211At-Labeled Polymer Nanoparticles for Targeted Radionuclide Therapy of Glucose-Dependent Insulinotropic Polypeptide Receptor (GIPR)-Overexpressed Cancer

Recent advances of polymeric nanoplatforms for cancer treatment: smart delivery systems (SDS), nanotheranostics and multidrug resistance (MDR) inhibition

Nanotheranostics is a promising field that combines the benefits of diagnostic and treatment into a single nano-platform that not only administers treatment but also allows for real-time monitoring of therapeutic response, decreasing the possibility of under/over-drug dosing. Furthermore, developing smart delivery systems (SDSs) for cancer theranostics that can take advantage of various tumour microenvironment (TME) conditions (such as deformed tumour vasculature, various over-expressed receptor proteins, reduced pH, oxidative stress, and resulting elevated glutathione levels) can aid in achieving improved pharmacokinetics, higher tumour accumulation, enhanced antitumour efficacy, and/or decreased side effects and multidrug resistance (MDR) inhibition. Polymeric nanoparticles (PNPs) are being widely investigated in this regard due to their unique features such as small size, passive/active targeting possibility, better pharmaceutical kinetics and biological distribution, decreased adverse reactions of the established drugs, inherent inhibitory properties to MDR efflux pump proteins, as well as the feasibility of delivering numerous therapeutic substances in just one design. Hence in this review, we have primarily discussed PNPs based targeted and/or controlled SDSs in which we have elaborated upon different TME mediated nanotheranostic platforms (NTPs) including active/passive/magnetic targeting platforms along with pH/ROS/redox-responsive platforms. Besides, we have elucidated different imaging guided cancer therapeutic platforms based on four major cancer imaging techniques i.e., fluorescence/photo-acoustic/radionuclide/magnetic resonance imaging, Furthermore, we have deliberated some of the most recently developed PNPs based multimodal NTPs (by combining two or more imaging or therapy techniques on a single nanoplatform) in cancer theranostics. Moreover, we have provided a brief update on PNPs based NTP which are recently developed to overcome MDR for effective cancer treatment. Additionally, we have briefly discussed about the tissue biodistribution/tumour targeting efficiency of these nanoplatforms along with recent preclinical/clinical studies. Finally, we have elaborated on various limitations associated with PNPs based nanoplatforms.

Imaging-guided targeted radionuclide tumor therapy: From concept to clinical translation

Since the first introduction of sodium iodide I-131 for use with thyroid patients almost 80 years ago, more than 50 radiopharmaceuticals have reached the markets for a wide range of diseases, especially cancers. The nuclear medicine paradigm also shifts from solely molecular imaging or radionuclide therapy to imaging-guided radionuclide therapy, which is deemed a vital component of precision cancer therapy and an emerging medical modality for personalized medicine. The imaging-guided radionuclide therapy highlights the systematic integration of targeted nuclear diagnostics and radionuclide therapeutics. Regarding this, nuclear imaging serves to "visualize" the lesions and guide the therapeutic strategy, followed by administration of a precise patient specific dose of radiotherapeutics for treatment according to the absorbed dose to different organs and tumors calculated by dosimetry tools, and finally repeated imaging to predict the prognosis. This strategy leads to significantly enhanced therapeutic efficacy, improved patient outcomes, and manageable adverse events. In this review, we provide an overview of imaging-guided targeted radionuclide therapy for different tumors such as advanced prostate cancer and neuroendocrine tumors, with a focus on development of new radioligands and their preclinical and clinical results, and further discuss about challenges and future perspectives.

Ionizing Radiation-Induced Ferroptosis Based on Nanomaterials

Ferroptosis is an iron-dependent form of regulated cell death (RCD), that is associated with peroxidative damage to cellular membranes. A promising therapeutic method is to target ferroptosis. Nanomaterial-induced ferroptosis attracts enormous attention. Nevertheless, there are still certain shortcomings in ferroptosis, such as inadequate triggered immunogenic cell death to suit clinical demands. Various investigations have indicated that ionizing radiation (IR) can further induce ferroptosis. Consequently, it is a potential strategy for cancer therapy that combines nanomaterials and IR to induce ferroptosis. Initially, we discuss various ferroptosis inducers based on nanomaterials in this review. Furthermore, mechanisms of IR-induced ferroptosis are briefly introduced. Ultimately, we assess the feasibility of combining nanomaterials with IR to induce ferroptosis, paving the way for future research.

Special radionuclide production activities – recent developments at QST and throughout Japan

National Institutes for Quantum Science and Technology (QST), formerly known as the National Institute of Radiological Sciences (NIRS), has been engaged in work on radiopharmaceutical science using cyclotrons since 1974. Eight pioneering researchers founded the basis of this field of research at NIRS, and to the present, many researchers and technicians have accumulated both scientific and technical achievements, as well as inherited the spirit of research. Besides, in recent years, we have developed production systems with AVF-930 cyclotron for various ‘non-standard’ radioisotopes applied in both diagnosis and therapy. Here, we review the past 50 years of our activities on radioisotope and radiopharmaceutical development, as well as more recent activities.

In vitro and in vivo evaluation of 211At-labeled fibroblast activation protein inhibitor for glioma treatment

Glioma is the most common primary intracranial tumor without effective treatment. Positron emission tomography tracers labeled with 68Ga targeting fibroblast activation protein (FAP) have shown favorable characteristics in the diagnosis of glioma. However, to the best of our knowledge, FAP-targeted endoradiotherapy has never been explored in glioma. Hence, in this study, we investigated the therapeutic effect of 211At-labeled fibroblast activation protein inhibitor (FAPI) for glioma in vitro and in vivo. By astatodestannylation reaction, we prepared 211At-FAPI-04 with a radiochemical yield of 45 ± 6.7% and radiochemical purity of 98%. With good stability in vitro, 211At-FAPI-04 showed fast and specific binding to FAP-positive U87MG cells, and could significantly reduce the cell viability, arrested cell cycle at G2/M phase and suppressed cell proliferative efficacy. Biodistribution studies revealed that 6-fold higher accumulation in tumor sites was achieved by intratumoral injection in comparison with intravenous injection. In U87MG xenografts, 211At-FAPI-04 obviously suppressed the tumor growth and prolonged the median survival in a dose-dependent manner without obvious toxicity to normal organs. In addition, reduced proliferation and increased apoptosis were also observed after 211At-FAPI-04 treatment. All these results suggest that targeted alpha-particle therapy (TAT) mediated by 211At-FAPI-04 can provide an effective and promising strategy for the treatment of glioma.

Acidity-Activated Charge Conversion of 177Lu-Labeled Nanoagent for the Enhanced Photodynamic Radionuclide Therapy of Cancer

Nanomaterials in combination with radionuclide therapy (RNT) provide new opportunities for cancer treatment. However, nanomaterials with efficient tumor accumulation have been less exploited for effective radionuclide-based therapy. Here, we report glycol chitosan-based nanoparticles (GCP-NPs) with acidic pH-dependent surface charge conversion for efficient radionuclide-based combination therapy. The nanoplatform can change the surface charge of nanoparticles from slight negative to positive in the acidic tumor microenvironment, which facilitates cellular internalization and penetration and thus improves the tumor accumulation efficiency of nanomaterials. Radiolabeling of GCP-NPs with ^99mTc enables in vivo radioactive imaging in the mouse subcutaneous tumor model, showing 8.1-fold enhanced tumor uptake relative to pH-insensitive control nanoparticles (termed as GCOP-NPs). Afterward, therapeutic radioisotope ¹⁷⁷Lu-labeled GCP-NPs (¹⁷⁷Lu-GCP-NPs) that utilize RNT synergistic with photodynamic therapy (PDT) derived from conjugated pyropheophorbide-a within nanoparticles endow superior antitumor efficacy in living cells and tumor-bearing mouse model. More importantly, the combination of RNT and PDT using ¹⁷⁷Lu-GCP-NPs can effectively inhibit lung metastasis and eliminate splenomegaly, which is not possible for individual RNT or PDT. Therefore, this study proposes a facile radionuclide-based combination therapy strategy toward complete cancer remission.