Therapy with 188Re-Labeled Radiopharmaceuticals: An Overview of Promising Results from Initial Clinical Trials

Clearable Nanoparticles for Cancer Photothermal Therapy

Nanoparticles are important mediators for cancer photothermal therapy (PTT) where they can efficiently convert photon energy into heat and ablate the surrounding cancer cells with superior spatial and temporal precision. Recent decades have witnessed a booming development of numerous formulations of PTT nanoparticles that exhibit outstanding anti-tumor efficacy in preclinical studies. However, their clinical translation has been mined by safety concerns, especially their long-term impact on human body. Biodegradable nanoparticles that can be excreted after PTT, therefore, are gaining popularity due to their biocompatibility and improved safety profiles. This chapter provides an update on the progress in clearable PTT nanoparticles for cancer treatment. We discuss their design, synthesis strategy, and physicochemical properties relevant to photothermal performance. We also review their biodistribution patterns and in vivo anti-tumor efficacy, along with their degradation mechanism and clearance kinetics. Lastly, we present a brief overview of the imaging techniques to noninvasively monitor the degradation of PTT nanoparticles.

Substitution reactivity and structural variability induced by tryptamine on the biomimetic rhenium tricarbonyl complex

A series of seven fac-[Re(CO)₃(5Me-Sal-Trypt)(L)] complexes containing tryptamine on the N,O 5-methyl-salicylidene bidentate ligand backbone and where L is MeOH, Py, Imi, DMAP, PPh₃ coordinated to the 6th position have been studied, including the formation of a dinuclear Re₂ cluster. The crystallographic solid state structures show marked similarity in structural tendency, in particular the rigidity of the Re core and the hydrogen bond interactions similar to those found in protein structures. The rates of formation and stability of the complexes were evaluated by rapid time-resolved stopped-flow techniques and the methanol substitution reaction indicates the significant activation induced by the use of the N,O salicylidene bidentate ligand as manifested by the second-order rate constants for the entering nucleophiles. Both linear and limiting kinetics were observed and a systematic evaluation of the kinetics is reported clearly indicating an interchange type of intimate mechanism for the methanol substitution. The anticancer activity of compounds 1–7 was tested on HeLa cells and it was found that all compounds showed similar cytotoxicity where solubility allowed. IC₅₀-values between ca. 11 and 22 μM indicate that some cytotoxicity resides most likely on the salicylidene–tryptamine ligand. The photoluminescence of the seven complexes is similar in maximum emission wavelength with little variation despite the broad range of ligands coordinated to the 6th position on the metal centre.

The biomimetic tryptamine rhenium tricarbonyl complex shows rapid substitution reactivity on the 6th position as well as cytotoxicity and photoluminescence capability induced by the salicylidene bidentate ligand.

Radiopharmaceutical therapy in cancer: clinical advances and challenges

Radiopharmaceutical therapy (RPT) is emerging as a safe and effective targeted approach to treating many types of cancer. In RPT, radiation is systemically or locally delivered using pharmaceuticals that either bind preferentially to cancer cells or accumulate by physiological mechanisms. Almost all radionuclides used in RPT emit photons that can be imaged, enabling non-invasive visualization of the biodistribution of the therapeutic agent. Compared with almost all other systemic cancer treatment options, RPT has shown efficacy with minimal toxicity. With the recent FDA approval of several RPT agents, the remarkable potential of this treatment is now being recognized. This Review covers the fundamental properties, clinical development and associated challenges of RPT.

Radiopharmaceutical therapy is emerging as a safe and effective approach for the treatment of cancer, offering several advantages over existing therapeutic strategies. Here, Sgouros and colleagues provide an overview of the fundamental properties of radiopharmaceutical therapy, discuss agents in use and in clinical development and highlight the associated translational challenges.

Magnetic Nanoparticles in Cancer Therapy and Diagnosis

There is urgency for the development of nanomaterials that can meet emerging biomedical needs. Magnetic nanoparticles (MNPs) offer high magnetic moments and surface-area-to-volume ratios that make them attractive for hyperthermia therapy of cancer and targeted drug delivery. Additionally, they can function as contrast agents for magnetic resonance imaging (MRI) and can improve the sensitivity of biosensors and diagnostic tools. Recent advancements in nanotechnology have resulted in the realization of the next generation of MNPs suitable for these and other biomedical applications. This review discusses methods utilized for the fabrication and engineering of MNPs. Recent progress in the use of MNPs for hyperthermia therapy, controlling drug release, MRI, and biosensing is also critically reviewed. Finally, challenges in the field and potential opportunities for the use of MNPs toward improving their properties are discussed.

Standardisation of Rhenium-188 and determination of calibration factors for secondary standard and radionuclide calibrator

The use of Rhenium-188 for various therapeutic applications in the field of nuclear medicine has increased in recent years due to its favourable properties like decay scheme, cost effective availability and easy chemistry. Two independent measuring setups were used to standardise ¹⁸⁸Re radioactive solution. The modus operandi of standardisation was 4πβ-γ coincidence technique where the beta detection was done by proportional counting and liquid scintillation counting and the gamma detection was done by using NaI(Tl) detectors. The secondary standard, high pressure ionisation chamber type Centronic IG12, 20A was calibrated with the standardised ¹⁸⁸Re solution and the sensitivity coefficient (pA MBq^-1) was determined. To enhance the accuracy of the commercial radionuclide calibrator and to ensure that patients receive optimum dose of these radiopharmaceuticals, calibration number of the Capintec CRC-15β radionuclide calibrator was also verified. This paper presents the standardisation of ¹⁸⁸Re radioactive solution by primary methods and calibration of BARC secondary standard ionisation chamber system and a Capintec CRC-15β radionuclide calibrator.

PEGylated rhenium nanoclusters: a degradable metal photothermal nanoagent for cancer therapy

A common issue of functional nanoagents for potential clinical translation is whether they are biodegradable or renal clearable. Previous studies have widely explored noble metal nanoparticles (Au and Pd) as the first generation of photothermal nanoagents for cancer therapy, but all of the reported noble metal nanoparticles are non-degradable. On the other hand, rhenium (Re), one of the noble and precious metals with a high atomic number (Z = 75), has been mainly utilized as a jet superalloy or chemical catalyst, but the biological characteristics and activity of Re nanoparticles have never been evaluated until now. To address these issues, here we report a simple and scalable liquid-reduction strategy to synthesize PEGylated Re nanoclusters, which exhibit intrinsically high photothermal conversion efficacy (33.0%) and high X-ray attenuation (21.2 HU mL mg-1), resulting in excellent photothermal ablation (100% tumor elimination) and higher CT enhancement (15.9 HU mL mg-1 for commercial iopromide in clinics). Impressively, biocompatible Re nanoclusters can degrade into renal clearable ReO4 - ions after exposure to H2O2, and thus achieve much higher renal clearance efficiency than conventional gold nanoparticles. This work reveals the potential of theranostic application of metallic Re nanoclusters with both biodegradation and renal clearance properties and provides insights into the design of degradable metallic platforms with high clinical prospects.

A phase 0 study of the pharmacokinetics, biodistribution, and dosimetry of 188Re-liposome in patients with metastatic tumors

BACKGROUND

Liposomes are drug nano-carriers that are capable of targeting therapeutics to tumor sites because of enhanced permeability retention (EPR). In several preclinical studies with various tumor-bearing mice models, ¹⁸⁸Re-liposome that has been developed by the Institute of Nuclear Energy Research (INER) demonstrates favorable in vivo tumor targeting, biodistribution, pharmacokinetics, and dosimetry. It inhibits the growth of tumors, increased survival, demonstrates good synergistic combination, and was safe to use. This study conducts a phase 0 low-radioactivity clinical trial of nano-targeted radiotherapeutics ¹⁸⁸Re-liposome to evaluate the effectiveness with which it targets tumors and the pharmacokinetics, biodistribution, dosimetry, and its safety in use. Twelve patients with metastatic cancers are studied in this trial. Serial whole-body scans and SPECT/CT are taken at 1, 4, 8, 24, 48, and 72 h after intravenous injection of 111 MBq of ¹⁸⁸Re-liposome. The effectiveness with which tumors are targeted, the pharmacokinetics, biodistribution, dosimetry, and safety are evaluated using the VelocityAI and OLINDA/EXM software. Blood samples are collected at different time points for a pharmacokinetics study and a safety evaluation that involves monitoring changes in liver, renal, and hematological functions.

RESULTS

The T_½z for ¹⁸⁸Re-liposome in blood and plasma are 36.73 ± 14.00 h and 52.02 ± 45.21 h, respectively. The doses of radiation that are absorbed to vital organs such as the liver, spleen, lung, kidney, and bone marrow are 0.92 ± 0.35, 1.38 ± 1.81, 0.58 ± 0.28, 0.32 ± 0.09, and 0.06 ± 0.01 mGy/MBq, respectively, which is far less than the reference maximum tolerance dose after injection of ¹⁸⁸Re-liposome. ¹⁸⁸Re-liposome is absorbed by metastatic tumor lesions and the normal reticuloendothelial (RES) system. Certain patients exhibit a therapeutic response.

CONCLUSION

This phase 0 exploratory IND study shows that nanocarrier ¹⁸⁸Re-liposome achieves favorable tumor accumulation and tumor to normal organ uptake ratios for a subset of cancer patients. The clinical pharmacokinetic, biodistribution, and dosimetry results justify a further dose-escalating phase 1 clinical trial.

TRIAL REGISTRATION

Taiwan FDA MA1101G0 (Jan 31, 2012).

Measurement of neutron capture cross section of 187W for production of 188W

Tungsten-188 (t_1/2 = 69.4 d) is routinely produced by double neutron capture using highly enriched ¹⁸⁶W target, ¹⁸⁶W(n,γ)¹⁸⁷W(n,γ)¹⁸⁸W reaction, at the ORNL 85 MWt High Flux Isotope Reactor. While the thermal neutron cross section for the first reaction, ¹⁸⁶W(n,γ)¹⁸⁷W, is well known, the single reported 64 b cross-section for the second reaction, ¹⁸⁷W(n,γ)¹⁸⁸W, cannot be validated by experimental results that yield lower than expected activities of ¹⁸⁸W. In this study, we report a new value for the thermal neutron capture cross section of ¹⁸⁷W. After confirming the neutron capture cross section of ¹⁸⁶W (σ⁰ = 37.8 ± 1.8 b for thermal and I⁰ = 476 ± 25 b for resonance integrals with σ⁰/I⁰ = 12.6 ± 0.4) in two short irradiations, longer irradiations (1-10 d) were performed to obtain a value of 6.5 ± 0.8 b for the σ⁰ of ¹⁸⁷W, which is lower than the adopted value by a factor of 10. Due to the short half-life of ¹⁸⁷W (t_1/2 = 23.7 d), the σ⁰ for ¹⁸⁷W was obtained empirically by comparing the ¹⁸⁸W experimental yields with the theoretical yields generated by code IsoChain and varying the ¹⁸⁷W cross section while keeping all other parameters constant.

Synthesis, characterization and biological studies of rhenium, technetium-99m and rhenium-188 pentapeptides

A pentapeptide macrocyclic ligand, KYCAR (lysyl-tyrosyl-cystyl-alanyl-arginine), has been designed as a potential chelating ligand for SPECT imaging and therapeutic in vivo agents. This study shows the synthesis and characterization of KYCAR complexes containing nonradioactive rhenium, ^99mTc, or ¹⁸⁸Re. The metal complexes were also biologically evaluated to determine in vivo distribution in healthy mice. The overall goals of this project were (1) to synthesize the Tc/Re pentapeptide complexes, (2) to identify spectroscopic methods for characterization of syn versus anti rhenium peptide complexes, (3) to analyze the ex vivo stability, and (4) to assess the biological properties of the [^99mTc]TcO-KYCAR and [¹⁸⁸Re]ReO-KYCAR complexes in vivo. Details on these efforts are provided below.

METHODS

^NatRe/^99mTc/¹⁸⁸ReO-KYCAR complexes were synthesized, and macroscopic species were characterized via HPLC, IR, NMR, and CD. These characterization data were compared to the crystallographic data of ReO-KYC to assist in the assignment of diastereomers and to aid in the determination of the structure of the complex.

RESULTS

The radiometal complexes were synthesized with high purity (>95%). HPLC, IR, NMR and CD data on the macroscopic ^natReO-KYCAR complexes confirm the successful complexation as well as the presence of two diastereomers in syn and anticonformations. Tracer level complexes show favorable stabilities ex vivo for 2+ h.

CONCLUSION

Macroscopic metal complexes form diastereomers with the KYCAR ligand; however, this phenomenon is not readily observed on the tracer level due to the rapid interconversion. It was determined through pK_a measurements that the macroscopic ^natReO-KYCAR complex is 0 at physiological pH. The [^99mTc]TcO-KYCAR is stable in vitro while the [¹⁸⁸Re]ReO-KYCAR shows 50% decomposition in PBS and serum. Biologically, the tracer level complexes clear through the hepatobiliary pathway. Some decomposition of both tracers is evident by uptake in the thyroid and stomach.

Synthesis, Functionalization, and Design of Magnetic Nanoparticles for Theranostic Applications

In order to translate nanotechnology into medical practice, magnetic nanoparticles (MNPs) have been presented as a class of non-invasive nanomaterials for numerous biomedical applications. In particular, MNPs have opened a door for simultaneous diagnosis and brisk treatment of diseases in the form of theranostic agents. This review highlights the recent advances in preparation and utilization of MNPs from the synthesis and functionalization steps to the final design consideration in evading the body immune system for therapeutic and diagnostic applications with addressing the most recent examples of the literature in each section. This study provides a conceptual framework of a wide range of synthetic routes classified mainly as wet chemistry, state-of-the-art microfluidic reactors, and biogenic routes, along with the most popular coating materials to stabilize resultant MNPs. Additionally, key aspects of prolonging the half-life of MNPs via overcoming the sequential biological barriers are covered through unraveling the biophysical interactions at the bio-nano interface and giving a set of criteria to efficiently modulate MNPs' physicochemical properties. Furthermore, concepts of passive and active targeting for successful cell internalization, by respectively exploiting the unique properties of cancers and novel targeting ligands are described in detail. Finally, this study extensively covers the recent developments in magnetic drug targeting and hyperthermia as therapeutic applications of MNPs. In addition, multi-modal imaging via fusion of magnetic resonance imaging, and also innovative magnetic particle imaging with other imaging techniques for early diagnosis of diseases are extensively provided.

Investigation of SP94 Peptide as a Specific Probe for Hepatocellular Carcinoma Imaging and Therapy

SP94 (SFSIIHTPILPL), a novel peptide, has shown specific binding to hepatocellular carcinoma (HCC) cells. We aimed to investigate the capability of SP94 as a targeting probe for HCC imaging and therapy following labeling with technetium-99m ((99m)Tc) and rhenium-188 ((188)Re). HYNIC-SP94 was prepared by solid phase synthesis and then labeled with (99m)Tc. Cell competitive binding, internalization assay, in vitro and in vivo stability, biodistribution and micro-single photon emission computed tomography /computed tomography (SPECT/CT) imaging studies were performed to investigate the capability of (99m)Tc tricine-EDDA/HYNIC-SP94 as a specific HCC imaging probe. Initial promising targeting results inspired evaluation of its therapeutic effect when labeled by (188)Re. HYNIC-SP94 was then labeled again with (188)Re to perform cell apoptosis, microSPECT/CT imaging evaluation and immunohistochemistry. Huh-7 cells exhibited typical apoptotic changes after (188)Re irradiation. According to (99m)Tc tricine-EDDA/HYNIC-SP94 microSPECT/CT imaging, tumor uptake was significantly decreased compared with that of pre-treatment with (188)Re-HYNIC-SP94. The immunohistochemistry also displayed obvious necrosis and apoptosis as well as inhibition of proliferation in the (188)Re-HYNIC-SP94 treatment group. The results supported that (99m)Tc tricine-EDDA/HYNIC-SP94 is able to target HCC cells and (188)Re-HYNIC- SP94 holds potential as a therapeutic agent for HCC, making (99m)Tc/(188)Re-HYNIC-SP94 a promising targeting probe for HCC imaging and therapy.

Future Perspectives of Radionanomedicine Using the Novel Micelle-Encapsulation Method for Surface Modification

The emerging radionanomedicine has multifunctional and theranostic purposes. For these purposes, radionanomedicine should achieve the efficient and specific delivery of therapeutic agents by multifunctional characteristics, using low amounts of nanomaterials in vivo. Recent research on radiolabeled micelle-encapsulated nanomaterials has been made on the their efficacy and safety using a one-step surface modification method (Jeong's method). This one-step multifunctional approach to the nanoparticle can be the important challenge in producing effective nanoplatforms for cancer imaging and therapy.

An overview of radioisotope separation technologies for development of 188W/188Re radionuclide generators providing 188Re to meet future research and clinical demands

Separation technologies for ¹⁸⁸W/¹⁸⁸Re radionuclide generators.

Development of 4-hexadecyl-4,7-diaza-1,10-decanedithiol (HDD) kit for the preparation of the liver cancer therapeutic agent Re-188-HDD/lipiodol

INTRODUCTION

A lipiodol solution of (188)Re-4-hexadecyl-2,2,9,9-tetramethyl-4,7-diaza-1,10-decanedithiol (HTDD) has been successfully developed for liver cancer therapy; however, its preparation requires a multi-step synthesis and it is characterized by a low labeling yield.

METHODS

We synthesized a new compound, 4-hexadecyl-4,7-diaza-1,10-decanedithioacetate (AHDD), without gem dimethyl groups to address these issues. AHDD was formulated into a kit and was labeled with (188)Re. Biodistribution study was performed using normal BALB/c mice.

RESULTS

The kit was labeled with (188)Re with a high efficiency (98.8±0.2%). After extraction with lipiodol, the overall yield of (188)Re-HDD/lipiodol was as high as 90.2±2.6%. A comparative biodistribution study of (188)Re-HTDD and (188)Re-HDD was performed in normal mice after intravenous injection. The lungs were identified as the main uptake site due to capillary-blockage. (188)Re-HDD/lipiodol showed a significantly higher lung uptake than that of (188)Re-HTDD/lipiodol (p<0.05).

CONCLUSION

The newly synthesized (188)Re-HDD/lipiodol showed improved radiolabeling yield and biodistribution results compared to (188)Re-HTDD/lipiodol, and may therefore be more suitable for liver cancer therapy.

188W/188Re Generator System and Its Therapeutic Applications

The188Re radioisotope represents a useful radioisotope for the preparation of radiopharmaceuticals for therapeutic applications, particularly because of its favorable nuclear properties. The nuclide decay pattern is through the emission of a principle beta particle having 2.12 MeV maximum energy, which is enough to penetrate and destroy abnormal tissues, and principle gamma rays (Eγ=155 keV), which can efficiently be used for imaging and calculations of radiation dose.188Re may be conveniently produced by188W/188Re generator systems. The challenges related to the double neutron capture reaction route to provide only modest yield of the parent188W radionuclide indeed have been one of the major issues about the use of188Re in nuclear medicine. Since the specific activity of188W used in the generator is relatively low (<185 GBq/g), the elutedRe188O4-can have a low radioactive concentration, often ineffective for radiopharmaceutical preparation. However, several efficient postelution concentration techniques have been developed, which yield clinically usefulRe188O4-solutions. This review summarizes the technologies developed for the preparation of188W/188Re generators, postelution concentration of the188Re perrhenate eluate, and a brief discussion of new chemical strategies available for the very high yield preparation of188Re radiopharmaceuticals.

Reduction of β-radiation exposure during preparation of 188Re-labelled Lipiodol for hepatocellular carcinoma treatment

Rhenium-188 (188Re) is of widespread interest for treating various diseases because of its attractive physical and chemical properties. The routine preparation of therapeutic doses of 188Re-labelled tracers can result in significant radiation exposure to the operator. We studied the impact of automating the preparation of 188Re-Lipiodol on the radiochemist's exposure, as well as the importance of the model of syringe shielding. To monitor radiation exposure continuously readable electronic personal dosimeters were used. Thermoluminescence dosimeters were fixed to the probable most exposed fingers of the radiochemist during preparation of the radiotracer and during the syringing. Dose rates were measured using a Babyline. Automation of the synthesis reduced personal dose equivalents from 2.60±4.35 to 1.61±1.20 µSv/GBq [Hp(10)] and from 38.37±55.28 to 21.84±16.14 µSv/GBq [Hp(0.07)]. Dose to the extremities was also reduced (-80% for the right hand; -58% for the left one). The Lemer-Pax PSWG syringe shield led to a slightly lower dose to the hands compared with the Medisystem (1.1±0.27 vs. 1.34±0.6 mSv/GBq for the right finger). Automation of the synthesis leads to a significant decrease in radiation exposure to the operator. The Lemer-Pax PSWG syringe shield provides better hand protection than the smaller Medisystem Mediclic.

(188)Re-SSS/Lipiodol: Development of a Potential Treatment for HCC from Bench to Bedside

Hepatocellular carcinoma (HCC) is the 5th most common tumour worldwide and has a dark prognosis. For nonoperable cases, metabolic radiotherapy with Lipiodol labelled with β-emitters is a promising therapeutic option. The Comprehensive Cancer Centre Eugène Marquis and the National Graduate School of Chemistry of Rennes (ENSCR) have jointly developed a stable and efficient labelling of Lipiodol with rhenium-188 (E_βmax = 2.1 MeV) for the treatment of HCC. The major “milestones” of this development, from the first syntheses to the recent first injection in man, are described.

Preparation of 99mTc(CO)3-TPPS4 and its biological behavior evaluation

99mTc(CO)3-TPPS4 was prepared via the precursor [99mTc(CO)3(H2O)3]+ and a preliminary investigation on its stability and behavior in Hep2 tumor cells and hepatoma-bearing mice were conducted. Labeling yield and stability of 99mTc(CO)3-TPPS4 was radioactively analyzed by paper chromatography. Hep2 tumor cells were incubated with 99mTc(CO)3-TPPS4 complex system in the substrate and isolated from the substrate for radioactivity count. Then 99mTc(CO)3-TPPS4 complex system was intravenously injected in hepatoma-bearing mice and directly injected in tumor tissue of the mice. Mice were photographed using SPECT. Labeling yields of 99mTc(CO)3-TPPS4 were more than 90% at pH = 7–8, 30 min, in a boiling bath, and it was stable for at least 14 h at pH = 2–8, rt ~95 °C. The uptake of 99mTc(CO)3-TPPS4 in HepG2 tumor cells was only 3–4% with the maximum uptake-time of 20 min. The SPECT images of hepatoma-bearing nude mice showed no uptake or little retention of 99mTc(CO)3-TPPS4 in the tumor tissue. Then the differences between 99mTc(CO)3-TPPS4 and TPPS4 were analyzed by fluoroscopy and molecular structure. It was found that the paper chromatography, HepG2 tumor cell uptake and the optimized porphyrin ring conformation of 99mTc(CO)3-TPPS4 were quite different from those of TPPS4. It was indicated that 99mTc(CO)3-TPPS4 had no uptake or little retention in hepatic tumors, unlike those biological behaviors of TPPS4. This may be due to the modification of porphyrin ring conformation of TPPS4 by 99mTc(CO)3 core.

Magnetic nanoparticles: an update of application for drug delivery and possible toxic effects

Magnetic nanoparticles (MNPs) represent a subclass within the overall category of nanomaterials and are widely used in many applications, particularly in the biomedical sciences such as targeted delivery of drugs or genes, in magnetic resonance imaging, and in hyperthermia (treating tumors with heat). Although the potential benefits of MNPs are considerable, there is a distinct need to identify any potential toxicity associated with these MNPs. The potential of MNPs in drug delivery stems from the intrinsic properties of the magnetic core combined with their drug loading capability and the biomedical properties of MNPs generated by different surface coatings. These surface modifications alter the particokinetics and toxicity of MNPs by changing protein-MNP or cell-MNP interactions. This review contains current advances in MNPs for drug delivery and their possible organ toxicities associated with disturbance in body iron homeostasis. The importance of protein-MNP interactions and various safety considerations relating to MNP exposure are also addressed.

188Re-loaded lipid nanocapsules as a promising radiopharmaceutical carrier for internal radiotherapy of malignant gliomas

PURPOSE

Lipid nanocapsules (LNC) entrapping lipophilic complexes of (188)Re ((188)Re(S(3)CPh)(2)(S(2)CPh) [(188)Re-SSS]) were investigated as a novel radiopharmaceutical carrier for internal radiation therapy of malignant gliomas. The present study was designed to evaluate the efficacy of intra-cerebral administration of (188)Re-SSS LNC by means of convection-enhanced delivery (CED) on a 9L rat brain tumour model.

METHODS

Female Fischer rats with 9L glioma were treated with a single injection of (188)Re-SSS LNC by CED 6 days after cell implantation. Rats were put into random groups according to the dose infused: 12, 10, 8 and 3 Gy in comparison with blank LNC, perrhenate solution (4 Gy) and non-treated animals. The radionuclide brain retention level was evaluated by measuring (188)Re elimination in faeces and urine over 72 h after the CED injection. The therapeutic effect of (188)Re-SSS LNC was assessed based on animal survival.

RESULTS

CED of (188)Re perrhenate solution resulted in rapid drug clearance with a brain T (1/2) of 7h. In contrast, when administered in LNC, (188)Re tissue retention was greatly prolonged, with only 10% of the injected dose being eliminated at 72 h. Rat median survival was significantly improved for the group treated with 8 Gy (188)Re-SSS LNC compared to the control group and blank LNC-treated animals. The increase in the median survival time was about 80% compared to the control group; 33% of the animals were long-term survivors. The dose of 8 Gy proved to be a very effective dose, between toxic (10-12 Gy) and ineffective (3-4 Gy) doses.

CONCLUSIONS

These findings show that CED of (188)Re-loaded LNC is a safe and potent anti-tumour system for treating malignant gliomas. Our data are the first to show the in vivo efficacy of (188)Re internal radiotherapy for the treatment of brain malignancy.

Rhenium-188 labelled meso-tetrakis[3,4-bis(carboxymethyleneoxy)phenyl] porphyrin for targeted radiotherapy: preliminary biological evaluation in mice

PURPOSE

This study focusses on a promising carrier system for therapeutic and imaging purposes using meso-tetrakis[3,4-bis(carboxymethyleneoxy)phenyl] porphyrin (T(3,4)CPP). To assess its potential for clinical use, we labelled T(3,4)CPP with (188)Re and analysed some kinetic biodistribution parameters after intravenous injection in mice.

MATERIALS AND METHODS

T(3,4)CPP was synthesized and labelled with (188)Re. Normal Kunming (KM) mice and melanoma- or hepatoma-bearing BALB/c nude mice were injected intravenously with 5.55 MBq (188)Re-labelled T(3,4)CPP and sacrificed at 0.5, 2, 4, and 24 h and 8, and 24 h, respectively.

RESULTS

The (188)Re-T(3,4)CPP yield was more than 95% with specific activity 16.9 GBq (mol)(-1), and Vitamin C (VC) could increase its stability in vitro. In normal KM mice, (188)Re-T(3,4)CPP had fast blood clearance (approximately 99%, 24 h postinjection), low retention in the vital organs and hepatotropic characteristics. In nude mice, more than 4.4 and 6.1% uptake per gram of tumour (%ID g(-1)) at 8 h postinjection was in melanoma and hepatoma, respectively; this remained as high levels after 24 h as 4.6 and 6.5%, respectively. At 8 h, the tumour/blood and tumour/muscle (T/M) ratios in melanomas and hepatoma bearing mice were 7.3, 13,and 7.0, 20, respectively. Twenty-four hours later, these high ratios still continued in existence which were 9.6, 19 and 10, 25, respectively.

CONCLUSION

The results obtained in this study indicate that (188)Re-T(3,4)CPP has better tumour affinity and retainable accumulation characteristics in carcinoma which can potentially be used for tumour-targeted radiotherapy.

Synthesis and preliminary biological studies of the novel conjugate 188Re-labeled meso-tetrakis(4-sulfophenyl)porphyrin in mice

OBJECTIVE

The objective of this study was to evaluate the biological behaviors of a novel (188)Re-labeled meso-tetrakis(4-sulfophenyl)porphyrin (TPPS(4)) in normal mice and tumor-bearing mice.

METHODS

TPPS(4) was synthesized and labeled by (188)ReO(4)(-). Normal KM mice and BALB/c nude mice bearing melanoma or hepatoma were prepared for distribution studies.

RESULTS

The [(188)Re]TPPS(4) yield was >98% with a specific activity of 11.2 GBq/mol, and vitamin C could increase its stability in vitro. In normal KM mice, [(188)Re]TPPS(4) had a fast blood clearance ( approximately 90%, 24 h postinjection), low retention in vital organs and hepatotropic characteristics. In nude mice, uptakes of >4.1% and 6.5% ID/g tumor at 8 h postinjection were observed in melanoma and hepatoma, respectively; this remained at high levels of 4.7% and 5.7%, respectively, after 24 h. At 8 h, the tumor/blood and tumor/muscle ratios in melanoma-bearing and hepatoma-bearing mice were 6.2-15.2 and 6.1-24.2, respectively. Twenty-four hours later, these high ratios still continued at 8.6-22.1 and 12-26.1, respectively.

CONCLUSION

The results obtained in this study indicate that [(188)Re]TPPS(4) has a high tumor affinity and retainable accumulation characteristics in carcinoma, which can potentially be used for tumor-targeted therapy.

Preparation and Imaging Research on 188Re-DTPA-Deoxyglucose in MCF-7 Tumor-Bearing Mice

OBJECTIVE

To investigate the preparation of (188)Re-diethylenetriaminepentaacetic acid-2-deoxyglucose ((188)Re-DTPA-DG) and its imaging quality and therapeutic effect.

METHODS

Labeling of DTPA-DG with (188)Re was performed in the presence of stannous ion and sodium D-gluconate at a pH of 5.5 with 3 hours of incubation at 37 degrees C. The radiolabeling yields of (188)Re-DTPA-DG were determined by paper chromatography with a solution of acetone and saline (0.9% NaCl) as a developing agent. The imaging quality of (188)Re-DTPA-DG was determined by injecting 0.1 mL of a preparation having a radioactivity of 92.5GBq/L into the tail vein of nude mice bearing MCF-7 mammary tumors and imaging the tumors at 2, 4, 8, 12, and 24 hours after injection of the radiolabeled agent. Tumor volume was recorded every 2 or 3 days for 21 days.

RESULTS

The radiochemical purity of the (188)Re-DTPA-DG complex was 95.0%. In the imaging study, the tumor-to-nontumor-tissue ratios (T/NT) of radioactivity at 12 and 24 hours after intravenous injection of the radiolabeled agent were 5.9 and 7.8, respectively. The tumor volume in the (188)Re-DTPA-DG-treated group of mice increased more slowly than that in the control group, and the two groups differed greatly in this measure at 21 days, with tumor volumes of 823.6 +/- 50.58 mm(3) and 1162.7 +/- 73.08 mm(3) in the (188)Re-DTPA-DG treated and control groups, respectively (p < 0.01).

CONCLUSIONS

(188)Re-DTPA-DG showed excellent tumor targeting and tumor-growth-suppressing effects, and holds promise as an internal agent for tumor radiotherapy.

Preparation and Biological Characterization of Isomeric 188Re(V) Oxocomplexes with Tetradentate S4 Ligands Derived from meso-Dimercaptosuccinic Acid for Labeling of Biomolecules

A new type of tetradentate S4 ligand has been synthesized by bridging two molecules of meso-2,3-dimercaptosuccinic acid for stable binding and easy conjugation of rhenium-188 to tumor targeting structures. The stereoisomeric tetrathiolato S4 ligands form very robust anionic five-coordinated oxorhenium(V) and oxotechnetium(V) complexes. Two routes for the preparation of the (188)Re(V) oxocomplexes with (iBu)2N(O)C-C(SH)C(SH)C(O)NH(CH2)3NH(CH2)3NHC(O)C(SH)C(SH)C(O)N(iBu)2 (ligand 1) and its hydrophilic crown ether derivative (ligand 2) were tested and optimized. Several isomers were separated by HPLC from the preparation solutions and characterized in vitro and in vivo. The identity of the species obtained was determined by comparison with the HPLC profiles of reference (185/187)Re analogues and (99/99m)Tc complexes which were characterized by ESI-MS. All of them were absolutely stable in rat and human plasma solutions. Challenge experiments with cysteine corroborated the high inertness of the isomers toward ligand exchange reactions. Various in vivo samples, taken off at different times from blood, intestine, and urine of rats, confirmed the high in vivo stability of the (188)Re-S4 complexes. Biodistribution studies using male Wistar rats were performed and exhibited a high uptake and fast clearance from the liver of the more lipophilic cis and trans isomers of complex I (log P(o/w) between 1.5 and 1.7), whereas the isomers of the hydrophilic complex II (log P(o/w) about -1.75) were rapidly excreted via the renal and the hepatobiliary pathway. The low level of activity in the stomach confirms good in vivo stability. Thus, these new (188)Re-S4 complexes fulfill the requirements for a stable and high specific activity labeling of biomolecules with rhenium-188.

Development of acetylated HDD kit for preparation of 188Re-HDD/lipiodol

A lipiodol solution of (188)Re-4-hexadecyl-2,2,9,9-tetramethyl-4,7-diaza-1,10-decanedithiol ((188)Re-HDD/lipiodol) is in clinical study for liver cancer therapy. However, formulation of it is difficult due to highly active and unstable sulfhydryl groups. We produced new kits using diacetylated HDD (AHDD), in which sulfhydryl groups are protected. We found that AHDD kit can replace HDD kit due to an increased stability for formulation, the better radiolabeling efficiency (78%) and the equivalent biodistribution pattern in mice.

Towards molecular imaging and treatment of disease with radionuclides: the role of inorganic chemistry

Molecular imaging and radiotherapy using radionuclides is a rapidly expanding field of medicine and medical research. This article highlights the development of the role of inorganic chemistry in designing and producing the radiopharmaceuticals on which this interdisciplinary science depends.

99mTc/188Re-labelled lipid nanocapsules as promising radiotracers for imaging and therapy: formulation and biodistribution

PURPOSE

This study focuses on a promising carrier system for imaging and therapeutic purposes using lipid nanocapsules. To assess their potential for clinical use, we labelled nanocapsules with (99m)Tc and (188)Re and analysed some kinetic biodistribution parameters after intravenous injection in rats.

METHODS

Lipophilic complexes [(99m)Tc/(188)Re(S(3)CPh)(2)(S(2)CPh)] ((99m)Tc/(188)Re-SSS) were encapsulated within the nanoparticles during their manufacture with quantitative yield and satisfactory radiochemical purity. Rats were injected intravenously with 3.7 MBq (99m)Tc/(188)Re-labelled nanocapsules and sacrificed at 5, 15 and 30 min and 1, 2, 4, 8, 12, 16, 20 and 24 h.

RESULTS

Dynamic scintigraphic acquisitions showed predominant hepatic uptake, and ex vivo counting indicated a long circulation time of labelled nanocapsules, with a half-life of 21+/-1 min for (99m)Tc and 22+/-2 min for (188)Re. Very weak urinary elimination was observed, indicating good stability of (99m)Tc and (188)Re labelling.

CONCLUSION

(99m)Tc/(188)Re-SSS nanocapsules can be obtained with high yield and satisfactory radiochemical purity. The biodistributions of (99m)Tc/(188)Re-labelled nanocapsules are close to those of classical PEG-coated particles and show good stability of (188)Re/(99m)Tc-SSS labelling.

Development of semi-automated system for preparation of (188)Re aqueous solutions of high and reproducible activity concentrations

A semi-automated system has been developed for elution and concentration of the (188)Re-eluate from 111 GBq (3 Ci) (188)W/(188)Re-generators to provide a dissolved beta-source of high (188)Re-activity per unit volume. The elution progress and concentration were precisely and continuously monitored by use of collimated diode detectors. By using ion exchange cartridges, small eluate volumes (2-3 ml) of maximum 40 GBq, (188)Re/ml activity concentration were routinely prepared. The concentrated (188)Re solutions were used to beta-irradiate aqueous suspensions and solutions of iodine species to evaluate a simulation of the extent of radiolytic decomposition of chemical species (AgI and CH(3)I) expected to accumulate in the containment sump of a nuclear reactor in the event of a severe accident with reproducible dose rates of up to 0.4 Gys(-1). Results have shown that AgI colloidal particles decompose to varying extents, depending on conditions, and in proportion to their initial mass, which indicates surface oxidation. Experiments have also confirmed CH(3)I decomposition in proportion to initial aqueous concentration.

Mixed-ligand rhenium-188 complexes with tetradentate/monodentate NS3/P ('4 + 1') coordination: relation of structure with antioxidation stability

Development of new radiopharmaceuticals based on rhenium-188 depends on finding appropriate ligands able to give complexes with high in vivo stability. Rhenium(III) mixed-ligand complexes with tetradentate/monodentate ('4 + 1') coordination of the general formula [Re(NS(3))(PRR'R' ')] (NS(3) = tris(2-mercaptoethyl)amine and derivatives thereof, PRR'R' ' = phosphorus(III) ligands) appear to be among the promising tools to achieve this goal. According to this approach, we synthesized and characterized a series of rhenium model complexes. In vitro stabilities of the corresponding rhenium-188 complexes were determined by incubating 2-3 MBq or alternatively 37 MBq of the complexes in phosphate buffer, human plasma, and rat plasma, respectively, at 22 degrees C or 37 degrees C, followed by checking the amount of (188)ReO(4)(-) formed after 1 h, 24, and 48 h by thin-layer chromatography. The rate of perrhenate formation varied over a wide range, depending primarily on the nature of the phosphorus(III) ligand. Physicochemical parameters of the corresponding nonradioactive rhenium complexes were analyzed in detail to find out the factors influencing their different stability and furthermore to design new substitution-inert '4 + 1' complexes. Tolman's cone angle of phosphorus(III) ligands and the lipophilic character of the inner coordination sphere were found to be crucial factors to build up stable rhenium '4 + 1' complexes. Additional information useful to describe electronic and steric properties of these compounds were selected from electronic spectra (wavelength of the Re-->S charge-transfer band), cyclovoltammetric measurements (E degrees of the Re(III)/Re(IV) couple), and NMR investigations ((31)P chemical shift of coordinated P(III) ligands).