1
|
Chen H, Teng M, Zhang H, Liang X, Cheng H, Liu G. Advanced radionuclides in diagnosis and therapy for hepatocellular carcinoma. CHINESE CHEM LETT 2022. [DOI: 10.1016/j.cclet.2022.03.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
2
|
Alrfooh A, Patel A, Laroia S. Transarterial Radioembolization Agents: a Review of the Radionuclide Agents and the Carriers. Nucl Med Mol Imaging 2021; 55:162-172. [PMID: 34422126 PMCID: PMC8322227 DOI: 10.1007/s13139-021-00709-3] [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: 02/26/2021] [Revised: 06/16/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Abstract
Liver tumors, both primary and secondary to metastatic disease, remain a major challenge, with an increasing incidence. In this context, taking advantage of the dual blood supply of the liver, and the fact that liver tumors derive majority of their blood supply from the hepatic artery, intraarterial therapies are gaining popularity. Intraarterial liver-directed therapy (IALDT) is the option when the surgery is not feasible due to the number of metastases or for other reasons. Transarterial radioembolization (TARE) is a specific type of IALDT, where a carrier particle/microsphere is labeled with a radioactive substance and then is injected into hepatic artery for therapeutic purposes. As this field is rapidly evolving, with multiple agents being investigated and being introduced into clinical practice, it is hard for the practitioners and researchers to encompass all the available information concisely. This article aims to present a comprehensive review of the prominent TARE technologies.
Collapse
Affiliation(s)
- Aysheh Alrfooh
- University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
| | - Aditi Patel
- Department of Radiology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
| | - Sandeep Laroia
- Department of Radiology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
| |
Collapse
|
3
|
Li R, Li D, Jia G, Li X, Sun G, Zuo C. Diagnostic Performance of Theranostic Radionuclides Used in Transarterial Radioembolization for Liver Cancer. Front Oncol 2021; 10:551622. [PMID: 33569342 PMCID: PMC7868560 DOI: 10.3389/fonc.2020.551622] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 12/07/2020] [Indexed: 12/18/2022] Open
Abstract
Primary liver tumor with hepatocellular carcinoma accounting for 75–80% of all such tumors, is one of the global leading causes of cancer-related death, especially in cirrhotic patients. Liver tumors are highly hypervascularized via the hepatic artery, while normal liver tissues are mainly supplied by the portal vein; consequently, intra-arterially delivered treatment, which includes transarterial chemoembolization (TACE) and transarterial radioembolization (TARE), is deemed as a palliative treatment. With the development of nuclear technology and radiochemistry, TARE has become an alternative for patients with hepatic cancer, especially for patients who failed other therapies, or for patients who need tumor downstaging treatment. In practice, some radionuclides have suitable physicochemical characteristics to act as radioactive embolism agents. Among them, 90Y emits β rays only and is suitable for bremsstrahlung single photon emission computed tomography (BS SPECT) and positron emission tomography (PET); meanwhile, some others, such as 131I, 153Sm, 166Ho, 177Lu, 186Re, and 188Re, emit both β and γ rays, enabling embolism beads to play a role in both therapy and single photon emission computed tomography (SPECT) imaging. During TARE, concomitant imaging provide additive diagnostic information and help to guide the course of liver cancer treatment. Therefore, we review the theranostic radionuclides that have been used or could potentially be used in TARE for liver cancer and focus on the clinical benefits of diagnostic applications, including real-time monitoring of embolism beads, evaluating irradiation dose, predicting therapy effects, and corresponding adjustments to TARE.
Collapse
Affiliation(s)
- Rou Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China.,School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| | - Danni Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Guorong Jia
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Xiao Li
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Gaofeng Sun
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Shanghai, China.,School of Medical Imaging, Xuzhou Medical University, Xuzhou, China
| |
Collapse
|
4
|
Wong YH, Tan HY, Kasbollah A, Abdullah BJJ, Acharya RU, Yeong CH. Neutron-activated biodegradable samarium-153 acetylacetonate-poly-L-lactic acid microspheres for intraarterial radioembolization of hepatic tumors. World J Exp Med 2020; 10:10-25. [PMID: 32266125 PMCID: PMC7117964 DOI: 10.5493/wjem.v10.i2.10] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 02/14/2020] [Accepted: 03/01/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver cancer is the 6th most common cancer in the world and the 4th most common death from cancer worldwide. Hepatic radioembolization is a minimally invasive treatment involving intraarterial administration of radioembolic microspheres.
AIM To develop a neutron-activated, biodegradable and theranostics samarium-153 acetylacetonate (153SmAcAc)-poly-L-lactic acid (PLLA) microsphere for intraarterial radioembolization of hepatic tumors.
METHODS Microspheres with different concentrations of 152SmAcAc (i.e., 100%, 150%, 175% and 200% w/w) were prepared by solvent evaporation method. The microspheres were then activated using a nuclear reactor in a neutron flux of 2 × 1012 n/cm2/s1, converting 152Sm to Samarium-153 (153Sm) via 152Sm (n, γ) 153Sm reaction. The SmAcAc-PLLA microspheres before and after neutron activation were characterized using scanning electron microscope, energy dispersive X-ray spectroscopy, particle size analysis, Fourier transform infrared spectroscopy, thermo-gravimetric analysis and gamma spectroscopy. The in-vitro radiolabeling efficiency was also tested in both 0.9% sodium chloride solution and human blood plasma over a duration of 550 h.
RESULTS The SmAcAc-PLLA microspheres with different SmAcAc contents remained spherical before and after neutron activation. The mean diameter of the microspheres was about 35 µm. Specific activity achieved for 153SmAcAc-PLLA microspheres with 100%, 150%, 175% and 200% (w/w) SmAcAc after 3 h neutron activation were 1.7 ± 0.05, 2.5 ± 0.05, 2.7 ± 0.07, and 2.8 ± 0.09 GBq/g, respectively. The activity of per microspheres were determined as 48.36 ± 1.33, 74.10 ± 1.65, 97.87 ± 2.48, and 109.83 ± 3.71 Bq for 153SmAcAc-PLLA microspheres with 100%, 150%, 175% and 200% (w/w) SmAcAc. The energy dispersive X-ray and gamma spectrometry showed that no elemental and radioactive impurities present in the microspheres after neutron activation. Retention efficiency of 153Sm in the SmAcAc-PLLA microspheres was excellent (approximately 99%) in both 0.9% sodium chloride solution and human blood plasma over a duration of 550 h.
CONCLUSION The 153SmAcAc-PLLA microsphere is potentially useful for hepatic radioembolization due to their biodegradability, favorable physicochemical characteristics and excellent radiolabeling efficiency. The synthesis of the formulation does not involve ionizing radiation and hence reducing the complication and cost of production.
Collapse
Affiliation(s)
- Yin-How Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia
| | - Hun-Yee Tan
- School of Biosciences, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia
| | - Azahari Kasbollah
- Medical Technology Division, Malaysian Nuclear Agency, Bangi 43000, Selangor, Malaysia
| | - Basri Johan Jeet Abdullah
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia
| | - Rajendra Udyavara Acharya
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia
- Department of Electronics and Computer Engineering, Ngee Ann Polytechnic, Singapore 599489, Singapore
| | - Chai-Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia
| |
Collapse
|
5
|
Abstract
The current review documents the major hallmarks in the history and development of radioembolization, the origins of which date back to the late 1940s. Radioembolization was initially abandoned because of the increased incidence of adverse effects and lack of commercial interest; however, it regained avid interest in clinical trials and has achieved established clinical utility in the last 15 years. This review focuses on the main stations of the evolution of radioembolization, namely, initial animal and human experimental studies, production of Y-microspheres, development of current therapeutic agents (resin and glass spheres and labeled Lipiodol), prediction and prevention of inadvertent, extrahepatic shunt side effects, initial prospective studies, and large randomized trials till final approval from the relevant official bodies. The historical knowledge of the initial concepts of the method and the limitations encountered may pave the way toward further evolution and possible new applications.
Collapse
|
6
|
Pandey U, Subramanian S, Shaikh S, Gamre N, Kumar S, Dash A. Synthesis and Preliminary Biological Evaluation of 177Lu-Labeled Polyhydroxamic Acid Microparticles Toward Therapy of Hepatocellular Carcinoma. Cancer Biother Radiopharm 2019; 34:306-315. [PMID: 31188652 DOI: 10.1089/cbr.2018.2747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Transarterial radioembolization (TARE) represents an effective targeted therapeutic option for hepatocellular carcinoma (HCC), a cancer with high mortality and poor prognosis. The aim of this study was the preparation and preliminary biological evaluation of 177Lu-labeled polyhydroxamic acid (PHA) microparticles toward possible use in the therapy of HCC. Materials and Methods: PHA microparticles were synthesized starting from polyacrylamide. They were characterized by Fourier-transform infrared spectroscopy (FT-IR), visual color test, and laser diffraction particle size analysis. Experimental variables such as reaction pH, amount of PHA microparticles, carrier Lu content, and incubation time were optimized for maximum uptake of 177Lu on PHA microparticles. Stability of 177Lu-PHA microparticles was tested in the presence of competing Fe(III) ions in solution. In vitro stability of 177Lu-PHA microparticles was evaluated in 0.05 M sodium phosphate solution (pH 7.5), saline, and serum. Bioevaluation studies were performed in normal Wistar rats by intrahepatic artery injection of the 177Lu-PHA microparticles. Results: Successful synthesis of PHA microparticles could be confirmed from the results of FT-IR analysis and visual color test. Laser diffraction-based particle size analysis confirmed median particle size to be 54 μm, suitable for TARE. Under the optimized conditions, >99% loading of 177Lu on PHA microparticles could be achieved. Even in the presence of high concentration of Fe(III) ions, 177Lu binding to PHA microparticles was stable. 177Lu-PHA microparticles exhibited excellent in vitro stability in sodium phosphate solution, saline, and serum up to 5 d at 37°C. In the bioevaluation studies performed in normal Wistar rats, 92.8% ± 3.1% of 177Lu-PHA microparticles were retained in the liver at 96 h postinjection without any significant leakage to other organs. Conclusion: This preliminary study demonstrates the potential of synthesized PHA microparticles as carriers of therapeutic radioisotopes such as 177Lu for treatment of HCC.
Collapse
Affiliation(s)
- Usha Pandey
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,2 Homi Bhabha National Institute, Mumbai, India
| | - Suresh Subramanian
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,2 Homi Bhabha National Institute, Mumbai, India
| | - Samina Shaikh
- 2 Homi Bhabha National Institute, Mumbai, India.,3 Analytical Chemistry Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Naresh Gamre
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Sanjukta Kumar
- 2 Homi Bhabha National Institute, Mumbai, India.,3 Analytical Chemistry Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Ashutosh Dash
- 1 Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,2 Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
7
|
Chen LC, Lee WC, Ho CL, Chang YJ, Chen SJ, Chang CH. Biodistribution, Pharmacokinetics and Efficacy of 188Re(I)-Tricarbonyl-Labeled Human Serum Albumin Microspheres in an Orthotopic Hepatoma Rat Model. ACTA ACUST UNITED AC 2018; 32:567-573. [PMID: 29695562 DOI: 10.21873/invivo.11277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 02/07/2018] [Accepted: 02/08/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND/AIM The biodistribution, pharmacokinetics and therapeutic evaluation of 188Re-human serum albumin microspheres (188Re-HSAM) by labeling with 188Re(I)-tricarbonyl ion (188Re(OH2)3(CO)3)+) were investigated in a GP7TB orthotopic hepatoma rat model. MATERIALS AND METHODS Male F344 rats received intrahepatic inoculations with GP7TB 1 mm3 cubes. The efficacy of 188Re-HSAM was examined following a single-dose treatment via the intraarterial route. Rats were monitored for survival until death. RESULTS The labeling efficiency of the 188Re-HSAM was about 80%. After intraarterial administration of 188Re-HSAM, radioactivity in tumors accumulated from 18.41±3.48 %ID/g at 1 h to 12.43±4.70 %ID/g at 24 h. The tumor/liver ratios ranged from 3.03 at 1 h to 1.89 at 72 h. The major uptake organs of 188Re-HSAM were liver (73.35%ID to 48.92%ID), tumor (10.54%ID to 3.51%ID) and kidney (7.48 %ID to 0.14%ID). The T1/2λz of 188Re-HSAM was 259.34 h after intraarterial injection. The AUC(0→96 h) of 188Re-HSAM was 0.69 h*% ID/g. In the efficacy study, the median survival time for the rat (n=6), that received normal saline was 80 d. The median survival times for the mice treated with 10 mCi (n=4), 5.2 mCi (n=6) and 2.9 mCi (n=3) of 188Re-HSAM were 130 d (p=0.003), 106 d (p=0.002) and 83.5 d (p=0.617), respectively. The increase in life span of 10 mCi, 5.2 mCi and 2.9 mCi of 188Re-HSAM were 62.5%, 32.5% and 4.4%, respectively. CONCLUSION Administration of 188Re-HSAM demonstrated better survival time and therapeutic efficacy at the higher dose in the GP7TB hepatoma model. These results suggested that intraarterial administration of 188Re-HSAM could provide a benefit and promising strategy for delivery of radiotherapeutics in oncology applications.
Collapse
Affiliation(s)
- Liang-Cheng Chen
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan, Taiwan, R.O.C
| | - Wan-Chi Lee
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan, Taiwan, R.O.C
| | - Chung-Li Ho
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan, Taiwan, R.O.C
| | - Ya-Jen Chang
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan, Taiwan, R.O.C
| | - Su-Jung Chen
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan, Taiwan, R.O.C
| | - Chih-Hsien Chang
- Isotope Application Division, Institute of Nuclear Energy Research, Taoyuan, Taiwan, R.O.C.
| |
Collapse
|
8
|
Chen LC, Chang YJ, Chen SJ, Lee WC, Chang CH, Lee TW, Shien JH. Imaging, biodistribution and efficacy evaluation of 188Re-human serum albumin microspheres via intraarterial route in an orthotopic hepatoma model. Int J Radiat Biol 2017; 93:477-486. [PMID: 28045339 DOI: 10.1080/09553002.2017.1276308] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Liver cancer is the second most common cause of death worldwide. This study was to investigate the SPECT/CT, ultrasound, biodistribution and therapeutic evaluation of 188Re-human serum albumin microspheres (188Re-HSAM) in the GP7TB orthotopic hepatoma rat model. MATERIALS AND METHODS HSAM was labeled with 188Re by using a home-made kit and microwave system. The 188Re-HSAM was administered via intraarterial route. The in vivo distribution of 188Re-HSAM was determined by biodistribution analysis and nanoSPECT/CT system. In efficacy, tumor volumes were tracked longitudinally by three-dimensional ultrasound. RESULTS The biodistribution and nanoSPECT/CT imaging showed that 188Re-HSAM could accumulate in liver and tumor. The correlation coefficient of tumor volumes done by three-dimensional ultrasound and at autopsy was 0.997. In efficacy, tumor volume in the normal saline-treated group was 1803.2 mm3 at 54 days after tumor inoculation. Tumor volumes in the 103.6 MBq and 240.5 MBq of 188Re-HSAM treated groups were 381 and 267.4 mm3 (p = 0.001 and 0.004), respectively. CONCLUSIONS These results show that three-dimensional ultrasound with a high spatial resolution and contrast in soft tissue can become imaging modality in assessing tumor burden and tumor progression in an orthotopic rat model. The longitudinally therapeutic evaluation of 188Re-HSAM demonstrated dose-dependent tumor growth inhibition with increased dose in the GP7TB orthotopic hepatoma rat model.
Collapse
Affiliation(s)
- Liang-Cheng Chen
- a Department of Veterinary Medicine , National Chung Hsing University , Taichung , Taiwan.,b Isotope Application Division , Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Ya-Jen Chang
- b Isotope Application Division , Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Su-Jung Chen
- b Isotope Application Division , Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Wan-Chi Lee
- b Isotope Application Division , Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Chih-Hsien Chang
- b Isotope Application Division , Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Te-Wei Lee
- b Isotope Application Division , Institute of Nuclear Energy Research , Taoyuan , Taiwan
| | - Jui-Hung Shien
- a Department of Veterinary Medicine , National Chung Hsing University , Taichung , Taiwan
| |
Collapse
|
9
|
Preparation and Characterization of Hyaluronic Acid-Polycaprolactone Copolymer Micelles for the Drug Delivery of Radioactive Iodine-131 Labeled Lipiodol. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4051763. [PMID: 28127555 PMCID: PMC5239969 DOI: 10.1155/2017/4051763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 12/05/2016] [Indexed: 11/29/2022]
Abstract
Micelles, with the structure of amphiphilic molecules including a hydrophilic head and a hydrophobic tail, are recently developed as nanocarriers for the delivery of drugs with poor solubility. In addition, micelles have shown many advantages, such as enhanced permeation and retention (EPR) effects, prolonged circulation times, and increased endocytosis through surface modification. In this study, we measured the critical micelle concentrations, diameters, stability, and cytotoxicity and the cell uptake of micelles against hepatic cells with two kinds of hydrophilic materials: PEG-PCL and HA-g-PCL. We used 131I as a radioactive tracer to evaluate the stability, drug delivery, and cell uptake activity of the micelles. The results showed that HA-g-PCL micelles exhibited higher drug encapsulation efficiency and stability in aqueous solutions. In addition, the 131I-lipiodol loaded HA-g-PCL micelles had better affinity and higher cytotoxicity compared to HepG2 cells.
Collapse
|
10
|
Mukherjee A, Subramanian S, Ambade R, Avhad B, Dash A, Korde A. Development of Semiautomated Module for Preparation of 131I Labeled Lipiodol for Liver Cancer Therapy. Cancer Biother Radiopharm 2017; 32:33-37. [PMID: 28128645 DOI: 10.1089/cbr.2016.2088] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Intra-arterial injection of 131I Lipiodol is an effective treatment option for primary hepatocellular carcinoma as it delivers high radiation dose to liver tumor tissue with minimal accumulation in adjacent normal tissue. The present article demonstrates design, fabrication, and utilization of a semiautomated radiosynthesis module for preparation of 131I labeled Lipiodol. The radiolabeling method was standardized for preparation of patient dose of 131I labeled Lipiodol radiochemical yield (RCY); radiochemical purity (RCP) and pharmaceutical purity of the product were determined using optimized procedures. Sterile and apyrogenic 131I labeled Lipiodol in >60% RCY could be prepared with >95% RCP. Preclinical evaluation in animals indicated retention of more than 90% of activity at 24 hours postportal vein injection. This is the first report demonstrating potential application of simple user friendly and safe semiautomated system for routine production of 131I labeled Lipiodol, which is adaptable at centralized hospital radiopharmacies. The described prototype module can be modified as per demand for preparation of other therapeutic radiopharmaceuticals.
Collapse
Affiliation(s)
- Archana Mukherjee
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) , Mumbai, India
| | - Suresh Subramanian
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) , Mumbai, India
| | - Rajwardhan Ambade
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) , Mumbai, India
| | - Bhaurao Avhad
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) , Mumbai, India
| | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) , Mumbai, India
| | - Aruna Korde
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC) , Mumbai, India
| |
Collapse
|
11
|
Ma J, Wang JH. 131I-Labeled-Metuximab Plus Transarterial Chemoembolization in Combination Therapy for Unresectable Hepatocellular Carcinoma: Results from a Multicenter Phase IV Clinical Study. Asian Pac J Cancer Prev 2016; 16:7441-7. [PMID: 26625741 DOI: 10.7314/apjcp.2015.16.17.7441] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE This study evaluated the safety and objective response of combining 131I-labeled-metuximab (Licartin) with transarterial chemoembolization (TACE) in the treatment of unresectable hepatocellular carcinoma (HCC). MATERIALS AND METHODS In a multicenter open-label clinical trial, 341 enrolled patients with stage III/IV HCC according to TNM criteria were nonrandomly assigned to a trial group (n=167) and a control group (n=174), undergoing TACE following hepatic intra-arterial injection of licartin or TACE alone from July 2007 to July 2009. Radiopharmaceutical distribution was evaluated. The primary endpoint was overall survival; secondary endpoints included time-to-progression (TTP), toxicity and adverse events (AEs). RESULTS The radiobiological distribution demonstrated better localization of licartin in liver tumors than other tissues (P<0.01). The organ absorbed doses to liver and red marrow were 3.19 ± 1.01 Gy and 0.55 ± 0.22 Gy, respectively. The 1-year survival rate was significantly higher [79.47% vs. 65.59%, hazard ratio (HR), 0.598, P=0.041] and TTP significantly improved (6.82 ± 1.28 vs. 4.7 ± 1.14 months, P=0.037) compared with the control group. Patients at stage III achieved more benefit of one year survival than stage IV in the trial group (86.9% vs. 53.8%, P<0.001). There were significant different toxicities in leukocytopenia, thrombocytopenia and increased total bilirubin level [P<0.001, P=0.013, P<0.01, relative risk (RR) 1.63, 1.33, 1.43], but no differences in severe AEs of upper GI hemorrhage and severe liver dysfunction between the groups (5.39% vs. 2.3%, P=0.136). CONCLUSIONS Owing to excellent tumor-targeting, promised efficacy and favourable toxicity profile, the novel combination therapy of licartin and TACE could be applied in patients with unresectable HCC.
Collapse
Affiliation(s)
- Jun Ma
- Department of Interventional Radiology, Zhongshan Hospital, Fudan University, Shanghai, China E-mail :
| | | |
Collapse
|
12
|
Therapeutic Strategies in HCC: Radiation Modalities. BIOMED RESEARCH INTERNATIONAL 2016; 2016:1295329. [PMID: 27563661 PMCID: PMC4987460 DOI: 10.1155/2016/1295329] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 05/24/2016] [Accepted: 06/05/2016] [Indexed: 12/22/2022]
Abstract
Patients with hepatocellular carcinoma (HCC) comply with an advanced disease and are not eligible for radical therapy. In this distressed scenario new treatment options hold great promise; among them transarterial chemoembolization (TACE) and transarterial metabolic radiotherapy (TAMR) have shown efficacy in terms of both tumor shrinking and survival. External radiation therapy (RTx) by using novel three-dimensional conformal radiotherapy has also been used for HCC patients with encouraging results while its role had been limited in the past for the low tolerance of surrounding healthy liver. The rationale of TAMR derives from the idea of delivering exceptional radiation dose locally to the tumor, with cell killing intent, while preserving normal liver from undue exposition and minimizing systemic irradiation. Since the therapeutic efficacy of TACE is being continuously disputed, the TAMR with 131I Lipiodol or 90Y microspheres has gained consideration providing adequate therapeutic responses regardless of few toxicities. The implementation of novel radioisotopes and technological innovations in the field of RTx constitutes an intriguing field of research with important translational aspects. Moreover, the combination of different therapeutic approaches including chemotherapy offers captivating perspectives. We present the role of the radiation-based therapies in hepatocellular carcinoma patients who are not entitled for radical treatment.
Collapse
|
13
|
Huang P, Zhang Y, Wang W, Zhou J, Sun Y, Liu J, Kong D, Liu J, Dong A. Co-delivery of doxorubicin and 131I by thermosensitive micellar-hydrogel for enhanced in situ synergetic chemoradiotherapy. J Control Release 2015; 220:456-464. [DOI: 10.1016/j.jconrel.2015.11.007] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/13/2015] [Accepted: 11/07/2015] [Indexed: 01/27/2023]
|
14
|
Lee CM, Kwon JI, Lee TK, Lim ST, Sohn MH, Jeong HJ. Local Retention and Combination Effects of Biocompatible Doxorubicin-Loaded and Radioiodine-Labeled Microhydrogels in Cancer Therapy. ACS Macro Lett 2014; 3:1126-1129. [PMID: 35610809 DOI: 10.1021/mz500497n] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
I-131-labeled chitosan microhydrogels (I-131-CMH) that are retained at an injection site without leaking free I-131 into normal tissue can provide opportunities to improve cancer therapy. This study focuses on the development of doxorubicin-loaded I-131-CMH (Dox-I-131-CMH) for use in radiochemotherapy against cancer. The radiolabeling of I-131-CMH was found to be stable over a period of 2 weeks with no disassociation of free I-131, and Dox showed a sustained release from the CMH. When I-131-CMH were injected into the thigh muscle or tumor tissue, in vivo gamma imaging showed a retention at the injection site with no significant leakage of I-131 into other areas of normal tissue, and after an intrahepatic arterial injection, I-131-CMH were selectively retained in the liver. Dox-I-131-CMH had significant synergistic therapeutic effects of radiation and chemotherapy on mouse breast cancer models. In this regard, Dox-I-131-CMH may be a new alternative agent for cancer therapy.
Collapse
Affiliation(s)
- Chang-Moon Lee
- Department
of Biomedical Engineering, Chonnam National University, Yeosu, Jeonnam 550-749, Republic of Korea
| | - Jeong-Il Kwon
- Department
of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research
Center, Biomedical Research Institute for Medical Sciences, and Cyclotron
Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk 561-712, Republic of Korea
| | - Tai-Kyoung Lee
- Department
of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research
Center, Biomedical Research Institute for Medical Sciences, and Cyclotron
Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk 561-712, Republic of Korea
| | - Seok Tae Lim
- Department
of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research
Center, Biomedical Research Institute for Medical Sciences, and Cyclotron
Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk 561-712, Republic of Korea
| | - Myung-Hee Sohn
- Department
of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research
Center, Biomedical Research Institute for Medical Sciences, and Cyclotron
Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk 561-712, Republic of Korea
| | - Hwan-Jeong Jeong
- Department
of Nuclear Medicine, Molecular Imaging and Therapeutic Medicine Research
Center, Biomedical Research Institute for Medical Sciences, and Cyclotron
Research Center, Chonbuk National University Medical School and Hospital, Jeonju, Jeonbuk 561-712, Republic of Korea
| |
Collapse
|
15
|
Chi JL, Li CC, Xia CQ, Li L, Ma Y, Li JH, Chen Z, Chen XL. Effect of (131)I gelatin microspheres on hepatocellular carcinoma in nude mice and its distribution after intratumoral injection. Radiat Res 2014; 181:416-24. [PMID: 24720750 DOI: 10.1667/rr13539.1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
In this study, we investigated the effect of (131)I gelatin microspheres ((131)I-GMSs) on human hepatocellular carcinoma cells (HepG2) in nude mice (Balb/c) and the biodistribution of (131)I-GMSs after intratumoral injection. The treatment group and control group animals received intratumoral injections of 1 mCi (131)I-GMSs and GMSs unlabeled (131)I, respectively. The size of the implanted tumor was measured once a week for 8 weeks, and the survival time was calculated from the day of injection to 64 days post-injection. Another 35 animals received intratumoral injections of 0.2 mCi (131)I-GMSs and were subject to single-photon emission computed tomography (SPECT) on days 1, 8, 16, 24 and 32 post-injection. Samples of various organs were collected and used to calculate tissue concentrations on days 1, 4, 8, 16 and 24. Free thyroxine (FT4) in fetal bovine serum was tested to evaluate thyroid function. The tumors were collected for histological examination. (131)I-GMSs produced a pronounced reduction in HepG2 tumor volume, and the overall survival was 73.3% in the treatment group and only 13.3% in the control group (P < 0.001). Tissue radioactivity concentration measurements and SPECT demonstrated that the injected (131)I-GMSs mainly accumulated within the tumors. The concentration of FT4 was stable during the observation period. The microspheres could be observed by histological methods on day 32. (131)I-GMSs suppressed the growth of HepG2 in the nude mice and were retained in the tumor for a long period of time after injection. Direct intratumoral injection of (131)I-GMSs offers a promising modality for the treatment of hepatocellular carcinoma.
Collapse
Affiliation(s)
- Jun-Lin Chi
- a Department of Hepato-bilio-pancreatology Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | | | | | | | | | | | | | | |
Collapse
|
16
|
Dai D, Xu W, Liu J, Zhu L, Zhu X, Ma X. Safety and efficacy of a peripheral intravenous bolus of Licartin for the treatment of advanced hepatocellular carcinoma. Exp Ther Med 2013; 6:1417-1422. [PMID: 24250722 PMCID: PMC3829723 DOI: 10.3892/etm.2013.1321] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 07/19/2013] [Indexed: 12/29/2022] Open
Abstract
The aim of the present study was to examine the safety and efficacy of a peripheral intravenous bolus of Licartin for the treatment of advanced hepatocellular carcinoma (HCC), and to explore the clinical value of this treatment. Clinical data from Tianjin Medical University Cancer Institute and Hospital (Tianjin, China) were analyzed. Thirty-three patients (38 cases) with advanced HCC received an intravenous bolus of Licartin. The patients underwent routine blood examinations and liver, kidney and thyroid function tests 1 week prior to treatment and 1 and 3 months after treatment, and a long-term follow-up was performed. These data were collected before and after treatment was statistically analyzed and compared with that of previous studies regarding the safety of Licartin combined with transcatheter arterial chemoembolization for the treatment of HCC. During treatment, adverse reactions, including non-infectious fever, pain in the liver area, nausea and vomiting, occurred in a minority of patients. The adverse reactions were endured in the majority of cases and the symptoms were spontaneously relieved. Following treatment, 15 patients (39.47% of cases) demonstrated drug-related adverse reactions, including decreased white blood cell counts, platelet counts, hemoglobin levels and neutrophil counts, and increased levels of alanine aminotransferase, aspartate aminotransferase, serum direct bilirubin, creatinine and blood urea nitrogen, from high to low incidence. Electrocardiograms indicated no significant differences in thyroid function between patients before and after treatment, and showed stable vital signs. This study demonstrated that peripheral intravenous bolus administration of Licartin for radioimmunotherapy is safe and effective, is tolerated by the patient and may potentially become a routine treatment for HCC.
Collapse
Affiliation(s)
- Dong Dai
- Department of Molecular Imaging and Nuclear Medicine, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, P.R. China
| | | | | | | | | | | |
Collapse
|
17
|
Interventional radionuclide therapy of hepatocellular carcinoma: Assessment of intratumoral retention of HPMA copolymers. Chem Res Chin Univ 2013. [DOI: 10.1007/s40242-013-2089-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
18
|
Das T, Pillai M. Options to meet the future global demand of radionuclides for radionuclide therapy. Nucl Med Biol 2013; 40:23-32. [DOI: 10.1016/j.nucmedbio.2012.09.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 09/05/2012] [Accepted: 09/10/2012] [Indexed: 01/09/2023]
|
19
|
Xie T, Liu Q, Zaidi H. Evaluation of S-values and dose distributions for90Y,131I,166Ho, and188Re in seven lobes of the rat liver. Med Phys 2012; 39:1462-72. [DOI: 10.1118/1.3681009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
|
20
|
Ahmadzadehfar H, Sabet A, Wilhelm K, Biersack HJ, Risse J. Iodine-131-lipiodol therapy in hepatic tumours. Methods 2011; 55:246-52. [PMID: 21664971 DOI: 10.1016/j.ymeth.2011.05.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2010] [Accepted: 05/25/2011] [Indexed: 01/05/2023] Open
Abstract
The incidence of hepatocellular carcinoma (HCC) is worldwide sharply on the rise and patients with advanced disease carry a poor prognosis. HCC is the sixth most common cancer and the third leading cause of cancer associated deaths in the world. Intra-arterially administered (131)I-Lipiodol is selectively retained by hepatocellular carcinomas, and has been used as a vehicle for delivery of therapeutic agents to these tumours. In this review we focus on the therapeutic indications, usefulness and methods of treatment with 131-Iodine Lipiodol. The effectiveness of (131)I-Lipiodol treatment is proven both in the treatment of HCC with portal thrombosis and also as an adjuvant to surgery after the resection of HCCs. It is at least as effective as chemoembolization and is tolerated much better. Severe liver dysfunction represents theoretic contraindication for radioembolization as well as for TACE. In such cases (131)I-Lipiodol is an alternative therapy option especially in tumours smaller than 6cm.
Collapse
|
21
|
Raoul JL, Edeline J, Pracht M, Boucher E, Rolland Y, Garin E. [Radioembolisation for hepatocellular carcinoma]. Cancer Radiother 2011; 15:64-8. [PMID: 21236718 DOI: 10.1016/j.canrad.2010.12.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 09/28/2010] [Accepted: 10/12/2010] [Indexed: 12/20/2022]
Abstract
Hepatocellular carcinoma is now a major public health concern. In intermediate stages (one third of hepatocellular carcinoma patients), chemoembolization is the standard of care despite a poor tolerance and a moderate efficacy. Moreover, despite recent improvements, this technique seems in a dead end. Radioembolization could be an excellent tool for such patients. Currently (131)I-Lipiodol, (188)Re-Lipiodol, (90)Y-glass or resin microspheres are available. More recent and promising data come from microspheres, but phase II and III studies are needed before drawing any conclusion. In the future, the combination of radioembolization with systemic chemotherapy or targeted agents (particularly antiangiogenic drugs) seems very promising.
Collapse
Affiliation(s)
- J-L Raoul
- Département d'oncologie médicale, centre Eugène-Marquis, rue de la bataille Flandres-Dunkerque, Rennes cedex, France.
| | | | | | | | | | | |
Collapse
|
22
|
Bonnet M, Mishellany F, Papon J, Cayre A, Penault-Llorca F, Madelmont JC, Miot-Noirault E, Chezal JM, Moins N. Anti-melanoma efficacy of internal radionuclide therapy in relation to melanin target distribution. Pigment Cell Melanoma Res 2010; 23:e1-11. [PMID: 20444199 DOI: 10.1111/j.1755-148x.2010.00716.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Targeted internal radionuclide therapy (TRT) could be an efficient, specific way to treat disseminated melanoma. Based on a previous pharmacomodulation study, we selected a quinoxaline-derived molecule (ICF01012) for its melanin specificity and kinetic properties suitable for TRT. Here, we determined the efficacy of [(131)I]ICF01012 radiotherapy in vitro and in vivo in relation to melanogenesis using human melanoma models. [(125)I]ICF01012 uptake was first assessed in relation to melanin content. We found that melanin distribution in different models was representative of pathology seen in human tumours: melanin content was high in the extracellular space of SKMel3 tumours, and accumulated primarily in melanophages in M4Beu tumours. Targeted [(131)I]ICF01012 radiotherapy had a strong anti-tumoural efficacy in pigmented versus unpigmented tumours, regardless of target distribution and content. This study supports the use of melanin targeting with (131)I-labelled iodoquinoxaline for effective treatment of melanoma.
Collapse
Affiliation(s)
- M Bonnet
- UMR 990 INSERM/UdA-Imagerie Moléculaire et Thérapie vectorisée, Clermont-Ferrand, France.
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Raoul JL, Boucher E, Rolland Y, Garin E. Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides. Nat Rev Gastroenterol Hepatol 2010; 7:41-9. [PMID: 20051971 DOI: 10.1038/nrgastro.2009.202] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Hepatocellular carcinoma (HCC) is becoming an important public health concern. Current therapeutic options are limited and new treatments are therefore being developed. The intra-arterial treatment chemoembolization has limited efficacy and few prospects for further progress. One particularly promising, though little used, alternative to chemoembolization is radioembolization with iodine-131 ((131)I) or rhenium-188 labeled lipiodol or yttrium-90 labeled microspheres (glass or resin beads). Three randomized studies have proven the effectiveness of (131)I-lipiodol in patients with HCC-as adjuvant therapy after surgery, compared with chemoembolization, and also in patients who have portal vein thrombosis. Microspheres enable the delivery of high-dose radiation (>200 Gy) to the tumor while sparing the neighboring hepatic tissue from overexposure. Overall, the efficacy of radioembolization has been good and toxic effects have been low. These results are comparable to those obtained with chemoembolization but further improvement can be expected by combining radioembolization with standard chemotherapy or with targeted therapies, such as anti-angiogenic drugs.
Collapse
|
24
|
Das T, Chakraborty S, Sarma HD, Venkatesh M, Banerjee S. 166Ho-labeled hydroxyapatite particles: a possible agent for liver cancer therapy. Cancer Biother Radiopharm 2009; 24:7-14. [PMID: 19216630 DOI: 10.1089/cbr.2008.0545] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Intra-arterial administration of particulates labeled with -emitting radionuclides is one of the promising modalities for the treatment of liver cancer. 166Ho [T1/2=26.9 hours, E(max) = 1.85 MeV, Egamma = 81keV (6.4%)] could be envisioned as an attractive radionuclide for use in liver cancer therapy owing to its high energy emission, short half-life, and feasibility of its production with adequately high specific activity and radionuclidic purity. Hydroxyapatite (HA) particles in the size range of 20-60 micros were chosen as the particulate carrier due to their biocompatibility and ease of labeling with lanthanides. METHODS 166Ho was produced by thermal neutron bombardment on a natural holmium target. HA particles of the desired size range were synthesized, characterized, and radiolabeled with 166Ho. The biologic behavior of166Ho-HA was tested in normal Wistar rats by carrying out biodistribution and imaging studies. RESULTS 166Ho was produced with a specific activity of 5.55-6.48 TBq/g and radionuclidic purity of approximately 100%. HA particles were labeled with 166Ho with a high radiochemical purity of >99% and good in vitro stability up to 7 days. The biodistribution and imaging studies revealed satisfactory hepatic retention (approximately 89% of injected activity after 2 days) with insignificant uptake in any other major organ/tissue. CONCLUSIONS 166Ho-HA exhibited promising features as an agent for liver cancer therapy in preliminary studies and warrants further investigation
Collapse
Affiliation(s)
- Tapas Das
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai, India
| | | | | | | | | |
Collapse
|
25
|
Preparation of 166Ho-oxine-lipiodol and its preliminary bioevaluation for the potential application in therapy of liver cancer. Nucl Med Commun 2009; 30:362-7. [PMID: 19282794 DOI: 10.1097/mnm.0b013e328329981a] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Intra-arterial administration of beta-emitting radionuclides in the form of suitable radiopharmaceuticals is one of the promising modalities for the treatment of liver cancer. Ho [T1/2=26.9 h, Ebeta(max)=1.85 MeV, Egamma=81 keV (6.4%)] could be envisaged as an attractive radionuclide for the use in liver cancer therapy owing to its high-energy beta-emission, short half-life and feasibility of its production with adequately high specific activity and radionuclidic purity using moderate flux reactors. Lipiodol is chosen as the vehicle to deliver localized doses of ionizing radiation to liver cancer cells after intra-arterial hepatic infusion as it is selectively retained in the vascular periphery of the proliferating cells. METHODS Ho was produced by thermal neutron bombardment on a natural Ho2O3 target at a flux of approximately 6 x 10 n/cm.s for 7 days. Radiolabelled lipiodol was prepared by dispersing the Ho-oxine complex in lipiodol. The biological behaviour of Ho-oxine-lipiodol was studied by biodistribution and imaging studies in normal Wistar rats. RESULTS Ho was produced with a specific activity of 9.25-11.10 TBq/g and radionuclidic purity of approximately 100%. The Ho-labelled oxine complex was prepared in high yield (approximately 97%). Approximately, 95% of the Ho activity was dispersed in lipiodol within 30 min. The resulting radiolabelled preparation was found to exhibit good stability in physiological saline and human serum up to 3 days. The biodistribution and imaging studies revealed satisfactory hepatic retention (88.43+/-2.85% of injected activity after 2 days) with insignificant uptake in any other major organ/tissue except skeleton (6.44+/-1.07% at 2 days postinjection). CONCLUSION The Ho-oxine-lipiodol preparation exhibited promising features in preliminary studies and warrants further investigation.
Collapse
|
26
|
Risse JH, Pauleit D, Bender H, Rabe C, Fischer HP, Biersack HJ, Bucerius J. 18F-FDG-PET and Histopathology in 131I-Lipiodol Treatment for Primary Liver Cancer. Cancer Biother Radiopharm 2009; 24:445-52. [DOI: 10.1089/cbr.2008.0560] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Jörn H. Risse
- Radiology and Nuclear Medicine Institute, Bad Honnef, Germany
- Department of Nuclear Medicine, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Dirk Pauleit
- Radiology and Nuclear Medicine Institute, Bad Honnef, Germany
- Institute of Medicine, Research Center Jülich, Jülich, Germany
| | - Hans Bender
- Department of Nuclear Medicine, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
- Department of Nuclear Medicine, Roentgeninstitut Düsseldorf, Düsseldorf, Germany
| | - Christian Rabe
- Department of Internal Medicine I, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Hans-Peter Fischer
- Institute of Pathology, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Hans-Jürgen Biersack
- Department of Nuclear Medicine, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Jan Bucerius
- Department of Nuclear Medicine, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| |
Collapse
|
27
|
Marques F, Gano L, Batista MKS, Gomes CAR, Gomes P, Santos I. Radiochemical and biological evaluation of novel153Sm/166Ho-amino acid-chitosan complexes. J Labelled Comp Radiopharm 2009. [DOI: 10.1002/jlcr.1571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
28
|
Chakraborty S, Das T, Sarma HD, Venkatesh M, Banerjee S. Preparation and preliminary studies on 177Lu-labeled hydroxyapatite particles for possible use in the therapy of liver cancer. Nucl Med Biol 2008; 35:589-97. [PMID: 18589303 DOI: 10.1016/j.nucmedbio.2008.03.003] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2007] [Revised: 03/05/2008] [Accepted: 03/16/2008] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Intra-arterial administration of particulates labeled with suitable beta(-)-emitting radionuclides has emerged as one of the most successful modality for the treatment of primary and metastatic liver cancer. (177)Lu [T(1/2)=6.73 d, E(beta)(max)=0.49 MeV, E(gamma)=208 keV (11%)] could be envisaged as a viable radionuclide for use in liver cancer therapy with wider acceptability owing to its feasibility of production in large-scale and relatively longer half-life providing logistic advantages. Hydroxyapatite (HA) particles of 20-60 microm size range are chosen as the particulate carrier due to its excellent biocompatibility and ease of labeling with lanthanides. METHODS (177)Lu was produced by thermal neutron bombardment on enriched Lu target. HA particles of desired size range were synthesized and characterized. Radiolabeling of HA particles was achieved at room temperatures within 30 min. The biological behavior of (177)Lu-labeled HA particles prepared under optimized conditions was tested in Wistar rats. RESULTS (177)Lu was produced with a specific activity of 444.2+/-41.8 GBq/mg and radionuclidic purity of 99.98%. (177)Lu-HA was prepared with high radiochemical purity of >99%, and the radiolabeled agent showed excellent in vitro stability. The agent exhibited approximately 73% retention of injected activity in liver after 14 days postadministration with insignificant uptake in any other major organ/tissue except skeleton in biodistribution and imaging studies. CONCLUSION (177)Lu-HA exhibited promising features in radiochemical studies. However, preliminary biodistribution studies in normal Wistar rats exhibited suboptimum liver retention and an undesirable skeletal uptake.
Collapse
|
29
|
Hamoudeh M, Kamleh MA, Diab R, Fessi H. Radionuclides delivery systems for nuclear imaging and radiotherapy of cancer. Adv Drug Deliv Rev 2008; 60:1329-46. [PMID: 18562040 DOI: 10.1016/j.addr.2008.04.013] [Citation(s) in RCA: 199] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 04/16/2008] [Indexed: 01/30/2023]
Abstract
The recent developments of nuclear medicine in oncology have involved numerous investigations of novel specific tumor-targeting radiopharmaceuticals as a major area of interest for both cancer imaging and therapy. The current progress in pharmaceutical nanotechnology field has been exploited in the design of tumor-targeting nanoscale and microscale carriers being able to deliver radionuclides in a selective manner to improve the outcome of cancer diagnosis and treatment. These carriers include chiefly, among others, liposomes, microparticles, nanoparticles, micelles, dendrimers and hydrogels. Furthermore, combining the more recent nuclear imaging multimodalities which provide high sensitivity and anatomical resolution such as PET/CT (positron emission tomography/computed tomography) and SPECT/CT (combined single photon emission computed tomography/computed tomography system) with the use of these specific tumor-targeting carriers constitutes a promising rally which will, hopefully in the near future, allow for earlier tumor detection, better treatment planning and more powerful therapy. In this review, we highlight the use, limitations, advantages and possible improvements of different nano- and microcarriers as potential vehicles for radionuclides delivery in cancer nuclear imaging and radiotherapy.
Collapse
Affiliation(s)
- Misara Hamoudeh
- Université de Lyon, 69622, France, Université Lyon1, CNRS, UMR 5007, LAGEP, Pharmacotechnical department, ISPB facuté de Pharmacie
| | | | | | | |
Collapse
|
30
|
Boucher E, Bouguen G, Garin E, Guillygomarch A, Boudjema K, Raoul JL. Adjuvant intraarterial injection of 131I-labeled lipiodol after resection of hepatocellular carcinoma: progress report of a case-control study with a 5-year minimal follow-up. J Nucl Med 2008; 49:362-6. [PMID: 18287267 DOI: 10.2967/jnumed.107.044750] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
UNLABELLED Recurrences after resection of hepatocellular carcinoma are frequent. A single postoperative injection of (131)I-labeled lipiodol in the hepatic artery was shown in 1999 by Lau and colleagues to be an effective adjuvant treatment, and those results were strengthened by our experience with a case-control study, reported in 2003. The goal of this paper is to update the 2003 results for a minimal follow-up of 5 y. METHODS Between January 1999 and September 2001, 38 patients were given an adjuvant postoperative intraarterial injection of (131)I-lipiodol and were matched (for Okuda group and tumor size) with 38 patients who had undergone resection between January 1997 and January 1999 without postoperative treatment. The 2 groups were similar. RESULTS There were 28 recurrences in the control group and 22 in the (131)I-lipiodol group (not statistically significant), and the mean time of recurrence was 21 and 26.5 mo, respectively, after surgery (statistically significant). The number of recurrences was lower in the first 2 y in the (131)I-lipiodol group (statistically significant). Disease-free survival was better (P < 0.03) in the (131)I-lipiodol group than in the control group (2-, 3-, and 5-y rates [+/-95% confidence interval] of 77% +/- 7%, 63% +/- 8%, and 42% +/- 8.5%, respectively, for the (131)I-lipiodol group vs. 47% +/- 8%, 34% +/- 8%, and 27% +/- 8%, respectively, for the control group). Overall survival did not differ between the 2 groups (P = 0.09), even though there was a trend toward better survival in the (131)I-lipiodol group (2-, 3-, and 5-y rates of 76% +/- 7%, 68% +/- 7.5%, and 51% +/- 9%, respectively, vs. 68% +/- 7.5%, 53% +/- 8%, and 39% +/- 8%, respectively, in the control group). CONCLUSION With a longer follow-up, the results of this retrospective case-control study still favor a single postoperative injection of (131)I-lipiodol. These retrospective findings point out the need for a large-scale, prospective, randomized study.
Collapse
Affiliation(s)
- Eveline Boucher
- Département d'Oncologie Médicale, Centre Eugène Marquis, Rennes, France.
| | | | | | | | | | | |
Collapse
|
31
|
Yttrium-86-labelled human serum albumin microspheres: relation of surface structure with in vivo stability. Nucl Med Biol 2008; 35:227-32. [DOI: 10.1016/j.nucmedbio.2007.10.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Revised: 10/12/2007] [Accepted: 10/22/2007] [Indexed: 11/23/2022]
|
32
|
Zielhuis SW, Seppenwoolde JH, Bakker CJG, Jahnz U, Zonnenberg BA, van het Schip AD, Hennink WE, Nijsen JFW. Characterization of holmium loaded alginate microspheres for multimodality imaging and therapeutic applications. J Biomed Mater Res A 2007; 82:892-8. [PMID: 17335019 DOI: 10.1002/jbm.a.31183] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In this paper the preparation and characterization of holmium-loaded alginate microspheres is described. The rapid development of medical imaging techniques offers new opportunities for the visualisation of (drug-loaded) microparticles. Therefore, suitable imaging agents have to be incorporated into these particles. For this reason, the element holmium was used in this study in order to utilize its unique imaging characteristics. The paramagnetic behaviour of this element allows visualisation with MRI and holmium can also be neutron-activated resulting in the emission of gamma-radiation, allowing visualisation with gamma cameras, and beta-radiation, suitable for therapeutic applications. Almost monodisperse alginate microspheres were obtained by JetCutter technology where alginate droplets of a uniform size were hardened in an aqueous holmium chloride solution. Ho(3+) binds via electrostatic interactions to the carboxylate groups of the alginate polymer and as a result alginate microspheres loaded with holmium were obtained. The microspheres had a mean size of 159 microm and a holmium loading of 1.3 +/- 0.1% (w/w) (corresponding with a holmium content based on dry alginate of 18.3 +/- 0.3% (w/w)). The binding capacity of the alginate polymer for Ho(3+) (expressed in molar amounts) is equal to that for Ca(2+), which is commonly used for the hardening of alginate. This indicates that Ho(3+) has the same binding affinity as Ca(2+). In line herewith, dynamic mechanical analyses demonstrated that alginate gels hardened with Ca(2+) or Ho(3+) had similar viscoelastic properties. The MRI relaxation properties of the microspheres were determined by a MRI phantom experiment, demonstrating a strong R(2)* effect of the particles. Alginate microspheres could also be labelled with radioactive holmium by adding holmium-166 to alginate microspheres, previously hardened with calcium (labelling efficiency 96%). The labelled microspheres had a high radiochemical stability (94% after 48 h incubation in human serum), allowing therapeutic applications for treatment of cancer. The potential in vivo application of the microspheres for a MR-guided renal embolization procedure was illustrated by selective administration of microspheres to the left kidney of a pig. Anatomic MR-imaging showed the presence of holmium-loaded microspheres in the kidney. In conclusion, this study demonstrates that the incorporation of holmium into alginate microspheres allows their visualisation with a gamma camera and MRI. Holmium-loaded alginate microspheres can be used therapeutically for embolization and, when radioactive, for local radiotherapy of tumours.
Collapse
Affiliation(s)
- S W Zielhuis
- Department of Nuclear Medicine, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|
33
|
Gunvén P. Liver Embolizations in Oncology. A Review. Part II. Arterial Radioembolizations, Portal Venous Embolizations, Experimental Arterial Embolization Procedures. Med Oncol 2007; 24:287-96. [PMID: 17873303 DOI: 10.1007/s12032-007-0040-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2007] [Revised: 11/30/1999] [Accepted: 05/20/2007] [Indexed: 01/17/2023]
Abstract
Arterial embolization of the liver may temporarily retard the growth of its primary and secondary tumors which are both mainly nourished arterially. Addition of radioisotopes, mostly (131)I or (90)Y, results in radioembolizations which predominantly act by radiation and less by ischemia. They may therefore be utilized in the absence of portal venous flow when conventional embolization is hazardous. (131)I-oily radioembolization seems to prolong short-term survival in such patients with unresectable hepatocellular cancers, and to improve the prognosis after resection of hepatocellular cancer. The procedure does however not palliate better than "cold" chemoembolization in patients with preserved portal flow, except for having milder side effects. Embolization with (90)Y-coupled microspheres may shrink primary and secondary liver tumors but has so far unproven effects on survival. Embolization of portal venous branches gives compensatory hypertrophy of the non-embolized liver and can increase the volume of the future remnant liver before resection. This diminishes the risk for postoperative liver failure after extensive resection and/or in the presence of chronic liver disease, and permits wider surgical indications. Tumor growth may however be accelerated, and the hypertrophy is inhibited by severe liver parenchymal disease in which situation the method would be most needed. Experimental use of liver arterial embolizations includes combined arterial and portal embolizations, i.e. "chemical hepatectomy," arterial embolizations before external radiotherapy, administration of boron for neutron capture therapy, immunoembolizations, and future gene therapy.
Collapse
Affiliation(s)
- Peter Gunvén
- Department of Oncology, Radiumhemmet, Karolinska University Hospital at Solna, Stockholm 171 76, Sweden.
| |
Collapse
|
34
|
Carlson SK, Classic KL, Hadac EM, Bender CE, Kemp BJ, Lowe VJ, Hoskin TL, Russell SJ. In vivo quantitation of intratumoral radioisotope uptake using micro-single photon emission computed tomography/computed tomography. Mol Imaging Biol 2007; 8:324-32. [PMID: 17053863 DOI: 10.1007/s11307-006-0058-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE This study was undertaken to determine the ability of micro-single photon emission computed tomography (micro-SPECT)/computed tomography (CT) to accurately quantitate intratumoral radioisotope uptake in vivo and to compare these measurements with planar imaging and micro-SPECT imaging alone. PROCEDURES Human pancreatic cancer xenografts were established in 10 mice. Intratumoral radioisotope uptake was achieved via intratumoral injection of an attenuated measles virus vector expressing the NIS gene (MV-NIS). On various days after MV-NIS injection, (123)I planar and micro-SPECT/CT imaging was performed. Tumor activity was determined by dose calibrator measurements and region-of-interest (ROI) image analysis. Agreement and reproducibility of tumor activity measurements were assessed by Bland-Altman plots and Lin's concordance correlation coefficient (CCC). RESULTS Intratumoral radioisotope uptake was detected in all mice. Scatterplots demonstrate strong agreement (CCC = 0.93) between micro-SPECT/CT ROI image analysis and dose calibrator tumor activity measurements. The differences between dose calibrator activity measurements and those obtained with ROI image analysis of micro-SPECT alone and planar imaging are less accurate and more variable (CCC = 0.84 and 0.78, respectively). CONCLUSIONS Micro-SPECT/CT can be used to accurately quantify intratumoral radioisotope uptake in vivo and is more reliable than planar or micro-SPECT imaging alone.
Collapse
Affiliation(s)
- Stephanie K Carlson
- Department of Radiology, Mayo Clinic, 200 First Street SW, Rochester, MN 559005, USA.
| | | | | | | | | | | | | | | |
Collapse
|
35
|
Zielhuis SW, Nijsen JFW, Krijger GC, van het Schip AD, Hennink WE. Holmium-loaded poly(L-lactic acid) microspheres: in vitro degradation study. Biomacromolecules 2006; 7:2217-23. [PMID: 16827590 DOI: 10.1021/bm060230r] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The clinical application of holmium-loaded poly(L-lactic acid) (PLLA) microspheres for the radionuclide treatment of liver malignancies requires in depth understanding of the degradation characteristics of the microspheres. To this end, an in-vitro degradation study was conducted. PLLA-microspheres with and without HoAcAc loading, and before and after neutron or gamma irradiation, were incubated in a phosphate buffer at 37 degrees C for 12 months. In contrast with the other microsphere formulations, only the neutron-irradiated Ho-PLLA-MS disintegrated. At the end of the experiment (52 weeks) highly crystalline fragments, as evidenced from Differential Scanning Calorimetry, were present. Infrared spectroscopy showed that these fragments consisted of holmium lactate. In conclusion, this study demonstrates that the degradation of neutron-irradiated Ho-PLLA-MS was substantially accelerated by the HoAcAc incorporation and subsequent neutron irradiation. The degradation of these microspheres in aqueous solution resulted in the formation of insoluble holmium lactate microcrystals without release of Ho3+.
Collapse
Affiliation(s)
- Sander W Zielhuis
- Department of Nuclear Medicine, University Medical Center, Utrecht, The Netherlands
| | | | | | | | | |
Collapse
|