker in patients with ER+ tumors treated with Z-endoxifen. METHODS Fifteen patients were recruited from a parent therapeutic trial of Z-endoxifen and underwent imaging with 18F-FES PET at baseline. Eight had positive lesions on the baseline scan and underwent follow-up imaging with 18F-FES 1-5 days post administration of Z-endoxifen. RESULTS Statistically significant changes (p = 0.0078) in standard uptake value (SUV)-Max were observed between the baseline and follow-up scans as early as 1 day post drug administration. CONCLUSION F-FES PET imaging could serve as a pharmacodynamic biomarker for patients treated with ER-directed therapy.
Collapse
Affiliation(s)
- Frank I Lin
- Cancer Imaging Program, National Cancer Institute, NIH, Bethesda, MD, USA.
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA.
| | - E M Gonzalez
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - S Kummar
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - K Do
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - J Shih
- Biometric Research Program, National Cancer Institute, NIH, Bethesda, MD, USA
| | - S Adler
- Clinical Research Directorate/Clinical Monitoring Research Program, Leidos Biomedical Research, Inc., NCI Campus at Frederick, Frederick, MD, 21702, USA
| | - K A Kurdziel
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - A Ton
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - B Turkbey
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - P M Jacobs
- Cancer Imaging Program, National Cancer Institute, NIH, Bethesda, MD, USA
| | - S Bhattacharyya
- Frederick National Laboratory for Cancer Research, Leidos Biomedical Research, Frederick, MD, USA
| | - A P Chen
- Early Clinical Trials Development Program, DCTD, National Cancer Institute, Bethesda, MD, USA
| | - J M Collins
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - J H Doroshow
- Division of Cancer Treatment and Diagnosis and Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - P L Choyke
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| | - M L Lindenberg
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|