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Moya E, Cerrato C, Bedoya LM, Guerra JA. Radiopharmaceutical small-scale preparation in Europe: will we be able to harmonize the situation? EJNMMI Radiopharm Chem 2024; 9:64. [PMID: 39235521 PMCID: PMC11377369 DOI: 10.1186/s41181-024-00281-z] [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: 02/16/2024] [Accepted: 06/13/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Radiopharmaceuticals have been considered a special group of medicines in Europe since 1989. The use of radiopharmaceuticals that have marketing authorization should always be the first option in clinical use, however due to their special properties the availability of approved radiopharmaceuticals is limited. For this reason, they can be produced on a small scale outside the marketing authorization process. MAIN BODY The in-house radiopharmaceutical preparations represent an important source of these special medicines for routine nuclear medicine practice. However, a lack of harmonization in Member States' regulations leads to extreme differences in the use and availability of radiopharmaceuticals across Europe. The aim of this work is to provide an overview of the different national regulatory frameworks in which Directive 2001/83/UE is adopted on the preparation of radiopharmaceuticals outside the marketing authorization track in Europe. Nine different national regulations have been studied to describe how unlicensed radiopharmaceuticals are prepared. Special attention is paid to reflect the minimum standards that these preparations should meet as well as the educational requirements to be a radiopharmacist in charge of them. CONCLUSION The rapid development of new radiopharmaceuticals used in radiometabolic therapy requires a common regulation that allows balance between the use and preparation of licensed and unlicensed radiopharmaceuticals. The absence of a harmonized regulation for the radiopharmaceutical small-scale preparation and the implementation of Good Manufacture Practices, leads to extreme differences in the use, quality assurance and availability of radiopharmaceuticals in Europe.
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Affiliation(s)
- Estrella Moya
- Chemical and Pharmaceutical Technology Division, Medicines for Human Use Department, AEMPS: Agencia Española de Medicamentos y Productos Sanitarios, C/ Campezo nº 1, Edificio 8, Madrid, 28022, Spain
| | - Celia Cerrato
- Chemical and Pharmaceutical Technology Division, Medicines for Human Use Department, AEMPS: Agencia Española de Medicamentos y Productos Sanitarios, C/ Campezo nº 1, Edificio 8, Madrid, 28022, Spain
| | - Luis Miguel Bedoya
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal s/n, Madrid, 28040, Spain
- AIDS Immunopathology Department, National Centre of Microbiology, Instituto de Salud Carlos III, Ctra. Pozuelo Km. 2, Madrid, 28224, Spain
| | - José Antonio Guerra
- Department of Pharmacology, Pharmacognosy and Botany, Faculty of Pharmacy, Universidad Complutense de Madrid, Plza. Ramón y Cajal s/n, Madrid, 28040, Spain.
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Shahalaei M, Azad AK, Sulaiman WMAW, Derakhshani A, Mofakham EB, Mallandrich M, Kumarasamy V, Subramaniyan V. A review of metallic nanoparticles: present issues and prospects focused on the preparation methods, characterization techniques, and their theranostic applications. Front Chem 2024; 12:1398979. [PMID: 39206442 PMCID: PMC11351095 DOI: 10.3389/fchem.2024.1398979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 07/04/2024] [Indexed: 09/04/2024] Open
Abstract
Metallic nanoparticles (MNPs) have garnered significant attention due to their ability to improve the therapeutic index of medications by reducing multidrug resistance and effectively delivering therapeutic agents through active targeting. In addition to drug delivery, MNPs have several medical applications, including in vitro and in vivo diagnostics, and they improve the biocompatibility of materials and nutraceuticals. MNPs have several advantages in drug delivery systems and genetic manipulation, such as improved stability and half-life in circulation, passive or active targeting into the desired target selective tissue, and gene manipulation by delivering genetic materials. The main goal of this review is to provide current information on the present issues and prospects of MNPs in drug and gene delivery systems. The current study focused on MNP preparation methods and their characterization by different techniques, their applications to targeted delivery, non-viral vectors in genetic manipulation, and challenges in clinical trial translation.
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Affiliation(s)
- Mona Shahalaei
- Biomaterial Group, Nanotechnology and Advanced Materials Department, Materials and Energy Research Center, Karaj, Iran
| | - Abul Kalam Azad
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University College of MAIWP International (UCMI), Kuala Lumpur, Malaysia
| | - Wan Mohd Azizi Wan Sulaiman
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University College of MAIWP International (UCMI), Kuala Lumpur, Malaysia
| | - Atefeh Derakhshani
- Department of Tissue Engineering and Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Banaee Mofakham
- Biomaterial Group, Nanotechnology and Advanced Materials Department, Materials and Energy Research Center, Karaj, Iran
| | - Mireia Mallandrich
- Department of Pharmacy, Pharmaceutical Technology and Physical-Chemistry, Faculty of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Vinoth Kumarasamy
- Department of Parasitology and Medical Entomology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Vetriselvan Subramaniyan
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Sunway, Malaysia
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Stokke C, Gnesin S, Tran-Gia J, Cicone F, Holm S, Cremonesi M, Blakkisrud J, Wendler T, Gillings N, Herrmann K, Mottaghy FM, Gear J. EANM guidance document: dosimetry for first-in-human studies and early phase clinical trials. Eur J Nucl Med Mol Imaging 2024; 51:1268-1286. [PMID: 38366197 PMCID: PMC10957710 DOI: 10.1007/s00259-024-06640-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 02/04/2024] [Indexed: 02/18/2024]
Abstract
The numbers of diagnostic and therapeutic nuclear medicine agents under investigation are rapidly increasing. Both novel emitters and novel carrier molecules require careful selection of measurement procedures. This document provides guidance relevant to dosimetry for first-in human and early phase clinical trials of such novel agents. The guideline includes a short introduction to different emitters and carrier molecules, followed by recommendations on the methods for activity measurement, pharmacokinetic analyses, as well as absorbed dose calculations and uncertainty analyses. The optimal use of preclinical information and studies involving diagnostic analogues is discussed. Good practice reporting is emphasised, and relevant dosimetry parameters and method descriptions to be included are listed. Three examples of first-in-human dosimetry studies, both for diagnostic tracers and radionuclide therapies, are given.
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Affiliation(s)
- Caroline Stokke
- Department of Diagnostic Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.
- Department of Physics, University of Oslo, Oslo, Norway.
| | - Silvano Gnesin
- Institute of Radiation Physics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Johannes Tran-Gia
- Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Francesco Cicone
- Nuclear Medicine Unit, Department of Experimental and Clinical Medicine, "Magna Graecia" University of Catanzaro, Catanzaro, Italy
| | - Søren Holm
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Marta Cremonesi
- Department of Medical Imaging and Radiation Sciences, European Institute of Oncology, IRCCS, Milan, Italy
| | - Johan Blakkisrud
- Department of Diagnostic Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
| | - Thomas Wendler
- Computer-Aided Medical Procedures and Augmented Reality, Technische Universität München, Munich, Germany
- Clinical Computational Medical Imaging Research, Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Augsburg, Augsburg, Germany
| | - Nic Gillings
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Ken Herrmann
- Department of Nuclear Medicine, University of Duisburg-Essen, and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
- National Center for Tumor Diseases (NCT), NCT West, Heidelberg, Germany
| | - Felix M Mottaghy
- Department of Radiology and Nuclear Medicine, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Nuclear Medicine, University Hospital RWTH Aachen, Aachen, Germany
| | - Jonathan Gear
- Joint Department of Physics, Royal Marsden NHSFT & Institute of Cancer Research, Sutton, UK
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Murce E, Ahenkorah S, Beekman S, Handula M, Stuurman D, de Ridder C, Cleeren F, Seimbille Y. Radiochemical and Biological Evaluation of 3p- C-NETA-ePSMA-16, a Promising PSMA-Targeting Agent for Radiotheranostics. Pharmaceuticals (Basel) 2023; 16:882. [PMID: 37375829 DOI: 10.3390/ph16060882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/12/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Bifunctional chelators (BFCs) are a key element in the design of radiopharmaceuticals. By selecting a BFC that efficiently complexes diagnostic and therapeutic radionuclides, a theranostic pair possessing almost similar biodistribution and pharmacokinetic properties can be developed. We have previously reported 3p-C-NETA as a promising theranostic BFC, and the encouraging preclinical outcomes obtained with [18F]AlF-3p-C-NETA-TATE led us to conjugate this chelator to a PSMA-targeting vector for imaging and treatment of prostate cancer. In this study, we synthesized 3p-C-NETA-ePSMA-16 and radiolabeled it with different diagnostic (111In, 18F) and therapeutic (177Lu, 213Bi) radionuclides. 3p-C-NETA-ePSMA-16 showed high affinity to PSMA (IC50 = 4.61 ± 1.33 nM), and [111In]In-3p-C-NETA-ePSMA-16 showed specific cell uptake (1.41 ± 0.20% ID/106 cells) in PSMA expressing LS174T cells. Specific tumor uptake of [111In]In-3p-C-NETA-ePSMA-16 was observed up to 4 h p.i. (1.62 ± 0.55% ID/g at 1 h p.i.; 0.89 ± 0.58% ID/g at 4 h p.i.) in LS174T tumor-bearing mice. Only a faint signal could be seen at 1 h p.i. in the SPECT/CT scans, whereas dynamic PET/CT scans performed after administration of [18F]AlF-3p-C-NETA-ePSMA-16 in PC3-Pip tumor xenografted mice resulted in a better tumor visualization and imaging contrast. Therapy studies with short-lived radionuclides such as 213Bi could further elucidate the therapeutic potential of 3p-C-NETA-ePSMA-16 as a radiotheranostic.
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Affiliation(s)
- Erika Murce
- Department of Radiology and Nuclear Medicine, University Medical Center Rotterdam, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Stephen Ahenkorah
- NURA Research Group, Belgian Nuclear Research Center (SCK CEN), 2400 Mol, Belgium
- Radiopharmaceutical Research, Department of Pharmacy and Pharmacology, University of Leuven, 3000 Leuven, Belgium
| | - Savanne Beekman
- Department of Radiology and Nuclear Medicine, University Medical Center Rotterdam, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Maryana Handula
- Department of Radiology and Nuclear Medicine, University Medical Center Rotterdam, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Debra Stuurman
- Department of Radiology and Nuclear Medicine, University Medical Center Rotterdam, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Corrina de Ridder
- Department of Radiology and Nuclear Medicine, University Medical Center Rotterdam, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
| | - Frederik Cleeren
- Radiopharmaceutical Research, Department of Pharmacy and Pharmacology, University of Leuven, 3000 Leuven, Belgium
| | - Yann Seimbille
- Department of Radiology and Nuclear Medicine, University Medical Center Rotterdam, Erasmus MC, 3015 GD Rotterdam, The Netherlands
- Erasmus MC Cancer Institute, 3015 GD Rotterdam, The Netherlands
- TRIUMF, Life Sciences Division, Vancouver, BC V6T 2A3, Canada
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Bartoli F, Elsinga P, Nazario LR, Zana A, Galbiati A, Millul J, Migliorini F, Cazzamalli S, Neri D, Slart RHJA, Erba PA. Automated Radiosynthesis, Preliminary In Vitro/In Vivo Characterization of OncoFAP-Based Radiopharmaceuticals for Cancer Imaging and Therapy. Pharmaceuticals (Basel) 2022; 15:ph15080958. [PMID: 36015106 PMCID: PMC9416253 DOI: 10.3390/ph15080958] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/29/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022] Open
Abstract
FAP-targeted radiopharmaceuticals represent a breakthrough in cancer imaging and a viable option for therapeutic applications. OncoFAP is an ultra-high-affinity ligand of FAP with a dissociation constant of 680 pM. OncoFAP has been recently discovered and clinically validated for PET imaging procedures in patients with solid malignancies. While more and more clinical validation is becoming available, the need for scalable and robust procedures for the preparation of this new class of radiopharmaceuticals continues to increase. In this article, we present the development of automated radiolabeling procedures for the preparation of OncoFAP-based radiopharmaceuticals for cancer imaging and therapy. A new series of [68Ga]Ga-OncoFAP, [177Lu]Lu-OncoFAP and [18F]AlF-OncoFAP was produced with high radiochemical yields. Chemical and biochemical characterization after radiolabeling confirmed its excellent stability, retention of high affinity for FAP and absence of radiolysis by-products. The in vivo biodistribution of [18F]AlF-NOTA-OncoFAP, a candidate for PET imaging procedures in patients, was assessed in mice bearing FAP-positive solid tumors. The product showed rapid accumulation in solid tumors, with an average of 6.6% ID/g one hour after systemic administration and excellent tumor-to-healthy organs ratio. We have developed simple, quick, safe and robust synthetic procedures for the preparation of theranostic OncoFAP-compounds based on Gallium-68, Lutetium-177 and Fluorine-18 using the commercially available FASTlab synthesis module.
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Affiliation(s)
- Francesco Bartoli
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy;
| | - Philip Elsinga
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
| | - Luiza Reali Nazario
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
| | - Aureliano Zana
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Andrea Galbiati
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Jacopo Millul
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Francesca Migliorini
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Samuele Cazzamalli
- Philochem AG, R&D Department, Libernstrasse 3, CH-8112 Otelfingen, Switzerland; (A.Z.); (A.G.); (J.M.); (F.M.); (S.C.)
| | - Dario Neri
- Department of Chemistry and Applied Biosciences, Swiss Federal Institute of Technology, CH-8093 Zurich, Switzerland;
- Philogen S.p.A., 53100 Siena, Italy
| | - Riemer H. J. A. Slart
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
- Biomedical Photonic Imaging Group, Faculty of Science and Technology, University of Twente, 7522 NB Enschede, The Netherlands
| | - Paola Anna Erba
- Nuclear Medicine, Department of Translational Research and Advanced Technologies in Medicine and Surgery, University of Pisa and Azienda Ospedaliero Universitaria Pisana, 56126 Pisa, Italy;
- Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9712 CP Groningen, The Netherlands; (P.E.); (L.R.N.); (R.H.J.A.S.)
- Correspondence:
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Korde A, Mikolajczak R, Kolenc P, Bouziotis P, Westin H, Lauritzen M, Koole M, Herth MM, Bardiès M, Martins AF, Paulo A, Lyashchenko SK, Todde S, Nag S, Lamprou E, Abrunhosa A, Giammarile F, Decristoforo C. Practical considerations for navigating the regulatory landscape of non-clinical studies for clinical translation of radiopharmaceuticals. EJNMMI Radiopharm Chem 2022; 7:18. [PMID: 35852679 PMCID: PMC9296747 DOI: 10.1186/s41181-022-00168-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background The development of radiopharmaceuticals requires extensive evaluation before they can be applied in a diagnostic or therapeutic setting in Nuclear Medicine. Chemical, radiochemical, and pharmaceutical parameters must be established and verified to ensure the quality of these novel products.
Main body To provide supportive evidence for the expected human in vivo behaviour, particularly related to safety and efficacy, additional tests, often referred to as “non-clinical” or “preclinical” are mandatory. This document is an outcome of a Technical Meeting of the International Atomic Energy Agency. It summarises the considerations necessary for non-clinical studies to accommodate the regulatory requirements for clinical translation of radiopharmaceuticals. These considerations include non-clinical pharmacology, radiation exposure and effects, toxicological studies, pharmacokinetic modelling, and imaging studies. Additionally, standardisation of different specific clinical applications is discussed.
Conclusion This document is intended as a guide for radiopharmaceutical scientists, Nuclear Medicine specialists, and regulatory professionals to bring innovative diagnostic and therapeutic radiopharmaceuticals into the clinical evaluation process in a safe and effective way.
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Affiliation(s)
- Aruna Korde
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna International Centre, PO Box 100, 1400, Vienna, Austria
| | - Renata Mikolajczak
- Radioisotope Centre POLATOM, National Centre for Nuclear Research, Andrzej Soltan 7, 05-400, Otwock, Poland
| | - Petra Kolenc
- Department of Nuclear Medicine, University Medical Centre Ljubljana, 1000, Ljubljana, Slovenia.,Faculty of Pharmacy, University of Ljubljana, 1000, Ljubljana, Slovenia
| | - Penelope Bouziotis
- National Centre for Scientific Research "Demokritos", Institute of Nuclear & Radiological Sciences and Technology, Energy & Safety, 15341, Athens, Greece
| | - Hadis Westin
- Department of Immunology, Genetics and Pathology, Ridgeview Instruments AB, Uppsala Universitet, Dag Hammarskjölds Väg 36A, 752 37, Uppsala, Sweden
| | - Mette Lauritzen
- Bruker BioSpin MRI GmbH, Rudolf-Plank-Str. 23, 76275, Ettlingen, Germany
| | - Michel Koole
- Nuclear Medicine and Molecular Imaging, Katholieke Universiteit Leuven, 3000, Louvain, Belgium
| | - Matthias Manfred Herth
- Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Jagtvej 160, 2100, Copenhagen, Denmark.,Department of Clinical Physiology, Nuclear Medicine and PET, Copenhagen University Hospital, Blegdamsvej 3, 2200, Copenhagen, Denmark
| | - Manuel Bardiès
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, Institut Régional du Cancer de Montpellier (ICM), Université de Montpellier, 34298, Montpellier, France
| | - Andre F Martins
- Department of Preclinical Imaging and Radiopharmacy, Werner Siemens Imaging Center, Eberhard Karls University Tübingen, Röntgenweg 13/1, 72076, Tübingen, Germany.,Cluster of Excellence iFIT (EXC 2180) "Image-Guided and Functionally Instructed Tumor Therapies", University of Tübingen, Tübingen, Germany
| | - Antonio Paulo
- Centro de Ciências E Tecnologias Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Bobadela Lrs, Campus Tecnológico e Nuclear, Estrada Nacional 10, Km 139.7, 2695-066, Lisbon, Portugal
| | - Serge K Lyashchenko
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sergio Todde
- Department of Medicine and Surgery, University of Milano-Bicocca, Tecnomed Foundation, Milan, Italy
| | - Sangram Nag
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet and Stockholm County Council, 171 76, Stockholm, Sweden
| | - Efthimis Lamprou
- Bioemtech, Lefkippos Attica Technology Park-N.C.S.R Demokritos, Athens, Greece
| | - Antero Abrunhosa
- ICNAS/CIBIT, Institute for Nuclear Sciences Applied to Health, University of Coimbra, Coimbra, Portugal
| | - Francesco Giammarile
- Department of Nuclear Sciences and Applications, International Atomic Energy Agency (IAEA), Vienna International Centre, PO Box 100, 1400, Vienna, Austria
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, 6020, Innsbruck, Austria.
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Wang H, Picchio ML, Calderón M. One stone, many birds: Recent advances in functional nanogels for cancer nanotheranostics. WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2022; 14:e1791. [PMID: 35338603 PMCID: PMC9540470 DOI: 10.1002/wnan.1791] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/28/2022] [Accepted: 03/01/2022] [Indexed: 12/18/2022]
Abstract
Inspired by the development of nanomedicine and nanotechnology, more and more possibilities in cancer theranostic have been provided in the last few years. Emerging therapeutic modalities like starvation therapy, chemodynamic therapy, and tumor oxygenation have been integrated with diagnosis, giving a plethora of theranostic nanoagents. Among all of them, nanogels (NGs) show superiority benefiting from their unique attributes: high stability, high water-absorption, large specific surface area, mechanical strength, controlled responsiveness, and high encapsulation capacity. There have been a vast number of investigations supporting various NGs combining drug delivery and multiple bioimaging techniques, encompassing photothermal imaging, photoacoustic imaging, fluorescent imaging, ultrasound imaging, magnetic resonance imaging, and computed tomography. This review summarizes recent advances in functional NGs for theranostic nanomedicine and discusses the challenges and future perspectives of this fast-growing field. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > In Vivo Nanodiagnostics and Imaging.
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Affiliation(s)
- Huiyi Wang
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country, UPV/EHU, Donostia-San Sebastián, Spain
| | - Matias L Picchio
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country, UPV/EHU, Donostia-San Sebastián, Spain
| | - Marcelo Calderón
- POLYMAT, Applied Chemistry Department, Faculty of Chemistry, University of the Basque Country, UPV/EHU, Donostia-San Sebastián, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain
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Cicone F, Viertl D, Denoël T, Stabin MG, Prior JO, Gnesin S. Comparison of absorbed dose extrapolation methods for mouse-to-human translation of radiolabelled macromolecules. EJNMMI Res 2022; 12:21. [PMID: 35403982 PMCID: PMC9001797 DOI: 10.1186/s13550-022-00893-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 03/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Extrapolation of human absorbed doses (ADs) from biodistribution experiments on laboratory animals is used to predict the efficacy and toxicity profiles of new radiopharmaceuticals. Comparative studies between available animal-to-human dosimetry extrapolation methods are missing. We compared five computational methods for mice-to-human AD extrapolations, using two different radiopharmaceuticals, namely [111In]CHX-DTPA-scFv78-Fc and [68Ga]NODAGA-RGDyK. Human organ-specific time-integrated activity coefficients (TIACs) were derived from biodistribution studies previously conducted in our centre. The five computational methods adopted are based on simple direct application of mice TIACs to human organs (M1), relative mass scaling (M2), metabolic time scaling (M3), combined mass and time scaling (M4), and organ-specific allometric scaling (M5), respectively. For [68Ga]NODAGA-RGDyK, these methods for mice-to-human extrapolations were tested against the ADs obtained on patients, previously published by our group. Lastly, an average [68Ga]NODAGA-RGDyK-specific allometric parameter αnew was calculated from the organ-specific biological half-lives in mouse and humans and retrospectively applied to M3 and M4 to assess differences in human AD predictions with the α = 0.25 recommended by previous studies. RESULTS For both radiopharmaceuticals, the five extrapolation methods showed significantly different AD results (p < 0.0001). In general, organ ADs obtained with M3 were higher than those obtained with the other methods. For [68Ga]NODAGA-RGDyK, no significant differences were found between ADs calculated with M3 and those obtained directly on human subjects (H) (p = 0.99; average M3/H AD ratio = 1.03). All other methods for dose extrapolations resulted in ADs significantly different from those calculated directly on humans (all p ≤ 0.0001). Organ-specific allometric parameters calculated using combined experimental [68Ga]NODAGA-RGDyK mice and human biodistribution data varied significantly. ADs calculated with M3 and M4 after the application of αnew = 0.17 were significantly different from those obtained by the application of α = 0.25 (both p < 0.001). CONCLUSIONS Available methods for mouse-to-human dosimetry extrapolations provided significantly different results in two different experimental models. For [68Ga]NODAGA-RGDyK, the best approximation of human dosimetry was shown by M3, applying a metabolic scaling to the mouse organ TIACs. The accuracy of more refined extrapolation algorithms adopting model-specific metabolic scaling parameters should be further investigated.
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Affiliation(s)
- Francesco Cicone
- Department of Experimental and Clinical Medicine, and Neuroscience Research Centre, PET/MR Unit, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
- Nuclear Medicine Unit, University Hospital “Mater Domini”, Catanzaro, Italy
- University of Lausanne, Lausanne, Switzerland
| | - David Viertl
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Thibaut Denoël
- Department of Experimental and Clinical Medicine, and Neuroscience Research Centre, PET/MR Unit, “Magna Graecia” University of Catanzaro, Catanzaro, Italy
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | | | - John O. Prior
- University of Lausanne, Lausanne, Switzerland
- Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Silvano Gnesin
- University of Lausanne, Lausanne, Switzerland
- Institute of Radiation Physics, Lausanne University Hospital, Lausanne, Switzerland
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9
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Bockhold S, Foley SJ, Rainford LA, Corridori R, Eberstein A, Hoeschen C, Konijnenberg MW, Molyneux-Hodgson S, Paulo G, Santos J, McNulty JP. Exploring the translational challenge for medical applications of ionising radiation and corresponding radiation protection research. J Transl Med 2022; 20:137. [PMID: 35303930 PMCID: PMC8932076 DOI: 10.1186/s12967-022-03344-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 03/06/2022] [Indexed: 01/19/2023] Open
Abstract
Background Medical applications of ionising radiation and associated radiation protection research often encounter long delays and inconsistent implementation when translated into clinical practice. A coordinated effort is needed to analyse the research needs for innovation transfer in radiation-based high-quality healthcare across Europe which can inform the development of an innovation transfer framework tailored for equitable implementation of radiation research at scale. Methods Between March and September 2021 a Delphi methodology was employed to gain consensus on key translational challenges from a range of professional stakeholders. A total of three Delphi rounds were conducted using a series of electronic surveys comprised of open-ended and closed-type questions. The surveys were disseminated via the EURAMED Rocc-n-Roll consortium network and prominent medical societies in the field. Approximately 350 professionals were invited to participate. Participants’ level of agreement with each generated statement was captured using a 6-point Likert scale. Consensus was defined as median ≥ 4 with ≥ 60% of responses in the upper tertile of the scale. Additionally, the stability of responses across rounds was assessed. Results In the first Delphi round a multidisciplinary panel of 20 generated 127 unique statements. The second and third Delphi rounds recruited a broader sample of 130 individuals to rate the extent to which they agreed with each statement as a key translational challenge. A total of 60 consensus statements resulted from the iterative Delphi process of which 55 demonstrated good stability. Ten statements were identified as high priority challenges with ≥ 80% of statement ratings either ‘Agree’ or ‘Strongly Agree’. Conclusion A lack of interoperability between systems, insufficient resources, unsatisfactory education and training, and the need for greater public awareness surrounding the benefits, risks, and applications of ionising radiation were identified as principal translational challenges. These findings will help to inform a tailored innovation transfer framework for medical radiation research. Supplementary Information The online version contains supplementary material available at 10.1186/s12967-022-03344-4.
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Affiliation(s)
- Sophie Bockhold
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Shane J Foley
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | - Louise A Rainford
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
| | | | | | - Christoph Hoeschen
- Institute of Medical Engineering, Otto Von Guericke Universität Magdeburg, Magdeburg, Germany
| | - Mark W Konijnenberg
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, Netherlands
| | | | - Graciano Paulo
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Coimbra, Coimbra, Portugal
| | - Joana Santos
- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Coimbra, Coimbra, Portugal
| | - Jonathan P McNulty
- Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
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10
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Lepareur N. Cold Kit Labeling: The Future of 68Ga Radiopharmaceuticals? Front Med (Lausanne) 2022; 9:812050. [PMID: 35223907 PMCID: PMC8869247 DOI: 10.3389/fmed.2022.812050] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/07/2022] [Indexed: 12/11/2022] Open
Abstract
Over the last couple of decades, gallium-68 (68Ga) has gained a formidable interest for PET molecular imaging of various conditions, from cancer to infection, through cardiac pathologies or neuropathies. It has gained routine use, with successful radiopharmaceuticals such as somatostatin analogs ([68Ga]Ga-DOTATOC and [68Ga]GaDOTATATE) for neuroendocrine tumors, and PSMA ligands for prostate cancer. It represents a major clinical impact, particularly in the context of theranostics, coupled with their 177Lu-labeled counterparts. Beside those, a bunch of new 68Ga-labeled molecules are in the preclinical and clinical pipelines, with some of them showing great promise for patient care. Increasing clinical demand and regulatory issues have led to the development of automated procedures for the production of 68Ga radiopharmaceuticals. However, the widespread use of these radiopharmaceuticals may rely on simple and efficient radiolabeling methods, undemanding in terms of equipment and infrastructure. To make them technically and economically accessible to the medical community and its patients, it appears mandatory to develop a procedure similar to the well-established kit-based 99mTc chemistry. Already available commercial kits for the production of 68Ga radiopharmaceuticals have demonstrated the feasibility of using such an approach, thus paving the way for more kit-based 68Ga radiopharmaceuticals to be developed. This article discusses the development of 68Ga cold kit radiopharmacy, including technical issues, and regulatory aspects.
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Affiliation(s)
- Nicolas Lepareur
- Comprehensive Cancer Center Eugène Marquis, Rennes, France
- Univ Rennes, Inrae, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer), UMR_A 1341, UMR_S 1241, Rennes, France
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11
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Monti M, Degenhardt T, Brain E, Wuerstlein R, Argusti A, Puntoni M, Rollandi GA, Corradengo D, Boni L, Ilhan H, Nanni O, Cortes J, Piris-Gimenez A, Piccardo A, Iacozzi M, Matteucci F, Di Iorio V, Alberini JL, Schröder C, Harbeck N, Gennari A. ERANET JTC 2011: Submission and Activation of an International Academic Translational Project in Advanced Breast Cancer. Experience From the ET-FES Study. Front Med (Lausanne) 2022; 8:817678. [PMID: 35096909 PMCID: PMC8794579 DOI: 10.3389/fmed.2021.817678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 12/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background: Academic research is important to face unmet medical needs. The Oncological community encounters many hurdles in setting up multicenter investigator-driven trials mainly due to administrative complexity. The purpose of a network organization at a multinational level is to facilitate clinical trials through standardization, coordination, and education for drug development and regulatory approval. Methods: The application of an European grant foresees the creation of a consortium which aims at facilitating multi-center academic clinical trials. Results: The ERA-NET TRANSCAN Call 2011 on “Validation of biomarkers for personalized cancer medicine” was released on December 2011. This project included Italian, Spanish, French and German centers. The approval process included Consortium constitution, project submission, Clinical Trial Submission, and activation on a national level. The different timescales for submitting study documents in each Country and the misalignment of objections by each Competent Authority CA, generated several requests for changes to the study documents which meant amendments had to be made; as requested by the 2001/20/EC Directive, the alignment of core documents is mandatory. This procedure impacted significantly on study activation timelines. Time to first patient in was 14, 10, 28, and 31 months from the date of submission in Italy, France, Spain, and Germany, respectively. Accrual was stopped on 22nd January 2021 due to an 18F FES shortage as the primary reason but also for having exceeded the project deadlines with consequent exhaustion of the funds allocated for the project. Conclusions: Pharmaceutical companies might be reluctant to fund research projects aimed at treatment individualization if the approval for a wider indication has already been achieved. Academic trials therefore become fundamental for promoting trials which are not attractive to big pharma. It was very difficult and time consuming to activate an academic clinical trial, for this reason, a study may become “old” as new drugs entered into the market. National institutions should promote the development of clinical research infrastructures and network with competence in regulatory, ethical, and legal skills to speed up academic research.
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Affiliation(s)
- Manuela Monti
- Unit of Biostatistics and Clinical Trials, Istituto di Ricovero e Cura a Carattere Scienteifico Istituto Romagnolo per lo Studio dei Tumori "DinoAmadori", Meldola, Italy
| | - Tom Degenhardt
- Breast Center, Department of Obstetrics and Gynaecology, Ludwig Maximilians University Hospital of Munich, Munich, Germany
| | - Etienne Brain
- Department of Clinical Research and Medical Oncology, Institut Curie-Hopital "René Huguenin", Saint-Cloud, France
| | - Rachel Wuerstlein
- Breast Center, Department of Obstetrics and Gynaecology, Ludwig Maximilians University Hospital of Munich, Munich, Germany
| | - Alessandra Argusti
- Clinical Trial Research Unit, Ente Ospedaliero Galliera Hospital, Genoa, Italy
| | - Matteo Puntoni
- Clinical Trial Research Unit, Ente Ospedaliero Galliera Hospital, Genoa, Italy
| | | | - Davide Corradengo
- Clinical Trial Research Unit, Ente Ospedaliero Galliera Hospital, Genoa, Italy
| | - Luca Boni
- Clinical Trials Unit, Istituto Nazionale per la Ricerca sul Cancro Istituto Scientifico Tumori, Genoa, Italy
| | - Harun Ilhan
- Die Radiologie (Centre for Radiology, Nuclear Medicine and Radiotherapy), Munich, Germany
| | - Oriana Nanni
- Unit of Biostatistics and Clinical Trials, Istituto di Ricovero e Cura a Carattere Scienteifico Istituto Romagnolo per lo Studio dei Tumori "DinoAmadori", Meldola, Italy
| | - Javier Cortes
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Alejandro Piris-Gimenez
- Vall d'Hebron Institute of Oncology (VHIO), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Arnoldo Piccardo
- Department of Nuclear Medicine, Ente Ospedaliero Galliera Hospitals, Genoa, Italy
| | - Massimiliano Iacozzi
- Department of Nuclear Medicine, Ente Ospedaliero Galliera Hospitals, Genoa, Italy
| | - Federica Matteucci
- Unit of Biostatistics and Clinical Trials, Istituto di Ricovero e Cura a Carattere Scienteifico Istituto Romagnolo per lo Studio dei Tumori "DinoAmadori", Meldola, Italy
| | - Valentina Di Iorio
- Unit of Biostatistics and Clinical Trials, Istituto di Ricovero e Cura a Carattere Scienteifico Istituto Romagnolo per lo Studio dei Tumori "DinoAmadori", Meldola, Italy
| | - Jean Louis Alberini
- Nuclear Medicine Department, Centre "Georges-François Leclerc", Dijon, France
| | - Carolien Schröder
- Department of Medical Oncology, Dutch Cancer Institute Nederlands Kanker Instituut - Antoni Van Leeuwenhoek, Amsterdam, Netherlands
| | - Nadia Harbeck
- Breast Center, Department of Obstetrics and Gynaecology, Ludwig Maximilians University Hospital of Munich, Munich, Germany
| | - Alessandra Gennari
- Department of Translational Oncology, University of Eastern Piedmont, Novara, Italy
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12
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Decristoforo C, Lyashchenko SK. Radiopharmaceutical legislation. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00068-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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13
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Maina T, Nock BA. Peptide radiopharmaceuticals for targeted diagnosis & therapy of human tumors. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00078-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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14
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Kaushik D, Jangra P, Verma R, Purohit D, Pandey P, Sharma S, Sharma RK. Radiopharmaceuticals: An insight into the latest advances in medical uses and regulatory perspectives. J Biosci 2021. [DOI: 10.1007/s12038-021-00147-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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15
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Bolcaen J, Kleynhans J, Nair S, Verhoeven J, Goethals I, Sathekge M, Vandevoorde C, Ebenhan T. A perspective on the radiopharmaceutical requirements for imaging and therapy of glioblastoma. Theranostics 2021; 11:7911-7947. [PMID: 34335972 PMCID: PMC8315062 DOI: 10.7150/thno.56639] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/29/2021] [Indexed: 11/26/2022] Open
Abstract
Despite numerous clinical trials and pre-clinical developments, the treatment of glioblastoma (GB) remains a challenge. The current survival rate of GB averages one year, even with an optimal standard of care. However, the future promises efficient patient-tailored treatments, including targeted radionuclide therapy (TRT). Advances in radiopharmaceutical development have unlocked the possibility to assess disease at the molecular level allowing individual diagnosis. This leads to the possibility of choosing a tailored, targeted approach for therapeutic modalities. Therapeutic modalities based on radiopharmaceuticals are an exciting development with great potential to promote a personalised approach to medicine. However, an effective targeted radionuclide therapy (TRT) for the treatment of GB entails caveats and requisites. This review provides an overview of existing nuclear imaging and TRT strategies for GB. A critical discussion of the optimal characteristics for new GB targeting therapeutic radiopharmaceuticals and clinical indications are provided. Considerations for target selection are discussed, i.e. specific presence of the target, expression level and pharmacological access to the target, with particular attention to blood-brain barrier crossing. An overview of the most promising radionuclides is given along with a validation of the relevant radiopharmaceuticals and theranostic agents (based on small molecules, peptides and monoclonal antibodies). Moreover, toxicity issues and safety pharmacology aspects will be presented, both in general and for the brain in particular.
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Affiliation(s)
- Julie Bolcaen
- Radiobiology, Radiation Biophysics Division, Nuclear Medicine Department, iThemba LABS, Cape Town, South Africa
| | - Janke Kleynhans
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Shankari Nair
- Radiobiology, Radiation Biophysics Division, Nuclear Medicine Department, iThemba LABS, Cape Town, South Africa
| | | | - Ingeborg Goethals
- Ghent University Hospital, Department of Nuclear Medicine, Ghent, Belgium
| | - Mike Sathekge
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
- Nuclear Medicine Department, University of Pretoria and Steve Biko Academic Hospital, Pretoria, South Africa
| | - Charlot Vandevoorde
- Radiobiology, Radiation Biophysics Division, Nuclear Medicine Department, iThemba LABS, Cape Town, South Africa
| | - Thomas Ebenhan
- Nuclear Medicine Research Infrastructure NPC, Pretoria, South Africa
- Nuclear Medicine Department, University of Pretoria, Pretoria, South Africa
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16
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Radiopharmaceutical Formulation and Preclinical Testing of 68Ga-Labeled DOTA-MGS5 for the Regulatory Approval of a First Exploratory Clinical Trial. Pharmaceuticals (Basel) 2021; 14:ph14060575. [PMID: 34208516 PMCID: PMC8235783 DOI: 10.3390/ph14060575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 06/11/2021] [Accepted: 06/12/2021] [Indexed: 12/15/2022] Open
Abstract
The new minigastrin analog DOTA-MGS5 is a promising new candidate for targeting cholecystokinin-2 receptor (CCK2R)-expressing tumors. To enable the clinical translation of PET/CT imaging using 68Ga-labeled DOTA-MGS5, different quality and safety aspects need to be considered to comply with the regulatory framework for clinical trial application. The preparation of the radiopharmaceutical was established using a cassette-based automated synthesis unit. Product specifications, including analytical procedures and acceptance criteria, were adopted from Ph. Eur. monographs for other 68Ga-labeled radiopharmaceuticals. Non-clinical studies included receptor affinity and cell uptake studies using two different CCK2R-expressing cell lines, as well as pharmacokinetic biodistribution studies in BALB/c mice for dosimetry calculations and toxicological studies in Wistar rats. The produced masterbatches fulfilled the defined acceptance criteria. DOTA-MGS5, with confirmed affinity to the CCK2R, showed a high specific cell uptake and no interaction with other receptors in vitro when radiolabeled with gallium-68. Favorable in vivo properties were observed in biodistribution and dosimetry studies. An effective dose of ~0.01 mSv/MBq was estimated for humans utilizing OLINDA/EXM software. A maximum peptide dose of 50 µg was established for the initial clinical dose based on the toxicity study in rats. The standardized production of [68Ga]Ga-DOTA-MGS5 using an automated synthesis module and the performed non-clinical safety studies support a first exploratory clinical trial with this new PET imaging agent.
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17
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De Silva RA, Gorin MA, Mease RC, Minn I, Lisok A, Plyku D, Nimmagadda S, Allaf ME, Yang X, Sgouros G, Rowe SP, Pomper MG. Process validation, current good manufacturing practice production, dosimetry, and toxicity studies of the carbonic anhydrase IX imaging agent [ 111 In]In-XYIMSR-01 for phase I regulatory approval. J Labelled Comp Radiopharm 2021; 64:243-250. [PMID: 33576099 PMCID: PMC8129612 DOI: 10.1002/jlcr.3906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Abstract
[111 In]In-XYIMSR-01 is a promising single-photon emission computed tomography (SPECT) imaging agent for identification of tumors that overexpress carbonic anhydrase IX. To translate [111 In]In-XYIMSR-01 to phase I trials, we performed animal toxicity and dosimetry studies, determined the maximum dose for human use, and completed the chemistry, manufacturing, and controls component of a standard regulatory application. The production process, quality control testing, stability studies, and specifications for sterile drug product release were based on United States Pharmacopeia chapters <823> and <825>, FDA 21 CFR Part 212. Toxicity was evaluated by using nonradioactive [113/115 In]In-XYIMSR-01 according to 21 CFR Part 58 guidelines. Organ Level INternal Dose Assessment/EXponential Modeling (OLINDA/EXM) was used to calculate the maximum single dose for human studies. Three process validation runs at starting radioactivities of ~800 MBq were completed with a minimum concentration of 407 MBq/ml and radiochemical purity of ≥99% at the end of synthesis. A single intravenous dose of 55 μg/ml of [113/115 In]In-XYIMSR-01 was well tolerated in male and female Sprague-Dawley rats. The calculated maximum single dose for human injection from dosimetry studies was 390.35 MBq of [111 In]In-XYIMSR-01. We have completed toxicity and dosimetry studies as well as validated a manufacturing process to test [111 In]In-XYIMSR-01 in a phase I clinical trial.
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Affiliation(s)
- Ravindra A. De Silva
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Michael A. Gorin
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Ronnie C. Mease
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Il Minn
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Ala Lisok
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Donika Plyku
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Sridhar Nimmagadda
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Mohamad E. Allaf
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Xing Yang
- Present address: Peking University First Hospital, Beijing 100034, China
| | - George Sgouros
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Steven P. Rowe
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
| | - Martin G. Pomper
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
- The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, 601 North Caroline Street, Baltimore, MD, 21287, USA
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18
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Decristoforo C, Neels O, Patt M. Emerging Radionuclides in a Regulatory Framework for Medicinal Products - How Do They Fit? Front Med (Lausanne) 2021; 8:678452. [PMID: 34124109 PMCID: PMC8192700 DOI: 10.3389/fmed.2021.678452] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/04/2021] [Indexed: 12/16/2022] Open
Abstract
Recent years have seen the establishment of several radionuclides as medicinal products in particular in the setting of theranostics and PET. [177Lu]Lutetium Chloride or [64Cu]Copper Chloride have received marketing authorization as radionuclide precursor, [68Ga]Gallium Chloride has received regulatory approval in the form of different 68Ge/68Ga generators. This is a formal requirement by the EU directive 2001/83, even though for some of these radionuclide precursors no licensed kit is available that can be combined to obtain a final radiopharmaceuticals, as it is the case for Technetium-99m. In view of several highly promising, especially metallic radionuclides for theranostic applications in a wider sense, the strict regulatory environment poses the risk of slowing down development, in particular for radionuclide producers that want to provide innovative radionuclides for clinical research purposes, which is the basis for their further establishment. In this paper we address the regulatory framework for novel radionuclides within the EU, the current challenges in particular related to clinical translation and potential options to support translational development within Europe and worldwide.
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Affiliation(s)
- Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Oliver Neels
- Department of Radiopharmaceuticals Production, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - Marianne Patt
- Department for Nuclear Medicine, Radiochemistry, University of Leipzig, Leipzig, Germany
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Saluja V, Mishra Y, Mishra V, Giri N, Nayak P. Dendrimers based cancer nanotheranostics: An overview. Int J Pharm 2021; 600:120485. [PMID: 33744447 DOI: 10.1016/j.ijpharm.2021.120485] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 02/26/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
Cancer is a known deadliest disease that requires a judicious diagnostic, targeting, and treatment strategy for an early prognosis and selective therapy. The major pitfalls of the conventional approach are non-specificity in targeting, failure to precisely monitor therapy outcome, and cancer progression leading to malignancies. The unique physicochemical properties offered by nanotechnology derived nanocarriers have the potential to radically change the landscape of cancer diagnosis and therapeutic management. An integrative approach of utilizing both diagnostic and therapeutic functionality using a nanocarrier is termed as nanotheranostic. The nanotheranostics platform is designed in such a way that overcomes various biological barriers, efficiently targets the payload to the desired locus, and simultaneously supports planning, monitoring, and verification of treatment delivery to demonstrate an enhanced therapeutic efficacy. Thus, a nanotheranostic platform could potentially assist in drug targeting, image-guided focal therapy, drug release and distribution monitoring, predictionof treatment response, and patient stratification. A class of highly branched nanocarriers known as dendrimers is recognized as an advanced nanotheranostic platform that has the potential to revolutionize the oncology arena by its unique and exciting features. A dendrimer is a well-defined three-dimensional globular chemical architecture with a high level of monodispersity, amenability of precise size control, and surface functionalization. All the dendrimer properties exhibit a reproducible pharmacokinetic behavior that could ensure the desired biodistribution and efficacy. Dendrimers are thus being exploited as a nanotheranostic platform embodying a diverse class of therapeutic, imaging, and targeting moieties for cancer diagnosis and treatment.
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Affiliation(s)
- Vikrant Saluja
- Faculty of Pharmaceutical Sciences, PCTE Group of Institutes, Ludhiana, Punjab, India; School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
| | - Yachana Mishra
- Department of Zoology, Shri Shakti Degree College, Sankhahari, Ghatampur, Kanpur Nagar, Uttar Pradesh, India
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India.
| | - Namita Giri
- College of Pharmacy, Ferris State University, Big Rapids, MI 49307, USA
| | - Pallavi Nayak
- Faculty of Pharmaceutical Sciences, PCTE Group of Institutes, Ludhiana, Punjab, India; School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab, India
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Ebenhan T, Kleynhans J, Zeevaart JR, Jeong JM, Sathekge M. Non-oncological applications of RGD-based single-photon emission tomography and positron emission tomography agents. Eur J Nucl Med Mol Imaging 2020; 48:1414-1433. [PMID: 32918574 DOI: 10.1007/s00259-020-04975-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 07/23/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Non-invasive imaging techniques (especially single-photon emission tomography and positron emission tomography) apply several RGD-based imaging ligands developed during a vast number of preclinical and clinical investigations. The RGD (Arg-Gly-Asp) sequence is a binding moiety for a large selection of adhesive extracellular matrix and cell surface proteins. Since the first identification of this sequence as the shortest sequence required for recognition in fibronectin during the 1980s, fundamental research regarding the molecular mechanisms of integrin action have paved the way for development of several pharmaceuticals and radiopharmaceuticals with clinical applications. Ligands recognizing RGD may be developed for use in the monitoring of these interactions (benign or pathological). Although RGD-based molecular imaging has been actively investigated for oncological purposes, their utilization towards non-oncology applications remains relatively under-exploited. METHODS AND SCOPE This review highlights the new non-oncologic applications of RGD-based tracers (with the focus on single-photon emission tomography and positron emission tomography). The focus is on the last 10 years of scientific literature (2009-2020). It is proposed that these imaging agents will be used for off-label indications that may provide options for disease monitoring where there are no approved tracers available, for instance Crohn's disease or osteoporosis. Fundamental science investigations have made progress in elucidating the involvement of integrin in various diseases not pertaining to oncology. Furthermore, RGD-based radiopharmaceuticals have been evaluated extensively for safety during clinical evaluations of various natures. CONCLUSION Clinical translation of non-oncological applications for RGD-based radiopharmaceuticals and other imaging tracers without going through time-consuming extensive development is therefore highly plausible. Graphical abstract.
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Affiliation(s)
- Thomas Ebenhan
- Nuclear Medicine, University of Pretoria, Pretoria, 0001, South Africa. .,Nuclear Medicine Research Infrastructure, NPC, Pretoria, 0001, South Africa.
| | - Janke Kleynhans
- Nuclear Medicine, University of Pretoria, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure, NPC, Pretoria, 0001, South Africa
| | - Jan Rijn Zeevaart
- Nuclear Medicine Research Infrastructure, NPC, Pretoria, 0001, South Africa.,DST/NWU Preclinical Drug Development Platform, North-West University, Potchefstroom, 2520, South Africa
| | - Jae Min Jeong
- Department of Nuclear Medicine, Institute of Radiation Medicine, Seoul National University College of Medicine, 101 Daehangno Jongno-gu, Seoul, 110-744, South Korea
| | - Mike Sathekge
- Nuclear Medicine, University of Pretoria, Pretoria, 0001, South Africa
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21
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Grob NM, Häussinger D, Deupi X, Schibli R, Behe M, Mindt TL. Triazolo-Peptidomimetics: Novel Radiolabeled Minigastrin Analogs for Improved Tumor Targeting. J Med Chem 2020; 63:4484-4495. [PMID: 32302139 DOI: 10.1021/acs.jmedchem.9b01936] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
MG11 is a truncated analog of minigastrin, a peptide with high affinity and specificity toward the cholecystokinin-2 receptor (CCK2R), which is overexpressed by different tumors. Thus, radiolabeled MG11 derivatives have great potential for use in cancer diagnosis and therapy. A drawback of MG11 is its fast degradation by proteases, leading to moderate tumor uptake in vivo. We introduced 1,4-disubstituted 1,2,3-triazoles as metabolically stable bioisosteres to replace labile amide bonds of the peptide. The "triazole scan" yielded peptidomimetics with improved resistance to enzymatic degradation and/or enhanced affinity toward the CCK2R. Remarkably, our lead compound achieved a 10-fold increase in receptor affinity, resulting in a 2.6-fold improved tumor uptake in vivo. Modeling of the ligand-CCK2R complex suggests that an additional cation-π interaction of the aromatic triazole moiety with the Arg356 residue of the receptor is accountable for these observations. We show for the first time that the amide-to-triazole substitution strategy offers new opportunities in drug development that go beyond the metabolic stabilization of bioactive peptides.
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Affiliation(s)
- Nathalie M Grob
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zürich, Switzerland
| | - Daniel Häussinger
- Department of Chemistry, University of Basel, 4056 Basel, Switzerland
| | - Xavier Deupi
- Condensed Matter Theory Group, Laboratory for Scientific Computing and Modelling, Paul Scherrer Institute, 5232 Villigen, Switzerland.,Laboratory of Biomolecular Research, Division of Biology and Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Roger Schibli
- Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zürich, Switzerland.,Center for Radiopharmaceutical Sciences, Division of Biology and Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Martin Behe
- Center for Radiopharmaceutical Sciences, Division of Biology and Chemistry, Paul Scherrer Institute, 5232 Villigen, Switzerland
| | - Thomas L Mindt
- Ludwig Boltzmann Institute Applied Diagnostics, General Hospital of Vienna, 1090 Vienna, Austria.,Department of Inorganic Chemistry, Faculty of Chemistry, University of Vienna, 1090 Vienna, Austria.,Department of Biomedical Imaging and Image Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria
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22
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Determination of ionic 68Ga impurity in radiopharmaceuticals: major revision of radio-HPLC methods. J Radioanal Nucl Chem 2019. [DOI: 10.1007/s10967-019-06964-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Nock BA, Maina T. Theranostic approaches in nuclear oncology: From bench to bed. J Labelled Comp Radiopharm 2019; 62:612-614. [PMID: 31325329 DOI: 10.1002/jlcr.3787] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 07/10/2019] [Indexed: 11/10/2022]
Affiliation(s)
- Berthold A Nock
- Molecular Radiopharmacy, INRASTES, NCSR "Demokritos,", Athens, Greece
| | - Theodosia Maina
- Molecular Radiopharmacy, INRASTES, NCSR "Demokritos,", Athens, Greece
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24
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Vermeulen K, Vandamme M, Bormans G, Cleeren F. Design and Challenges of Radiopharmaceuticals. Semin Nucl Med 2019; 49:339-356. [PMID: 31470930 DOI: 10.1053/j.semnuclmed.2019.07.001] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This review describes general concepts with regard to radiopharmaceuticals for diagnostic or therapeutic applications that help to understand the specific challenges encountered during the design, (radio)synthesis, in vitro and in vivo evaluation and clinical translation of novel radiopharmaceuticals. The design of a radiopharmaceutical requires upfront decisions with regard to combining a suitable vector molecule with an appropriate radionuclide, considering the type and location of the molecular target, the desired application, and the time constraints imposed by the relatively short half-life of radionuclides. Well-designed in vitro and in vivo experiments allow nonclinical validation of radiotracers. Ultimately, in combination with a limited toxicology package, the radiotracer becomes a radiopharmaceutical for clinical evaluation, produced in compliance with regulatory requirements for medicines for intravenous (IV) injection.
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Affiliation(s)
- Koen Vermeulen
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Leuven, Belgium
| | - Mathilde Vandamme
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Leuven, Belgium
| | - Guy Bormans
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Leuven, Belgium.
| | - Frederik Cleeren
- Laboratory for Radiopharmaceutical Research, Department of Pharmaceutical and Pharmacological Sciences, University of Leuven, Leuven, Belgium
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25
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Kolenc Peitl P, Rangger C, Garnuszek P, Mikolajczak R, Hubalewska-Dydejczyk A, Maina T, Erba P, Decristoforo C. Clinical translation of theranostic radiopharmaceuticals: Current regulatory status and recent examples. J Labelled Comp Radiopharm 2019; 62:673-683. [PMID: 30741441 PMCID: PMC6767129 DOI: 10.1002/jlcr.3712] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/06/2019] [Accepted: 02/07/2019] [Indexed: 12/03/2022]
Abstract
With the development of ever more radiopharmaceuticals suitable for theranostic applications, translation of novel compounds from the preclinical stage towards clinical application becomes a bottleneck for the advances in Nuclear Medicine. This review article summarizes the current regulatory framework for clinical trials with radiopharmaceuticals in the European Union, provides a general overview of the documentation required, and addresses quality, safety, and clinical aspects to be considered. By using a recent successful example of translating a theranostic peptide radioligand, namely 111In‐CP04, which targets receptors expressed in medullary thyroid carcinoma, the pathway from the preclinical development over establishing the required pharmaceutical documentation to designing and submitting a clinical trial is reviewed. Details regarding preclinical data, generation of the documentation, and final successful application are described. This article should provide an insight in an ever more complex process to bring innovations in the field of radiopharmaceuticals into patients.
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Affiliation(s)
- Petra Kolenc Peitl
- Deparment of Nuclear Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Christine Rangger
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Piotr Garnuszek
- Radioisotope Centre POLATOM, National Centre for Nuclear Research, Otwock, Poland
| | - Renata Mikolajczak
- Radioisotope Centre POLATOM, National Centre for Nuclear Research, Otwock, Poland
| | | | - Theodosia Maina
- Molecular Radiopharmacy, INRASTES, NCSR "Demokritos", Athens, Greece
| | - Paola Erba
- Nuclear Medicine, Department of Translational Research and New Technologies in Medicine University of Pisa and Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Innsbruck, Austria
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