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Microspheres as a Carrier System for Therapeutic Embolization Procedures: Achievements and Advances. J Clin Med 2023; 12:jcm12030918. [PMID: 36769566 PMCID: PMC9917963 DOI: 10.3390/jcm12030918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/17/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023] Open
Abstract
The targeted delivery of anti-cancer drugs and isotopes is one of the most pursued goals in anti-cancer therapy. One of the prime examples of such an application is the intra-arterial injection of microspheres containing cytostatic drugs or radioisotopes during hepatic embolization procedures. Therapy based on the application of microspheres revolves around vascular occlusion, complemented with local therapy in the form of trans-arterial chemoembolization (TACE) or radioembolization (TARE). The broadest implementation of these embolization strategies currently lies within the treatment of untreatable hepatocellular cancer (HCC) and metastatic colorectal cancer. This review aims to describe the state-of-the-art TACE and TARE technologies investigated in the clinical setting for HCC and addresses current trials and new developments. In addition, chemical properties and advancements in microsphere carrier systems are evaluated, and possible improvements in embolization therapy based on the modification of and functionalization with therapeutical loads are explored.
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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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Verger E, Drion P, Meffre G, Bernard C, Duwez L, Lepareur N, Couturier O, Hindré F, Hustinx R, Lacoeuille F. 68Ga and 188Re Starch-Based Microparticles as Theranostic Tool for the Hepatocellular Carcinoma: Radiolabeling and Preliminary In Vivo Rat Studies. PLoS One 2016; 11:e0164626. [PMID: 27741267 PMCID: PMC5065223 DOI: 10.1371/journal.pone.0164626] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Accepted: 09/28/2016] [Indexed: 12/31/2022] Open
Abstract
Purpose This work aims to develop, validate and optimize the radiolabeling of Starch-Based Microparticles (SBMP) by 188Re and 68Ga in the form of ready-to-use radiolabeling kits, the ultimate goal being to obtain a unique theranostic vector for the treatment of Hepatocellular Carcinoma. Methods Optimal labeling conditions and composition of freeze-dried kits were defined by monitoring the radiochemical purity while varying several parameters. In vitro stability studies were carried out, as well as an in vivo biodistribution as a preliminary approach with the intra-arterial injection of 68Ga radiolabeled SBMP into the hepatic artery of DENA-induced rats followed by PET/CT imaging. Results Kits were optimized for 188Re and 68Ga with high and stable radiochemical purity (>95% and >98% respectively). The in vivo preliminary study was successful with more than 95% of activity found in the liver and mostly in the tumorous part. Conclusion SBMP are a promising theranostic agent for the Selective Internal Radiation Therapy of Hepatocellular carcinoma.
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Affiliation(s)
- Elise Verger
- INSERM UMR-S 1066 MINT (Micro- et Nano-médecines Biomimétiques), University of Angers, Angers, France
- Nuclear Medicine department, CHU de Liège, University of Liège, Liège, Belgium
- * E-mail:
| | - Pierre Drion
- Animal Facility, Experimental Surgery, GIGA-R & Credec, University of Liège, Liège, Belgium
| | - Geneviève Meffre
- Nuclear Medicine department, CHU de Liège, University of Liège, Liège, Belgium
| | - Claire Bernard
- Nuclear Medicine department, CHU de Liège, University of Liège, Liège, Belgium
| | - Luc Duwez
- Animal Facility, Experimental Surgery, GIGA-R & Credec, University of Liège, Liège, Belgium
| | - Nicolas Lepareur
- Nuclear Medicine Department, Centre de Lutte Contre le Cancer (CLCC) Eugène Marquis, INSERM U991, Rennes, France
| | - Olivier Couturier
- Nuclear Medicine department, CHU d'Angers, University of Angers, Angers, France
| | - François Hindré
- INSERM UMR-S 1066 MINT (Micro- et Nano-médecines Biomimétiques), University of Angers, Angers, France
- PRIMEX (Plateforme de Radiobiologie et d'IMagerie EXperimentale), University of Angers, Angers, France
| | - Roland Hustinx
- Nuclear Medicine department, CHU de Liège, University of Liège, Liège, Belgium
| | - Franck Lacoeuille
- INSERM UMR-S 1066 MINT (Micro- et Nano-médecines Biomimétiques), University of Angers, Angers, France
- Nuclear Medicine department, CHU d'Angers, University of Angers, Angers, France
- PRIMEX (Plateforme de Radiobiologie et d'IMagerie EXperimentale), University of Angers, Angers, France
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Abstract
Radiopharmaceuticals are widely accepted to be a very safe class of drugs, with very few adverse reactions and unexpected biodistributions. However, problems can arise because of technical issues in manufacture or reconstitution, patient preparation, or drug administration. This review presents highlights of issues that have arisen in the newer classes of radiopharmaceuticals in the last 20 years and expands the scope of the previous report to include PET and therapeutic radiopharmaceuticals. Variations in the "quality" of the eluate of a (99)Mo/(99m)Tc generator remain a major issue. Several of the newer (99m)Tc tracers require a heating step in preparation that can also lead to unacceptably low radiochemical purity. Radiolytic breakdown can be a problem with all classes of radiopharmaceuticals. Many of the newer radiopharmaceuticals localize by receptor- or transporter-mediated processes and thus can be affected by other drugs, making patient preparation more important than ever. Therapeutic radiopharmaceuticals may require coadministration of radioprotectant regimens, such as the use of lysine-arginine infusions with radiopeptide therapy. Extravasation can have serious consequences with therapeutic radiopharmaceuticals. Adverse reactions to newer radiopharmaceuticals remain rare, though may increase because of coadministration of agents such as contrast media. However, there is known to be underreporting of minor adverse reactions. Knowledge of the pitfalls that can occur with radiopharmaceuticals is important in the interpretation of nuclear medicine images and optimal patient care.
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Affiliation(s)
- James R Ballinger
- Department of Nuclear Medicine, Guy's and St Thomas' Hospital, London, UK; Division of Imaging Sciences, King's College London School of Medicine, London, UK.
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Lobov SA, King DW, Knox KJ, Senden TJ, Stephens RW. Cationised radiolabelled nanoparticles for perfusion imaging of the lungs. Biomaterials 2013; 34:1732-8. [DOI: 10.1016/j.biomaterials.2012.11.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 11/15/2012] [Indexed: 12/27/2022]
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Wu SY, Kuo JW, Chang TK, Liu RS, Lee RC, Wang SJ, Lin WJ, Wang HE. Preclinical characterization of 18F-MAA, a novel PET surrogate of 99mTc-MAA. Nucl Med Biol 2012; 39:1026-33. [DOI: 10.1016/j.nucmedbio.2012.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 04/13/2012] [Accepted: 04/23/2012] [Indexed: 10/28/2022]
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Lacoeuille F, Hindré F, Venier-Julienne MC, Sergent M, Bouchet F, Jouaneton S, Denizot B, Askienazy S, Benoit JP, Couturier OF, Le Jeune JJ. A starch-based microparticulate system dedicated to diagnostic and therapeutic nuclear medicine applications. Biomaterials 2011; 32:7999-8009. [PMID: 21788070 DOI: 10.1016/j.biomaterials.2011.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 07/04/2011] [Indexed: 01/18/2023]
Abstract
The aim of this work was to develop a new microparticulate system able to form a complex with radionuclides with a high yield of purity for diagnostic or therapeutic applications. Owing to its properties potato starch was chosen as starting material and modified by oxidization and coupling of a ligand (polyamine) enabling modified starch to chelate radionuclides. The choice of suitable experiments was based on a combination of a Rechtschaffner experimental design and a surface response design to determine the influence of experimental parameters and to optimize the final product. Starch-based microparticle formulations from the experimental plans were compared and characterized through particle size analysis, scanning electron microscopy, elemental analysis and, for the most promising formulations, by in vitro labeling stability studies and determination of free polyamine content or in vivo imaging studies. The mechanism of starch-based microparticle degradation was identified by means of size measurements. The results of the Rechtschaffner design showed the positive qualitative effect of the temperature and the duration of coupling reaction whereas surface response analysis clearly showed that, by increasing the oxidization level and starch concentration, the nitrogen content in the final product is increased. In vitro and in vivo characterization led to identification of the best formulation. With a size around 30 μm, high radiochemical purity (over 95%) and a high signal-to-noise ratio (over 600), the new starch-based microparticulate system could be prepared as ready-to-use kits and sterilized without modification of its characteristics, and thus meet the requirement for in vivo diagnostic and therapeutic applications.
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Affiliation(s)
- F Lacoeuille
- LUNAM Université, Université d'Angers, Inserm U646, Centre Hospitalier Universitaire d'Angers, 4 rue Larrey, F 49100 Angers, France.
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Häfeli UO, Saatchi K, Elischer P, Misri R, Bokharaei M, Labiris NR, Stoeber B. Lung perfusion imaging with monosized biodegradable microspheres. Biomacromolecules 2010; 11:561-7. [PMID: 20143805 DOI: 10.1021/bm9010722] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
After intravenous injection, particles larger than red blood cells will be trapped in the first capillary bed that they encounter. This is the principle of lung perfusion imaging in nuclear medicine, where macroaggregated albumin (MAA) is radiolabeled with (99m)Tc, infused into a patient's arm vein, and then imaged with gamma scintigraphy. Our aim was to evaluate if monosized microspheres could replace (99m)Tc-MAA. Biodegradable poly(L-lactide) microspheres containing chelating bis(picolylamine) end groups were prepared by a flow focusing method on a microfluidic glass chip and were of highly homogeneous size (9.0 +/- 0.4 microm). The microspheres were radiolabeled with [(99m)Tc(H(2)O)(3)(CO)(3)](+) and then evaluated in mice for lung perfusion imaging. Fifteen minutes after injection, 79.6 +/- 3.8% of the injected activity was trapped in the lungs of mice. Monosized biodegradable radioactive microspheres are, thus, appropriate lung perfusion imaging agents. Other sizes of these highly uniform microspheres have the potential to improve diagnostic and therapeutic approaches in diverse areas of medicine.
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Affiliation(s)
- Urs O Häfeli
- Faculty of Pharmaceutical Sciences and Department of Mechanical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada.
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