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Moraitis A, Jentzen W, Reiter G, Schmitz J, Pöppel TD, Weber M, Herrmann K, Fendler WP, Fragoso Costa P, Bockisch A, Kersting D. Biodistribution and radiation dosimetry of 124I-mIBG in adult patients with neural crest tumours and extrapolation to paediatric models. EJNMMI Phys 2024; 11:3. [PMID: 38167953 PMCID: PMC10761661 DOI: 10.1186/s40658-023-00604-0] [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: 07/25/2023] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
AIM Positron emission tomography (PET) using 124I-mIBG has been established for imaging and pretherapeutic dosimetry. Here, we report the first systematic analysis of the biodistribution and radiation dosimetry of 124I-mIBG in patients with neural crest tumours and project the results to paediatric patient models. METHODS Adult patients with neural crest tumours who underwent sequential 124I-mIBG PET were included in this retrospective single-center analysis. PET data were acquired 4, 24, 48, and/or 120 h after administration of a mean of 43 MBq 124I-mIBG. Whole-body counting and blood sampling were performed at 2, 4, 24, 48 and 120 h after administration. Absorbed organ dose and effective dose coefficients were estimated in OLINDA/EXM 2.2 according to the MIRD formalism. Extrapolation to paediatric models was performed based on mass-fraction scaling of the organ-specific residence times. Biodistribution data for adults were also projected to 123I-mIBG and 131I-mIBG. RESULTS Twenty-one patients (11 females, 10 males) were evaluated. For adults, the organs exposed to the highest dose per unit administered activity were urinary bladder (1.54 ± 0.40 mGy/MBq), salivary glands (0.77 ± 0.28 mGy/MBq) and liver (0.65 ± 0.22 mGy/MBq). Mean effective dose coefficient for adults was 0.25 ± 0.04 mSv/MBq (male: 0.24 ± 0.03 mSv/MBq, female: 0.26 ± 0.06 mSv/MBq), and increased gradually to 0.29, 0.44, 0.69, 1.21, and 2.94 mSv/MBq for the 15-, 10-, 5-, 1-years-old, and newborn paediatric reference patients. Projected mean effective dose coefficients for 123I-mIBG and 131I-mIBG for adults were 0.014 ± 0.002 mSv/MBq and 0.18 ± 0.04 mSv/MBq, respectively. CONCLUSION PET-based derived radiation dosimetry data for 124I-mIBG from this study agreed well with historical projected data from ICRP 53. The effective dose coefficients presented here may aid in guidance for establishing weight-based activity administration protocols.
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Affiliation(s)
- Alexandros Moraitis
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany.
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany.
| | - Walter Jentzen
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Gloria Reiter
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Jochen Schmitz
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Thorsten Dirk Pöppel
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Manuel Weber
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Wolfgang Peter Fendler
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Pedro Fragoso Costa
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - Andreas Bockisch
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
| | - David Kersting
- Department of Nuclear Medicine, West German Cancer Center (WTZ), University Hospital Essen, University of Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
- German Cancer Consortium (DKTK), Partner Site University Hospital Essen, Essen, Germany
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2
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Nanotheranostics for Image-Guided Cancer Treatment. Pharmaceutics 2022; 14:pharmaceutics14050917. [PMID: 35631503 PMCID: PMC9144228 DOI: 10.3390/pharmaceutics14050917] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 04/18/2022] [Accepted: 04/20/2022] [Indexed: 12/13/2022] Open
Abstract
Image-guided nanotheranostics have the potential to represent a new paradigm in the treatment of cancer. Recent developments in modern imaging and nanoparticle design offer an answer to many of the issues associated with conventional chemotherapy, including their indiscriminate side effects and susceptibility to drug resistance. Imaging is one of the tools best poised to enable tailoring of cancer therapies. The field of image-guided nanotheranostics has the potential to harness the precision of modern imaging techniques and use this to direct, dictate, and follow site-specific drug delivery, all of which can be used to further tailor cancer therapies on both the individual and population level. The use of image-guided drug delivery has exploded in preclinical and clinical trials although the clinical translation is incipient. This review will focus on traditional mechanisms of targeted drug delivery in cancer, including the use of molecular targeting, as well as the foundations of designing nanotheranostics, with a focus on current clinical applications of nanotheranostics in cancer. A variety of specially engineered and targeted drug carriers, along with strategies of labeling nanoparticles to endow detectability in different imaging modalities will be reviewed. It will also introduce newer concepts of image-guided drug delivery, which may circumvent many of the issues seen with other techniques. Finally, we will review the current barriers to clinical translation of image-guided nanotheranostics and how these may be overcome.
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Naskar N, Lahiri S. Separation of 71,72As from alpha particle induced gallium oxide target by solid cation and anion exchangers, DOWEX-50 and DOWEX-1. Appl Radiat Isot 2021; 176:109876. [PMID: 34330034 DOI: 10.1016/j.apradiso.2021.109876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/28/2021] [Accepted: 07/20/2021] [Indexed: 11/26/2022]
Abstract
46.0 MeV alpha particle induced reaction on gallium oxide target results production of no-carrier-added (NCA) 71,72As and 67Ga tracer. 71,72As were separated from the target matrix by solid liquid extraction (SLX) using two different exchangers, Dowex-1 and Dowex-50. At best condition of 0.2 g Dowex-1 + 6 M HCl and 0.2 g Dowex-50 + 10-3 M HCl bulk gallium was completely extracted leaving behind NCA 71,72As in the aqueous phase. Dowex-50 was found to be more suitable and offered high separation factor, 3.2 × 105.
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Affiliation(s)
- Nabanita Naskar
- Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata, 700064, India
| | - Susanta Lahiri
- Saha Institute of Nuclear Physics, 1/AF Bidhannagar, Kolkata, 700064, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai, 400094, India.
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Production of a broad palette of positron emitting radioisotopes using a low-energy cyclotron: Towards a new success story in cancer imaging? Appl Radiat Isot 2021; 176:109860. [PMID: 34284216 DOI: 10.1016/j.apradiso.2021.109860] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 06/28/2021] [Accepted: 07/09/2021] [Indexed: 12/20/2022]
Abstract
Over the last several years, positron emission tomography (PET) has matured as an indispensable component of cancer diagnostics. Owing to the large variability observed among the cancer patients and the need to personalize individual patient's diagnosis and treatment, the need for new positron emitting radioisotopes has continued to grow. This mini review opens with a brief introduction to the criteria for radioisotope selection for PET imaging. Subsequently, positron emitting radioisotopes are categorized as: established, emerging and futuristic, based on the stages of their advancement. The production methodologies and the radiochemical separation procedures for obtaining the important radioisotopes in a form suitable for preparation of radiopharmaceuticals for PET imaging are briefly discussed.
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Naskar N, Lahiri S. Theranostic Terbium Radioisotopes: Challenges in Production for Clinical Application. Front Med (Lausanne) 2021; 8:675014. [PMID: 34136508 PMCID: PMC8200528 DOI: 10.3389/fmed.2021.675014] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/06/2021] [Indexed: 12/19/2022] Open
Abstract
Currently, research on terbium has gained a momentum owing to its four short-lived radioisotopes, 149Tb, 152Tb, 155Tb, and 161Tb, all of which can be considered in one or another field of nuclear medicine. The members of this emerging quadruplet family have appealing nuclear characteristics and have the potential to do justice to the proposed theory of theranostics nuclear medicine, which amalgamates therapeutic and diagnostic radioisotopes together. The main challenge for in vivo use of these radioisotopes is to produce them in sufficient quantity. This review discusses that, at present, neither light charged particle nor the heavy ion (HI) activation are suitable for large-scale production of neutron deficient terbium nuclides. Three technological factors like (i) enrichment of stable isotopes to a considerable level, (ii) non-availability of higher energies in commercial cyclotrons, and (iii) non-availability of the isotope separation technique coupled with commercial accelerators limit the large scale production of terbium radionuclides by light charged particle activation. If in future, the technology can overcome these hurdles, then the light charged particle activation of enriched targets would produce a high amount of useful terbium radionuclides. On the other hand, to date, the spallation reaction coupled with an online isotope separator has been found suitable for such a requirement, which has been adopted by the CERN MEDICIS programme. The therapeutic 161Tb radionuclide can be produced in a reactor by neutron bombardment on enriched 160Gd target to produce 161Gd which subsequently decays to 161Tb. The radiochemical separation is mandatory even if the ISOL technique is used to obtain high radioisotopic purity of the desired radioisotope.
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Affiliation(s)
- Nabanita Naskar
- Chemical Sciences Duvision, Saha Institute of Nuclear Physics, Kolkata, India
| | - Susanta Lahiri
- Chemical Sciences Duvision, Saha Institute of Nuclear Physics, Kolkata, India
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Abstract
The major applications for molecular imaging with PET in clinical practice concern cancer imaging. Undoubtedly, 18F-FDG represents the backbone of nuclear oncology as it remains so far the most widely employed positron emitter compound. The acquired knowledge on cancer features, however, allowed the recognition in the last decades of multiple metabolic or pathogenic pathways within the cancer cells, which stimulated the development of novel radiopharmaceuticals. An endless list of PET tracers, substantially covering all hallmarks of cancer, has entered clinical routine or is being investigated in diagnostic trials. Some of them guard significant clinical applications, whereas others mostly bear a huge potential. This chapter summarizes a selected list of non-FDG PET tracers, described based on their introduction into and impact on clinical practice.
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Abstract
Neuroblastoma is one of the most common pediatric malignant tumors. Functional imaging plays an important role in the diagnosis, staging, and therapy response monitoring of neuroblastoma. Although metaiodobenzylguanidine scan with single-photon emission computed tomography/computed tomography remains the mainstay in functional imaging of the neuroblastomas, PET/CT has begun to show increased utility in this clinical setting.
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Sitarz M, Cussonneau JP, Matulewicz T, Haddad F. Radionuclide candidates for β+γ coincidence PET: An overview. Appl Radiat Isot 2020; 155:108898. [DOI: 10.1016/j.apradiso.2019.108898] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Revised: 09/11/2019] [Accepted: 09/19/2019] [Indexed: 12/20/2022]
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9
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Wong YH, Tan HY, Kasbollah A, Abdullah BJJ, Yeong CH. Preparation and In Vitro Evaluation of Neutron-Activated, Theranostic Samarium-153-Labeled Microspheres for Transarterial Radioembolization of Hepatocellular Carcinoma and Liver Metastasis. Pharmaceutics 2019; 11:pharmaceutics11110596. [PMID: 31718079 PMCID: PMC6920762 DOI: 10.3390/pharmaceutics11110596] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/03/2019] [Accepted: 10/08/2019] [Indexed: 01/02/2023] Open
Abstract
Introduction: Transarterial radioembolization (TARE) has been proven as an effective treatment for unresectable liver tumor. In this study, neutron activated, 153Sm-labeled microspheres were developed as an alternative to 90Y-labeled microspheres for hepatic radioembolization. 153Sm has a theranostic advantage as it emits both therapeutic beta and diagnostic gamma radiations simultaneously, in comparison to the pure beta emitter, 90Y. Methods: Negatively charged acrylic microspheres were labeled with 152Sm ions through electrostatic interactions. In another formulation, the Sm-labeled microsphere was treated with sodium carbonate solution to form the insoluble 152Sm carbonate (152SmC) salt within the porous structures of the microspheres. Both formulations were neutron-activated in a research reactor. Physicochemical characterization, gamma spectrometry, and radiolabel stability tests were carried out to study the performance and stability of the microspheres. Results: The Sm- and SmC-labeled microspheres remained spherical and smooth, with a mean size of 35 µm before and after neutron activation. Fourier transform infrared (FTIR) spectroscopy indicated that the functional groups of the microspheres remained unaffected after neutron activation. The 153Sm- and 153SmC-labeled microspheres achieved activity of 2.53 ± 0.08 and 2.40 ± 0.13 GBq·g−1, respectively, immediate after 6 h neutron activation in the neutron flux of 2.0 × 1012 n·cm−2·s−1. Energy-dispersive X-ray (EDX) and gamma spectrometry showed that no elemental and radioactive impurities were present in the microspheres after neutron activation. The retention efficiency of 153Sm in the 153SmC-labeled microspheres was excellent (~99% in distilled water and saline; ~97% in human blood plasma), which was higher than the 153Sm-labeled microspheres (~95% and ~85%, respectively). Conclusion: 153SmC-labeled microspheres have demonstrated excellent properties for potential application as theranostic agents for hepatic radioembolization.
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Affiliation(s)
- Yin How Wong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia; (Y.H.W.); (H.Y.T.); (B.J.J.A.)
| | - Hun Yee Tan
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia; (Y.H.W.); (H.Y.T.); (B.J.J.A.)
- 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; (Y.H.W.); (H.Y.T.); (B.J.J.A.)
| | - Chai Hong Yeong
- School of Medicine, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya 47500, Selangor, Malaysia; (Y.H.W.); (H.Y.T.); (B.J.J.A.)
- Correspondence: ; Tel.: +603-5629-5495
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10
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Ehlerding EB, Ferreira CA, Aluicio-Sarduy E, Jiang D, Lee HJ, Theuer CP, Engle JW, Cai W. 86/90Y-Based Theranostics Targeting Angiogenesis in a Murine Breast Cancer Model. Mol Pharm 2018; 15:2606-2613. [PMID: 29787283 PMCID: PMC6028311 DOI: 10.1021/acs.molpharmaceut.8b00133] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Angiogenesis is widely recognized as one of the hallmarks of cancer. Therefore, imaging and therapeutic agents targeted to angiogenic vessels may be widely applicable in many types of cancer. To this end, the theranostic isotope pair, 86Y and 90Y, were used to create a pair of agents for targeted imaging and therapy of neovasculature in murine breast cancer models using a chimeric anti-CD105 antibody, TRC105. Serial positron emission tomography imaging with 86Y-DTPA-TRC105 demonstrated high uptake in 4T1 tumors, peaking at 9.6 ± 0.3%ID/g, verified through ex vivo studies. Additionally, promising results were obtained in therapeutic studies with 90Y-DTPA-TRC105, wherein significantly ( p < 0.05) decreased tumor volumes were observed for the targeted treatment group over all control groups near the end of the study. Dosimetric extrapolation and tissue histological analysis corroborated trends found in vivo. Overall, this study demonstrated the potential of the pair 86/90Y for theranostics, enabling personalized treatments for cancer.
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MESH Headings
- Animals
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/pharmacology
- Antibodies, Monoclonal/therapeutic use
- Antineoplastic Agents/chemistry
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Cell Line, Tumor/transplantation
- Drug Screening Assays, Antitumor
- Female
- Humans
- Immunoconjugates/chemistry
- Immunoconjugates/pharmacology
- Immunoconjugates/therapeutic use
- Mammary Neoplasms, Experimental/diagnostic imaging
- Mammary Neoplasms, Experimental/pathology
- Mammary Neoplasms, Experimental/radiotherapy
- Mice
- Mice, Inbred BALB C
- Neovascularization, Pathologic/diagnostic imaging
- Neovascularization, Pathologic/drug therapy
- Positron-Emission Tomography/methods
- Radioimmunotherapy/methods
- Theranostic Nanomedicine/methods
- Tissue Distribution
- Treatment Outcome
- Yttrium Radioisotopes/chemistry
- Yttrium Radioisotopes/pharmacology
- Yttrium Radioisotopes/therapeutic use
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Affiliation(s)
| | - Carolina A Ferreira
- Department of Biomedical Engineering , Univesity of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
| | | | | | | | - Charles P Theuer
- TRACON Pharmaceuticals, Inc. , San Diego , California 92122 , United States
| | | | - Weibo Cai
- Department of Biomedical Engineering , Univesity of Wisconsin-Madison , Madison , Wisconsin 53706 , United States
- Carbone Comprehensive Cancer Center , University of Wisconsin-Madison , Madison , Wisconsin 53792 , United States
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Ballinger JR. Theranostic radiopharmaceuticals: established agents in current use. Br J Radiol 2018; 91:20170969. [PMID: 29474096 DOI: 10.1259/bjr.20170969] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Although use of the term "theranostic" is relatively recent, the concept goes back to the earliest days of nuclear medicine, with the use of radioiodine for diagnosis and therapy of benign and malignant thyroid disease being arguably the most successful molecular radiotherapy in history. A diagnostic scan with 123I-, 124I-, or a low activity of 131I-iodide is followed by therapy with high activity 131I-iodide. Similarly, adrenergic tumours such as phaeochromocytoma and neuroblastoma can be imaged with 123I-metaiodobenzylguanidine and treated with 131I-metaiodobenzylguanidine. Bone scintigraphy can be used to select patients with painful bone metastases from prostate cancer who may benefit from treatment with beta- or alpha-particle emitting bone seeking agents, the most recent and successful of which is 223Ra radium chloride. Anti-CD20 monoclonal antibodies can be used to image and treat non-Hodgkins lymphoma, though this has not been as commercially successful as initially predicted. More recently established theranostics include somatostatin receptor targeting peptides for diagnosis and treatment of neuroendocrine tumours with agents such as 68Ga-DOTATATE and 177Lu-DOTATATE, respectively. Finally, agents which target prostate-specific membrane antigen are becoming increasingly widely available, despite the current lack of a commercial product. With the recent licensing of the somatostatin peptides and the rapid adoption of 68Ga- and 177Lu-labelled prostate-specific membrane antigen targeting agents, we have built upon the experience of radioiodine and are already seeing a great expansion in the availability of widely accepted theranostic radiopharmaceuticals.
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Affiliation(s)
- James R Ballinger
- 1 Department of Imaging Chemistry and Biology, School of Biomedical Engineering and Imaging Sciences, King's College London , London , UK
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12
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Notni J, Wester HJ. Re-thinking the role of radiometal isotopes: Towards a future concept for theranostic radiopharmaceuticals. J Labelled Comp Radiopharm 2017; 61:141-153. [PMID: 29143368 DOI: 10.1002/jlcr.3582] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 10/26/2017] [Accepted: 10/26/2017] [Indexed: 12/22/2022]
Abstract
The potential and future role of certain metal radionuclides, for example, 44 Sc, 89 Zr, 86 Y, 64 Cu, 68 Ga, 177 Lu, 225 Ac, and 213 Bi, and several terbium isotopes has been controversially discussed in the past decades. Furthermore, the possible benefits of "matched pairs" of isotopes for tandem applications of diagnostics and therapeutics (theranostics) have been emphasized, while such approaches still have not made their way into routine clinical practice. Analysis of bibliographical data illustrates how popularity of certain nuclides has been promoted by cycles of availability and applications. We furthermore discuss the different practical requirements for diagnostic and therapeutic radiopharmaceuticals and the resulting consequences for efficient development of clinically useful pairs of radionuclide theranostics, with particular emphasis on the underlying economical factors. Based on an exemplary assessment of overall production costs for 68 Ga and 18 F radiopharmaceuticals, we venture a look into the future of theranostics and predict that high-throughput PET applications, that is, diagnosis of frequent conditions, will ultimately rely on 18 F tracers. PET radiometals will occupy a niche in the clinical low-throughput sector (diagnosis of rare diseases), but above all, dominate preclinical research and clinical translation. Matched isotope pairs will be of lesser relevance for theranostics but may become important for future PET-based therapeutic dosimetry.
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Affiliation(s)
- Johannes Notni
- Pharmaceutical Radiochemistry, Technische Universität München, Garching, Germany
| | - Hans-Jürgen Wester
- Pharmaceutical Radiochemistry, Technische Universität München, Garching, Germany
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Beijst C, Kunnen B, Lam MGEH, de Jong HWAM. Technical Advances in Image Guidance of Radionuclide Therapy. J Nucl Med Technol 2017; 45:272-279. [PMID: 29042472 DOI: 10.2967/jnmt.117.190991] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 07/05/2017] [Indexed: 11/16/2022] Open
Abstract
Internal radiation therapy with radionuclides (i.e., radionuclide therapy) owes its success to the many advantages over other, more conventional, treatment options. One distinct advantage of radionuclide therapies is the potential to use (part of) the emitted radiation for imaging of the radionuclide distribution. The combination of diagnostic and therapeutic properties in a set of matched radiopharmaceuticals (sometimes combined in a single radiopharmaceutical) is often referred to as theranostics and allows accurate diagnostic imaging before therapy. The use of imaging benefits treatment planning, dosimetry, and assessment of treatment response. This paper focuses on a selection of advances in imaging technology relevant for image guidance of radionuclide therapy. This involves developments in nuclear imaging modalities, as well as other anatomic and functional imaging modalities. The quality and quantitative accuracy of images used for guidance of radionuclide therapy is continuously being improved, which in turn may improve the therapeutic outcome and efficiency of radionuclide therapies.
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Affiliation(s)
- Casper Beijst
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands; and .,Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Britt Kunnen
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands; and.,Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands; and
| | - Hugo W A M de Jong
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands; and
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14
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Abstract
Nuclear medicine has an important role in the management of many cancers in pediatric age group with multiple imaging modalities and radiopharmaceuticals targeting various biological uptake mechanisms. 18-Flourodeoxyglucose is the radiotracer of choice especially in patients with sarcoma and lymphoma. (18)FDG-PET, for sarcoma and lymphomas, is proved to be superior to conventional imaging in staging and therapy response. Although studies are limited in pediatric population, (18)FDG-PET/CT has found its way through international guidelines. Limitations and strengths of PET imaging must be noticed before adapting PET imaging in clinical protocols. Established new response criteria using multiple parameters derived from (18)FDG-PET would increase the accuracy and repeatability of response evaluation. Current data suggest that I-123 metaiodobenzylguanidine (MIBG) remains the tracer of choice in the evaluation of neuroblastoma (NB) because of its high sensitivity, specificity, diagnostic accuracy, and prognostic value. It is valuable in determining the response to therapy, surveillance for disease recurrence, and in selecting patients for I-131 therapy. SPECT/CT improves the diagnostic accuracy and the interpretation confidence of MIBG scans. (18)FDG-PET/CT is an important complementary to MIBG imaging despite its lack of specificity to NB. It is valuable in cases of negative or inconclusive MIBG scans and when MIBG findings underestimate the disease status as determined from clinical and radiological findings. F-18 DOPA is promising tracer that reflects catecholamine metabolism and is both sensitive and specific. F-18 DOPA scintigraphy provides the advantages of PET/CT imaging with early and short imaging times, high spatial resolution, inherent morphologic correlation with CT, and quantitation. Regulatory and production issues currently limit the tracer's availability. PET/CT with Ga-68 DOTA appears to be useful in NB imaging and may have a unique role in selecting patients for peptide receptor radionuclide therapy with somatostatin analogues. C-11 hydroxyephedrine PET/CT is a specific PET tracer for NB, but the C-11 label that requires an on-site cyclotron production and the high physiologic uptake in the liver and kidneys limit its use. I-124 MIBG is useful for I-131 MIBG pretherapeutic dosimetry planning. Its use for diagnostic imaging as well as the use of F-18 labeled MIBG analogues is currently experimental. PET/MR imaging is emerging and is likely to become an important tool in the evaluation. It provides metabolic and superior morphological data in one imaging session, expediting the diagnosis and lowering the radiation exposure. Radioactive iodines not only detect residual tissue and metastatic disease but also are used in the treatment of differentiated thyroid cancer. However, these are not well documented in pediatric age group like adult patients. Use of radioactivity in pediatric population is very important and strictly controlled because of the possibility of secondary malignities; therefore, management of oncological cases requires detailed literature knowledge. This article aims to review the literature on the use of radionuclide imaging and therapy in pediatric population with thyroid cancer, sarcomas, lymphoma, and NB.
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Affiliation(s)
- Pınar Özgen Kiratli
- Department of Nuclear Medicine, Hacettepe University Medical Center, Ankara, Turkey.
| | - Murat Tuncel
- Department of Nuclear Medicine, Hacettepe University Medical Center, Ankara, Turkey
| | - Zvi Bar-Sever
- Department of Nuclear Medicine, Schneider Children's Medical Center, Petah Tikva, Israel
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Beijst C, de Keizer B, Lam MGEH, Janssens GO, Tytgat GAM, de Jong HWAM. A phantom study: Should 124 I-mIBG PET/CT replace 123 I-mIBG SPECT/CT? Med Phys 2017; 44:1624-1631. [PMID: 28273347 DOI: 10.1002/mp.12202] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 02/24/2017] [Accepted: 02/28/2017] [Indexed: 11/11/2022] Open
Abstract
PURPOSE The isotope 123 I is commonly labeled with meta-iodobenzylguanidine (mIBG) for imaging of neuroendocrine tumors, such as pheochromocytomas and neuroblastomas. 123 I-mIBG SPECT/CT imaging is performed for staging, follow-up and selection of patients for treatment with 131 I mIBG. As an alternative to 123 I, 124 I-mIBG PET/CT may be used, potentially taking advantage of the superior PET image quality. The purpose of this study was to investigate whether 124 I PET/CT improves image quality as compared with 123 I SPECT/CT for equal patient effective radiation dose (in mSv). METHODS Phantom measurements were performed using the NEMA-2007 image quality phantom. SPECT and PET reconstruction settings were used with and without time-of-flight (TOF) and point-spread-function (PSF) modeling. As a measure of image quality, the contrast-to-noise ratio (CNR) was calculated. The ratio of the 123 I to 124 I activity concentration was determined at which the contrast-to-noise ratio was equal for both modalities. This metric was defined as the contrast equivalent activity ratio (CEAR). RESULTS CEARs of 47.7, 25.6, 23.1, 14.6, 10.0, and 9.1 were obtained for a TOF and PSF modeled 124 I reconstruction method and an attenuation and scatter-corrected 123 I reconstruction method for sphere sizes of 10 to 37 mm, respectively. As the effective radiation dose of 124 I-mIBG is higher than of 123 I-mIBG (in mSv/MBq), an equal effective dose corresponds to a CEAR of 5 to 10. Therefore, CEARs higher than 5 to 10 indicate that 124 I PET/CT outperforms 123 I SPECT/CT in the sense of image quality for equal patient effective radiation dose. CONCLUSION The CEAR is much larger than a factor of 5 to 10 (needed for equal patient effective radiation dose) for most of the reconstruction methods and sphere sizes. Therefore, 124 I-mIBG PET/CT is expected to improve image quality and/or may be used to reduce effective patient dose as compared with 123 I-mIBG SPECT/CT.
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Affiliation(s)
- Casper Beijst
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands.,Image Sciences Institute, UMC Utrecht, Utrecht, The Netherlands
| | - Bart de Keizer
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Marnix G E H Lam
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
| | - Geert O Janssens
- Department of Radiation Oncology, UMC Utrecht, Utrecht, The Netherlands
| | | | - Hugo W A M de Jong
- Department of Radiology and Nuclear Medicine, UMC Utrecht, Utrecht, The Netherlands
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Kendi AT, Moncayo VM, Nye JA, Galt JR, Halkar R, Schuster DM. Radionuclide Therapies in Molecular Imaging and Precision Medicine. PET Clin 2017; 12:93-103. [DOI: 10.1016/j.cpet.2016.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Abstract
Neuroblastoma is an embryonic tumor of the peripheral sympathetic nervous system, and is metastatic or otherwise high risk for relapse in nearly 50% of cases, with a long-term survival of <40%. Therefore, exact staging with radiological and nuclear medicine imaging methods is crucial for finding the adequate therapeutic choice. The tumor cells express the norepinephrine transporter, which makes metaiodobenzylguanidine (MIBG), an analogue of norepinephrine, an ideal tumor-specific agent for imaging. On the contrary, MIBG imaging has several disadvantages such as limited spatial resolution, limited sensitivity in small lesions, need for two or even more acquisition sessions, and a delay between the start of the examination and result. Most of these limitations can be overcome with positron emission tomography (PET) using different radiotracers. Furthermore, for operative or biopsy planning, a combination with morphological imaging methods is indispensable. This article would discuss the therapeutic strategy for primary and follow-up diagnosis in neuroblastoma using MIBG scintigraphy and different new PET tracers as well as multimodality imaging.
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Affiliation(s)
- Thomas Pfluger
- Department of Nuclear Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany.
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Dietrich A, Koi L, Zöphel K, Sihver W, Kotzerke J, Baumann M, Krause M. Improving external beam radiotherapy by combination with internal irradiation. Br J Radiol 2015; 88:20150042. [PMID: 25782328 DOI: 10.1259/bjr.20150042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The efficacy of external beam radiotherapy (EBRT) is dose dependent, but the dose that can be applied to solid tumour lesions is limited by the sensitivity of the surrounding tissue. The combination of EBRT with systemically applied radioimmunotherapy (RIT) is a promising approach to increase efficacy of radiotherapy. Toxicities of both treatment modalities of this combination of internal and external radiotherapy (CIERT) are not additive, as different organs at risk are in target. However, advantages of both single treatments are combined, for example, precise high dose delivery to the bulk tumour via standard EBRT, which can be increased by addition of RIT, and potential targeting of micrometastases by RIT. Eventually, theragnostic radionuclide pairs can be used to predict uptake of the radiotherapeutic drug prior to and during therapy and find individual patients who may benefit from this treatment. This review aims to highlight the outcome of pre-clinical studies on CIERT and resultant questions for translation into the clinic. Few clinical data are available until now and reasons as well as challenges for clinical implementation are discussed.
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Affiliation(s)
- A Dietrich
- 1 German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.,2 OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - L Koi
- 2 OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,3 Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - K Zöphel
- 1 German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.,2 OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,4 Clinic and Policlinic for Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - W Sihver
- 5 Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Dresden, Germany
| | - J Kotzerke
- 1 German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.,2 OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,4 Clinic and Policlinic for Nuclear Medicine, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Baumann
- 1 German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.,2 OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,3 Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,6 Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiooncology, Dresden, Germany
| | - M Krause
- 1 German Cancer Consortium (DKTK) Dresden and German Cancer Research Center (DKFZ), Heidelberg, Germany.,2 OncoRay-National Center for Radiation Research in Oncology, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,3 Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,6 Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiooncology, Dresden, Germany
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Müller C, Bunka M, Haller S, Köster U, Groehn V, Bernhardt P, van der Meulen N, Türler A, Schibli R. Promising Prospects for 44Sc-/47Sc-Based Theragnostics: Application of 47Sc for Radionuclide Tumor Therapy in Mice. J Nucl Med 2014; 55:1658-64. [DOI: 10.2967/jnumed.114.141614] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Braghirolli AMS, Waissmann W, da Silva JB, dos Santos GR. Production of iodine-124 and its applications in nuclear medicine. Appl Radiat Isot 2014; 90:138-48. [PMID: 24747530 DOI: 10.1016/j.apradiso.2014.03.026] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 03/07/2014] [Accepted: 03/24/2014] [Indexed: 12/16/2022]
Abstract
Until recently, iodine-124 was not considered to be an attractive isotope for medical applications owing to its complex radioactive decay scheme, which includes several high-energy gamma rays. However, its unique chemical properties, and convenient half-life of 4.2 days indicated it would be only a matter of time for its frequent application to become a reality. The development of new medical imaging techniques, especially improvements in the technology of positron emission tomography (PET), such as the development of new detectors and signal processing electronics, has opened up new prospects for its application. With the increasing use of PET in medical oncology, pharmacokinetics, and drug metabolism, (124)I-labeled radiopharmaceuticals are now becoming one of the most useful tools for PET imaging, and owing to the convenient half-life of I-124, they can be used in PET scanners far away from the radionuclide production site. Thus far, the limited availability of this radionuclide has been an impediment to its wider application in clinical use. For example, sodium [(124)I]-iodide is potentially useful for diagnosis and dosimetry in thyroid disease and [(124)I]-M-iodobenzylguanidine ([(124)I]-MIBG) has enormous potential for use in cardiovascular imaging, diagnosis, and dosimetry of malignant diseases such as neuroblastoma, paraganglioma, pheochromocytoma, and carcinoids. However, despite that potential, both are still not widely used. This is a typical scenario of a rising new star among the new PET tracers.
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Affiliation(s)
- Ana Maria S Braghirolli
- Instituto de Engenharia Nuclear, IEN-CNEN, Divisão de Radiofármacos, Rua Hélio de Almeida 75, Cidade Universitária, Ilha do Fundão, 21941-906 Rio de Janeiro, Brazil.
| | - William Waissmann
- Fundação Oswaldo Cruz, Escola Nacional de Sáúde Pública Sérgio Arouca, Centro de Estudos da Saúde do Trabalhador e Ecologia Humana, Rua Leopoldo Bulhões 1480, Manguinhos, RJ, Rio de Janeiro 21041-210, Brazil.
| | - Juliana Batista da Silva
- Centro de Desenvolvimento da Tecnologia Nuclear, CDTN-CNEN, Av. Antônio Carlos, 6627 Campus UFMG, Pampulha, BH/MG CEP: 30161-970, Brazil.
| | - Gonçalo R dos Santos
- Instituto de Engenharia Nuclear, IEN-CNEN, Divisão de Radiofármacos, Rua Hélio de Almeida 75, Cidade Universitária, Ilha do Fundão, 21941-906 Rio de Janeiro, Brazil.
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21
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Radiosynthesis of [124I]Iodometomidate and Biological Evaluation Using Small-Animal PET. Mol Imaging Biol 2013; 16:317-21. [DOI: 10.1007/s11307-013-0696-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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22
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Abstract
Personalized dosimetry in radionuclide therapy has gained much attention in recent years. This attention has also an impact on peptide receptor radionuclide therapy (PRRT). This article reviews the PET-based imaging techniques that can be used for pretherapeutic prediction of doses in PRRT. More specifically the usage of (86)Y, (90)Y, (68)Ga, and (44)Sc are discussed: their characteristics for PET acquisition, the available peptides for labeling, the specifics of the imaging protocols, and the experiences gained from phantom and clinical studies. These techniques are evaluated with regard to their usefulness for dosimetry predictions in PRRT, and future perspectives are discussed.
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23
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Rufini V, Treglia G, Perotti G, Giordano A. The evolution in the use of MIBG scintigraphy in pheochromocytomas and paragangliomas. Hormones (Athens) 2013; 12:58-68. [PMID: 23624132 DOI: 10.1007/bf03401287] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Radioiodinated metaiodobenzylguanidine (MIBG) was developed in the late 1970's, at the Michigan University Medical Center, for imaging of the adrenal medulla and its diseases. Soon after, MIBG was shown to depict a wide range of tumors of neural crest origin other than pheochromocytomas/paragangliomas (Pheo/PGL) with the result that its use rapidly spread to many countries. After more than 30 years of clinical application, MIBG continues to be the most widespread radiopharmaceutical for the functional imaging of Pheo/PGL in spite of the emergent role of PET agents for detection of these tumors. In this paper we review the evolution in the use of MIBG over more than 30 years of experimental and clinical applications, with particular focus on the uptake mechanisms, pharmacokinetics, biodistribution and drug interaction as well as on clinical studies in Pheo/PGL also in comparison to other gamma-emitters tracers and PET radiopharmaceuticals.
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Affiliation(s)
- Vittoria Rufini
- Institute of Nuclear Medicine, Università Cattolica del Sacro Cuore, Rome, Italy.
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El-Zaria ME, Janzen N, Blacker M, Valliant JF. Synthesis, Characterisation, and Biodistribution of Radioiodinated C-Hydroxy-Carboranes. Chemistry 2012; 18:11071-8. [DOI: 10.1002/chem.201200833] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2012] [Revised: 05/18/2012] [Indexed: 12/22/2022]
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Darwish A, Blacker M, Janzen N, Rathmann SM, Czorny S, Hillier SM, Joyal JL, Babich JW, Valliant JF. Triazole Appending Agent (TAAG): A New Synthon for Preparing Iodine-Based Molecular Imaging and Radiotherapy Agents. ACS Med Chem Lett 2012; 3:313-6. [PMID: 24900470 DOI: 10.1021/ml300003v] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Accepted: 02/18/2012] [Indexed: 01/17/2023] Open
Abstract
A new prosthetic group referred to as the triazole appending agent (TAAG) was developed as a means to prepare targeted radioiodine-based molecular imaging and therapy agents. Tributyltin-TAAG and the fluorous analogue were synthesized in high yield using simple click chemistry and the products labeled in greater than 95% RCY with (123)I. A TAAG derivative of an inhibitor of prostate-specific membrane antigen was prepared and radiolabeled with (123)I in 85% yield where biodistribution studies in LNCap prostate cancer tumor models showed rapid clearance of the agent from nontarget tissues and tumor accumulation of 20% injected dose g(-1) at 1 h. The results presented demonstrate that the TAAG group promotes minimal nonspecific binding and that labeled conjugates can achieve high tumor uptake and exquisite target-to-nontarget ratios.
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Affiliation(s)
- Alla Darwish
- Department of Chemistry and Chemical
Biology, McMaster University, 1280 Main
Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Megan Blacker
- Centre for Probe Development and Commercialization, McMaster University, 1280 Main Street West Hamilton,
Ontario L8S 4K1, Canada
| | - Nancy Janzen
- Department of Chemistry and Chemical
Biology, McMaster University, 1280 Main
Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Stephanie M. Rathmann
- Department of Chemistry and Chemical
Biology, McMaster University, 1280 Main
Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Shannon Czorny
- Department of Chemistry and Chemical
Biology, McMaster University, 1280 Main
Street West, Hamilton, Ontario L8S 4L8, Canada
| | - Shawn M. Hillier
- Molecular Insight Pharmaceuticals, 160 Second Street,
Cambridge, Massachusetts 02142, United States
| | - John L. Joyal
- Molecular Insight Pharmaceuticals, 160 Second Street,
Cambridge, Massachusetts 02142, United States
| | - John W. Babich
- Molecular Insight Pharmaceuticals, 160 Second Street,
Cambridge, Massachusetts 02142, United States
| | - John F. Valliant
- Department of Chemistry and Chemical
Biology, McMaster University, 1280 Main
Street West, Hamilton, Ontario L8S 4L8, Canada
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Barbet J, Bardiès M, Bourgeois M, Chatal JF, Chérel M, Davodeau F, Faivre-Chauvet A, Gestin JF, Kraeber-Bodéré F. Radiolabeled antibodies for cancer imaging and therapy. Methods Mol Biol 2012; 907:681-97. [PMID: 22907380 DOI: 10.1007/978-1-61779-974-7_38] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Radiolabeled antibodies were studied first for tumor detection by single-photon imaging, but FDG PET stopped these developments. In the meantime, radiolabeled antibodies were shown to be effective in the treatment of lymphoma. Radiolabeling techniques are well established and radiolabeled antibodies are a clinical and commercial reality that deserves further studies to advance their application in earlier phase of the diseases and to test combination and adjuvant therapies including radiolabeled antibodies in hematological diseases. In solid tumors, more resistant to radiations and less accessible to large molecules such as antibodies, clinical efficacy remains limited. However, radiolabeled antibodies used in minimal or small-size metastatic disease have shown promising clinical efficacy. In the adjuvant setting, ongoing clinical trials show impressive increase in survival in otherwise unmanageable tumors. New technologies are being developed over the years: recombinant antibodies and pretargeting approaches have shown potential in increasing the therapeutic index of radiolabeled antibodies. In several cases, clinical trials have confirmed preclinical studies. Finally, new radionuclides, such as lutetium-177, with better physical properties will further improve the safety of radioimmunotherapy. Alpha particle and Auger electron emitters offer the theoretical possibility to kill isolated tumor cells and microscopic clusters of tumor cells, opening the perspective of killing the last tumor cell, which is the ultimate challenge in cancer therapy. Preliminary preclinical and preliminary clinical results confirm the feasibility of this approach.
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Affiliation(s)
- Jacques Barbet
- Centre de Recherche en Cancérologie de Nantes-Angers, Inserm, Université de Nantes, Nantes, France.
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