Investigating intrinsic radiosensitivity biomarkers to peptide receptor radionuclide therapy with [177Lu]Lu-DOTATATE in a panel of cancer cell lines

Short life fission products extracted from molten salt reactor fuel for radiopharmaceutical applications

This work studies the potential of using short life fission product (AFp) radioisotopes e.g. 82Br, 86Rb, (90Sr) - 90mY, (99Mo) - 99mTc, 103Ru - 103mRh, 111Ag, 127Sb - 127(m)Te, 126I, 131I, 133Xe, 136Cs, 141Ce, 143Ce, 143Pr, 147Nd - 147Pm, 149Pm, 153Sm, 156Eu, 159Gd and 161Tb, extracted from a molten salt reactor and their separation using specific thermodynamic and radiochemical conditions. Their utilisation for coupled radiodiagnostics and radiotherapy is a key consideration. A molten salt reactor produces fission products during operation. These radioisotopes can be separated at line from the liquid fuel by evaporation/distillation, chemical reduction (using H2 doped gas), electro-deposition and/or chemical oxidation (using Cl2 doped gas). They can be refined and chemically treated for radiopharmaceutical use for imaging and radiodiagnostics utilising γ radioscopy or positron emission tomography, and potentially in radiotherapy to target specific cancers or viral diseases using β- emitters. Some of the AFp isotopes are currently used for radiodiagnostics because they emit γ rays of energy 50-200 keV. However, some may also be used in parallel for radiotherapy utilising their β- (EMean ≈ 100 keV) emission whose mean free pathway of c.a. 100 nm in biological tissue is much smaller than their penetration depth. Focus is given to 86Rb, 90Y, 99mTc, 131I and 133Xe as well as on the ALn isotopes (141Ce, 143Ce - 143Pr, 147Nd - 147Pm, 149Pm and 153Sm) because of their strong potential for complexation with bio-ligands (e.g. DOTA) or for their ability to form micro-nano-spheres, and because of their potential for dual radiodiagnostics and radiotherapy. It is shown that these radio-lanthanides could also replace 177Lu for the treatment of specific cancers.

Disturbing the Redox Balance Using Buthionine Sulfoximine Radiosensitized Somatostatin Receptor-2 Expressing Pre-Clinical Models to Peptide Receptor Radionuclide Therapy with 177Lu-DOTATATE

Peptide receptor radionuclide therapy with ¹⁷⁷Lu-DOTATATE improves the outcome of patients with somatostatin receptor (SSTR)-expressing neuroendocrine tumours. Nevertheless, stable disease has been the main response pattern observed, with some rare complete responses. Lu-177 exerts about two-thirds of its biological effects via the indirect effects of ionizing radiation that generate reactive oxygen species, eventually leading to oxidative damage and cell death. This provides a rationale for targeting the antioxidant defence system in combination with ¹⁷⁷Lu-DOTATATE. In the present study, the radiosensitizing potential and the safety of depleting glutathione (GSH) levels using buthionine sulfoximine (BSO) during ¹⁷⁷Lu-DOTATATE therapy were assessed in vitro and in vivo using a xenograft mouse model. In vitro, the combination resulted in a synergistic effect in cell lines exhibiting a BSO-mediated GSH decrease. In vivo, BSO neither influenced ¹⁷⁷Lu-DOTATATE biodistribution nor induced liver, kidney or bone marrow toxicity. In terms of efficacy, the combination resulted in reduced tumour growth and metabolic activity. Our results showed that disturbing the cell redox balance using a GSH synthesis inhibitor increased ¹⁷⁷Lu-DOTATATE efficacy without additional toxicity. Targeting the antioxidant defence system opens new safe treatment combination opportunities with ¹⁷⁷Lu-DOTATATE.

Understanding the Radiobiological Mechanisms Induced by 177Lu-DOTATATE in Comparison to External Beam Radiation Therapy

Radionuclide Therapy (RNT) with ¹⁷⁷Lu-DOTATATE targeting somatostatin receptors (SSTRs) in neuroendocrine tumours (NET) has been successfully used in routine clinical practice, mainly leading to stable disease. Radiobiology holds promise for RNT improvement but is often extrapolated from external beam radiation therapy (EBRT) studies despite differences in these two radiation-based treatment modalities. In a panel of six human cancer cell lines expressing SSTRs, common radiobiological endpoints (i.e., cell survival, cell cycle, cell death, oxidative stress and DNA damage) were evaluated over time in ¹⁷⁷Lu-DOTATATE- and EBRT-treated cells, as well as the radiosensitizing potential of poly (ADP-ribose) polymerase inhibition (PARPi). Our study showed that common radiobiological mechanisms were induced by both ¹⁷⁷Lu-DOTATATE and EBRT, but to a different extent and/or with variable kinetics, including in the DNA damage response. A higher radiosensitizing potential of PARPi was observed for EBRT compared to ¹⁷⁷Lu-DOTATATE. Our data reinforce the need for dedicated RNT radiobiology studies, in order to derive its maximum therapeutic benefit.

Application of peptide biomarkers in life analysis based on liquid chromatography-mass spectrometry technology

Biomedicine is developing rapidly in the 21st century. Among them, the qualitative and quantitative analysis of peptide biomarkers is of considerable importance for the diagnosis and therapy of diseases and the quality evaluation of drugs and food. The identification and quantitative analysis of peptides have been going on for decades. Traditionally, immunoassays or biological assays are generally used to quantify peptides in biological matrices. However, the selectivity and sensitivity of these methods cannot meet the requirements of the application. The separation and analysis technique of liquid chromatography-mass spectrometry (LC-MS) supplies a reliable alternative. In contrast to immunoassays, LC-MS methods are capable of providing the analytical prowess necessary to satisfy the demands of peptide biomarker research in the life sciences arena. This review article provides a historical account of the in-roads made by LC-MS technology for the detection of peptide biomarkers in the past 10 years, with the focus on the qualification/quantification developments and their applications.