1
|
Oh SW, Suh M, Cheon GJ. Current Status of PSMA-Targeted Radioligand Therapy in the Era of Radiopharmaceutical Therapy Acquiring Marketing Authorization. Nucl Med Mol Imaging 2022; 56:263-281. [PMID: 36425273 PMCID: PMC9679068 DOI: 10.1007/s13139-022-00764-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 04/11/2022] [Accepted: 07/11/2022] [Indexed: 10/15/2022] Open
Abstract
Prostate-specific membrane antigen (PSMA) is highly expressed in PCa, which gradually increases in high-grade tumors, metastatic tumors, and tumors nonresponsive to androgen deprivation therapy. PSMA has been a topic of interest during the past decade for both diagnostic and therapeutic targets. Radioligand therapy (RLT) utilizes the delivery of radioactive nuclides to tumors and tumor-associated targets, and it has shown better efficacy with minimal toxicity compared to other systemic cancer therapies. Nuclear medicine has faced a new turning point claiming theranosis as the core of academic identity, since new RLTs have been introduced to clinics through the official new drug development processes for approval from the Food and Drug Administration (FDA) or European Medical Agency. Recently, PSMA targeting RLT was approved by the US FDA in March 2022. This review introduces PSMA RLT focusing on ongoing clinical trials to enhance our understanding of nuclear medicine theranosis and strive for the development of new radiopharmaceuticals.
Collapse
Affiliation(s)
- So Won Oh
- Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, 07061 Korea
| | - Minseok Suh
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, 03080 Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, 03080 Korea
| |
Collapse
|
2
|
Preliminary biological evaluation of rhenium-188-MAG3-PSMA. J Radioanal Nucl Chem 2022. [DOI: 10.1007/s10967-022-08306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
3
|
Rodnick ME, Sollert C, Stark D, Clark M, Katsifis A, Hockley BG, Parr DC, Frigell J, Henderson BD, Bruton L, Preshlock S, Abghari-Gerst M, Piert MR, Fulham MJ, Eberl S, Gagnon K, Scott PJH. Synthesis of 68Ga-radiopharmaceuticals using both generator-derived and cyclotron-produced 68Ga as exemplified by [ 68Ga]Ga-PSMA-11 for prostate cancer PET imaging. Nat Protoc 2022; 17:980-1003. [PMID: 35246649 DOI: 10.1038/s41596-021-00662-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 10/25/2021] [Indexed: 11/09/2022]
Abstract
[68Ga]Ga-PSMA-11, a urea-based peptidomimetic, is a diagnostic radiopharmaceutical for positron emission tomography (PET) imaging that targets the prostate-specific membrane antigen (PSMA). The recent Food and Drug Administration approval of [68Ga]Ga-PSMA-11 for PET imaging of patients with prostate cancer, expected follow-up approval of companion radiotherapeutics (e.g., [177Lu]Lu-PSMA-617, [225Ac]Ac-PSMA-617) and large prostate cancer patient volumes requiring access are poised to create an unprecedented demand for [68Ga]Ga-PSMA-11 in nuclear medicine clinics around the world. Meeting this global demand is going to require a variety of synthesis methods compatible with 68Ga eluted from a generator or produced on a cyclotron. To address this urgent need in the PET radiochemistry community, herein we report detailed protocols for the synthesis of [68Ga]Ga-PSMA-11, (also known as HBED-CC, Glu-urea-Lys(Ahx)-HBED-CC and PSMA-HBED-CC) using both generator-eluted and cyclotron-produced 68Ga and contrast the pros and cons of each method. The radiosyntheses are automated and have been validated for human use at two sites (University of Michigan (UM), United States; Royal Prince Alfred Hospital (RPA), Australia) and used to produce [68Ga]Ga-PSMA-11 for patient use in good activity yields (single generator, 0.52 GBq (14 mCi); dual generators, 1.04-1.57 GBq (28-42 mCi); cyclotron method (single target), 1.47-1.89 GBq (40-51 mCi); cyclotron method (dual target), 3.63 GBq (98 mCi)) and high radiochemical purity (99%) (UM, n = 645; RPA, n > 600). Both methods are appropriate for clinical production but, in the long term, the method employing cyclotron-produced 68Ga is the most promising for meeting high patient volumes. Quality control testing (visual inspection, pH, radiochemical purity and identity, radionuclidic purity and identity, sterile filter integrity, bacterial endotoxin content, sterility, stability) confirmed doses are suitable for clinical use, and there is no difference in clinical prostate cancer PET imaging using [68Ga]Ga-PSMA-11 prepared using the two production methods.
Collapse
Affiliation(s)
- Melissa E Rodnick
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | | | - Daniela Stark
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Mara Clark
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | - Andrew Katsifis
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Brian G Hockley
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | | | - Jens Frigell
- GE Healthcare, GEMS PET Systems, Uppsala, Sweden
| | - Bradford D Henderson
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | - Laura Bruton
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | - Sean Preshlock
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | - Monica Abghari-Gerst
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | - Morand R Piert
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA
| | - Michael J Fulham
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia.,Faculty of Engineering School of Computer Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Stefan Eberl
- Department of Molecular Imaging, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia. .,Faculty of Engineering School of Computer Science, The University of Sydney, Sydney, New South Wales, Australia.
| | | | - Peter J H Scott
- University of Michigan, Department of Radiology, Division of Nuclear Medicine, Ann Arbor, MI, USA.
| |
Collapse
|
4
|
Privé BM, Derks YHW, Rosar F, Franssen GM, Peters SMB, Khreish F, Bartholomä M, Maus S, Gotthardt M, Laverman P, Konijnenberg MW, Ezziddin S, Nagarajah J, Heskamp S. 89Zr-labeled PSMA ligands for pharmacokinetic PET imaging and dosimetry of PSMA-617 and PSMA-I&T: a preclinical evaluation and first in man. Eur J Nucl Med Mol Imaging 2021; 49:2064-2076. [PMID: 34932154 DOI: 10.1007/s00259-021-05661-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/12/2021] [Indexed: 01/04/2023]
Abstract
RATIONALE Prolonged in vivo evaluation of PSMA tracers could improve tumor imaging and patient selection for 177Lu-PSMA-617 and 177Lu-PSMA-I&T. In this study, we present the radiolabeling method of PSMA-617 and PSMA-I&T with the long-lived positron emitter 89Zr to enable PET imaging up to 7 days post-injection. We compared the biodistribution of 89Zr-PSMA-617 and 89Zr-PSMA-I&T to those of 177Lu-PSMA-617 and 177Lu-PSMA-I&T, respectively, in a PSMA+ xenograft model. Moreover, we provide the first human 89Zr-PSMA-617 images. MATERIALS AND METHODS PSMA ligands were labeled with 50-55 MBq [89Zr]ZrCl4 using a two-step labeling protocol. For biodistribution, BALB/c nude mice bearing PSMA+ and PSMA- xenografts received 0.6 µg (0.6-1 MBq) of 89Zr-PSMA-617, 89Zr-PSMA-I&T, 177Lu-PSMA-617, or 177Lu-PSMA-I&T intravenously. Ex vivo biodistribution and PET/SPECT imaging were performed up to 168 h post-injection. Dosimetry was performed from the biodistribution data. The patient received 90.5 MBq 89Zr-PSMA-617 followed by PET/CT imaging. RESULTS 89Zr-labeled PSMA ligands showed a comparable ex vivo biodistribution to its respective 177Lu-labeled counterparts with high tumor accumulation in the PSMA+ xenografts. However, using a dose estimation model for 177Lu, absorbed radiation dose in bone and kidneys differed among the 177Lu-PSMA and 89Zr-PSMA tracers. 89Zr-PSMA-617 PET in the first human patient showed high contrast of PSMA expressing tissues up to 48 h post-injection. CONCLUSION PSMA-617 and PSMA-I&T were successfully labeled with 89Zr and demonstrated high uptake in PSMA+ xenografts, which enabled PET up to 168 h post-injection. The biodistribution of 89Zr-PSMA-I&T and 89Zr-PSMA-617 resembled that of 177Lu-PSMA-I&T and 177Lu-PSMA-617, respectively. The first patient 89Zr-PSMA-617 PET images were of high quality warranting further clinical investigation.
Collapse
Affiliation(s)
- Bastiaan M Privé
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands.
| | - Yvonne H W Derks
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Florian Rosar
- Department of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany
| | - Gerben M Franssen
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Steffie M B Peters
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Fadi Khreish
- Department of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany
| | - Mark Bartholomä
- Department of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany
| | - Stephan Maus
- Department of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany
| | - Martin Gotthardt
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Peter Laverman
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Mark W Konijnenberg
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Samer Ezziddin
- Department of Nuclear Medicine, Saarland University Medical Center, Homburg, Germany
| | - James Nagarajah
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| | - Sandra Heskamp
- Department of Medical Imaging, Nuclear Medicine, Radboud University Medical Center, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
| |
Collapse
|
5
|
Byun BH, Kim MH, Han YH, Jeong HJ. KSNM60 in Non-thyroidal Radionuclide Therapy: Leaping into the Future. Nucl Med Mol Imaging 2021; 55:203-209. [PMID: 34721713 DOI: 10.1007/s13139-021-00703-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 05/02/2021] [Accepted: 05/31/2021] [Indexed: 11/28/2022] Open
Abstract
This year, the Korean Society of Nuclear Medicine (KSNM) is celebrating its 60th anniversary. Treatment, as well as diagnosis, has played a very important role in the development of nuclear medicine. Since I-131 was used for thyroid therapy in 1959, other radionuclide therapy is still being used, and attempts to use new radionuclide are increasing. In this review, we briefly summarize and introduce the therapies such as radioimmunotherapy, transarterial radioembolization, radionuclide therapy for neuroendocrine tumors, peptide receptor radionuclide therapy, control of metastatic bone pain, radiation synovectomy, radionuclide brachytherapy, alpha particle therapy, and boron neutron capture therapy, which has been being attempted so far in the field of nuclear medicine.
Collapse
Affiliation(s)
- Byung Hyun Byun
- Department of Nuclear Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences (KIRAMS), Seoul, South Korea
| | - Myoung Hyoun Kim
- Department of Nuclear Medicine, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Jeollabuk-do South Korea
| | - Yeon-Hee Han
- Department of Nuclear Medicine, Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, 20, Geonji-ro, Duckjin-gu, Jeonju-si, Jeollabuk-do 561-803 South Korea
| | - Hwan-Jeong Jeong
- Department of Nuclear Medicine, Research Institute of Clinical Medicine of Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, 20, Geonji-ro, Duckjin-gu, Jeonju-si, Jeollabuk-do 561-803 South Korea
| |
Collapse
|
6
|
Mirzaei S, Lipp R, Zandieh S, Leisser A. Single-Center Comparison of [ 64Cu]-DOTAGA-PSMA and [ 18F]-PSMA PET-CT for Imaging Prostate Cancer. Curr Oncol 2021; 28:4167-4173. [PMID: 34677271 PMCID: PMC8534892 DOI: 10.3390/curroncol28050353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 10/04/2021] [Accepted: 10/13/2021] [Indexed: 11/16/2022] Open
Abstract
Introduction: the diagnostic performance of [64Cu]-DOTAGA-PSMA PET–CT imaging was compared retrospectively to [18F]-PSMA PET–CT in prostate cancer patients with recurrent disease and in the primary staging of selected patients with advanced local and possible metastatic disease. Methods: We retrospectively selected a total of 100 patients, who were consecutively examined in our department, with biochemical recurrence after radical prostatectomy or who had progressive local and possible metastatic disease in the last 3 months prior to this investigation. All patients were examined with a dedicated PET–CT scanner (Biograph; Siemens Healthineers). A total of 250 MBq (3.5 MBq per kg bodyweight, range 230–290 MBq) of [64Cu]-DOTAGA-PSMA or [18-F]-PSMA was applied intravenously. PET images were performed 1 h post-injection (skull base to mid-thigh). The maximum standardized uptake values (SUVmax) of PSMA-positive lesions and the mean standardized uptake value (SUVmean) of the right liver lobe were measured. Results: All but 9/50 of the patients (18%; PSA range: 0.01–0.7 µg/L) studied with [64Cu]-DOTAGA-PSMA and 6/50 of the ones (12%; PSA range: 0.01–4.2) studied with [18F]-PSMA had at least one positive PSMA lesion shown by PET–CT. The total number of lesions was higher with [64Cu]-DOTAGA-PSMA (209 vs. 191); however, the median number of lesions was one for [64Cu]-DOTAGA-PSMA and two for [18F]-PSMA. Interestingly, the median SUVmean of the right liver lobe was slightly higher for [18F]-PSMA (11.8 vs. 8.9). Conclusions: [64Cu]-DOTAGA-PSMA and [18F]-PSMA have comparable detection rates for the assessment of residual disease in patients with recurrent or primary progressive prostate cancer. The uptake in the liver is moderately different, and therefore at least the SUVs of the lesions in both studies would not be comparable.
Collapse
Affiliation(s)
- Siroos Mirzaei
- Department of Nuclear Medicine with PET-Center, Clinic Ottakring (Wilhelminenspital), 1160 Vienna, Austria;
- Correspondence:
| | - Rainer Lipp
- Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria;
| | - Shahin Zandieh
- Department of Radiology and Nuclear Medicine, Hanusch Hospital, 1160 Vienna, Austria;
| | - Asha Leisser
- Department of Nuclear Medicine with PET-Center, Clinic Ottakring (Wilhelminenspital), 1160 Vienna, Austria;
| |
Collapse
|
7
|
Shahrokhi P, Masteri Farahani A, Tamaddondar M, Rezazadeh F. The utility of radiolabeled PSMA ligands for tumor imaging. Chem Biol Drug Des 2021; 99:136-161. [PMID: 34472217 DOI: 10.1111/cbdd.13946] [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: 06/02/2021] [Revised: 08/06/2021] [Accepted: 08/16/2021] [Indexed: 01/19/2023]
Abstract
Prostate-specific membrane antigen (PSMA) is a glycosylated type-II transmembrane protein expressed in prostatic tissue and significantly overexpressed in several prostate cancer cells. Despite its name, PSMA has also been reported to be overexpressed in endothelial cells of benign and malignant non-prostate disease. So its clinical use was extended to detection, staging, and therapy of various tumor types. Recently small molecules targeting PSMA have been developed as imaging probes for diagnosis of several malignancies. Preliminary studies are emerging improved diagnostic sensitivity and specificity of PSMA imaging, leading to a change in patient management. In this review, we evaluated the first preclinical and clinical studies on PSMA ligands resulting future perspectives radiolabeled PSMA in staging and molecular characterization, based on histopathologic examinations of PSMA expression.
Collapse
Affiliation(s)
- Pejman Shahrokhi
- Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Arezou Masteri Farahani
- Nuclear Medicine Center, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Mohammad Tamaddondar
- Nephrology Department, Payambar Azam Hospital, Hormozgan University of Medical Sciences, Bandar Abbas, Hormozgan, Iran
| | - Farzaneh Rezazadeh
- Department of Radiopharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
8
|
Alghazo O, Eapen R, Koschel S, Cumberbatch M, Buteau J, Loh R, Lawrentschuk N, Murphy DG. The application of theranostics in different stages of prostate cancer. Future Oncol 2021; 17:3637-3644. [PMID: 34227404 DOI: 10.2217/fon-2020-1209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Despite the remarkable achievements in treating metastatic prostate cancer over the last two decades, castrate-resistant status is still considered the lethal stage of the disease. Theranostics combines a targeting compound (ligand) with a therapeutic radioisotope (radioactive particle) injected into the blood to target the cancer cells. The most studied radioligand is 177Lu-PSMA-617, which targets PSMA, a protein found in prostate cancer cells. This new approach has shown promising results in treating metastatic castration-resistant prostate cancer. Currently, many trials are using PSMA-targeting radioligands in combination with conventional therapies in advanced prostate cancer or even in the earlier stages of the disease. Other preclinical trials are exploring the possibility of using newer ligands or radioisotopes to treat prostate cancer to increase the specificity and efficacy of this treatment.
Collapse
Affiliation(s)
- Omar Alghazo
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Prostate Cancer Theranostics & Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia.,Urology Division, Clinical Sciences Department, Yarmouk University, Irbid 21163, Jordan
| | - Renu Eapen
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Prostate Cancer Theranostics & Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia
| | - Samantha Koschel
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne 3000, Australia
| | - Marcus Cumberbatch
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Department of Academic Urology, University of Sheffield, Sheffield, UK
| | - James Buteau
- Prostate Cancer Theranostics & Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Molecular Imaging & Nuclear Medicine Therapeutics, Peter MacCallum Cancer Centre, Melbourne 3000, Australia
| | - Rebecca Loh
- Prostate Cancer Theranostics & Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne 3000, Australia
| | - Nathan Lawrentschuk
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Prostate Cancer Theranostics & Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Department of Urology, Royal Melbourne Hospital, Melbourne 3052, Australia.,E J Whitten Prostate Cancer Research Centre, Epworth Healthcare, Victoria 3121, Australia
| | - Declan G Murphy
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,Prostate Cancer Theranostics & Imaging Centre of Excellence, Peter MacCallum Cancer Centre, Melbourne 3000, Australia.,The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne 3000, Australia
| |
Collapse
|