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Salvarese N, Morellato N, Gobbi C, Gandin V, De Franco M, Marzano C, Dolmella A, Bolzati C. Synthesis, characterization and in vitro cytotoxicity of gallium(III)-dithiocarbamate complexes. Dalton Trans 2024; 53:4526-4543. [PMID: 38348686 DOI: 10.1039/d3dt03552b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2024]
Abstract
A library of homoleptic mononuclear Ga(III) complexes of the general formula [Ga(DTC)3], where DTC is an alicyclic or a linear dithiocarbamate chelator, is reported. The complexes were prepared in high yields starting from Ga(NO3)3·6H2O and fully characterized by elemental analysis and IR and NMR spectroscopy. Crystals of five of these complexes were obtained. The antitumor activity of the newly synthesized compounds against a panel of human cancer cell lines was evaluated. The chemical nature of the DTC does not have a marked impact on the structural features of the final compound. X-ray crystal structure analyses revealed that all these complexes have a trigonal prismatic geometry with three identical chelating DTCs coordinating the Ga(III) ion. It is noteworthy that in complex 22, [Ga(NHEt)3] (NHEt = N-ethyldithiocarbamate), the asymmetric unit is formed by two independent and structurally different molecules. Cellular studies showed that all the synthesized Ga-DTC complexes exhibit marked cytotoxic activity, even against human colon cancer cells that are less sensitive to cisplatin. Among the tested compounds, 6 ([Ga(CEPipDTC)3], CEPipDTC = (ethoxycarbonyl)-piperidinedithiocarbamate) and 21 ([Ga(Pr-13)3], PR13 = 4 and N-(2-ethoxy-2-oxoethyl)-N-methyldithiocarbamate) are very promising derivatives, but they have no selectivity towards cancer cells. Nevertheless, the obtained data provide a foundation for developing gallium-dithiocarbamate complexes as anticancer agents.
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Affiliation(s)
- Nicola Salvarese
- Consiglio Nazionale delle Ricerche - Istituto di Chimica della Materia Condensata e di Tecnologie per l'Energia (CNR-ICMATE), Corso Stati Uniti 4, 35127 Padua, Italy.
| | - Nicolò Morellato
- Dipartimento di Scienze del Farmaco, Università degli Studi di Padova, Via F. Marzolo 5, 35131 Padua, Italy
| | - Carolina Gobbi
- Consiglio Nazionale delle Ricerche - Istituto di Chimica della Materia Condensata e di Tecnologie per l'Energia (CNR-ICMATE), Corso Stati Uniti 4, 35127 Padua, Italy.
| | - Valentina Gandin
- Dipartimento di Scienze del Farmaco, Università degli Studi di Padova, Via F. Marzolo 5, 35131 Padua, Italy
| | - Michele De Franco
- Dipartimento di Scienze del Farmaco, Università degli Studi di Padova, Via F. Marzolo 5, 35131 Padua, Italy
| | - Cristina Marzano
- Dipartimento di Scienze del Farmaco, Università degli Studi di Padova, Via F. Marzolo 5, 35131 Padua, Italy
| | - Alessandro Dolmella
- Dipartimento di Scienze del Farmaco, Università degli Studi di Padova, Via F. Marzolo 5, 35131 Padua, Italy
| | - Cristina Bolzati
- Consiglio Nazionale delle Ricerche - Istituto di Chimica della Materia Condensata e di Tecnologie per l'Energia (CNR-ICMATE), Corso Stati Uniti 4, 35127 Padua, Italy.
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Kumar N, Gupta P, Shamim SA, Chirayil V, Subramanian S, Mallia MB, Bal C. 188 Re-N-DEDC Lipiodol for Treatment of Hepatocellular Carcinoma (HCC)-A Clinical and Prospective Study to Assess In-Vivo Distribution in Patients and Clinical Feasibility of Therapy. World J Nucl Med 2023; 22:114-123. [PMID: 37223628 PMCID: PMC10202571 DOI: 10.1055/s-0043-1764306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023] Open
Abstract
Objective The incidence of inoperable hepatocellular carcinoma (HCC) with/without malignant portal vein thrombosis (PVT) is increasing in India for the last decade; thus, Bhabha Atomic Research Centre (BARC), Mumbai, India, developed diethydithiocarbamate (DEDC), a new transarterial radionuclide therapy (TART) agent. 188 Re-N-DEDC lipiodol is an emerging radiotherapeutic agent for inoperable HCC treatment due to its simple and onsite labeling procedure, cost-effectiveness, and least radiation-induced side effects. This study aimed to evaluate in-vivo biodistribution and clinical feasibility of 188 Re-N-DEDC lipiodol TART in HCC and optimization of labeling procedure to assess post-labeling stability and radiochemical yield of labeled lipiodol with 188 Re-N-DEDC complex. Materials and Methods DEDC kits were obtained as gift from BARC, Mumbai. Therapy was given to 31 HCC patients. Post-therapy planar and single-photon emission computed tomography/computed tomography (SPECT/CT) imaging were performed to see tumor uptake and biodistribution. Clinical feasibility and toxicity were decided by Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v 5.0). Statistical Analysis Descriptive statistics was done for data using SPSS v22. Values was expressed as mean ± standard deviation or median with range. Results Post-therapy planar and SPECT/CT imaging showed radiotracer localization in hepatic lesions. Few patients showed lungs uptake due to hepato-pulmonary shunt (lung shunt < 10%). Maximum clearance was observed through urinary tract with very less elimination through hepatobiliary route due to slow rate of leaching of tracer. No patient showed myelosuppression or any other long-term toxicity over median follow-up of 6 months. Mean overall % radiochemical yield of 188 Re-N-DEDC lipiodol was 86.04 ± 2.35%. The complex 188 Re-N-DEDC was found to be stable at 37°C under sterile condition over a period of 1 hour without any significant change on the % radiochemical purity (90.83 ± 3.24%, 89.78 ± 3.67%, 89.22 ± 3.77% at 0, 0.5, 1 hours, respectively). Conclusion Human biodistribution showed very high retention of radiotracer in hepatic lesions with no long-term toxicity with this therapy. The kit preparation procedure is ideally suited for a busy hospital radio-pharmacy. By this procedure, 188 Re-N-DEDC lipiodol can be prepared in high radiochemical yield within a short time (∼45 minutes). Thus, 188 Re-N-DEDC lipiodol can be considered for TART in advanced and/or intermediate HCC.
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Affiliation(s)
- Naresh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Priyanka Gupta
- Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shamim Ahmed Shamim
- Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Viju Chirayil
- Bhabha Atomic Research Centre, Mumbai, Maharashtra, India
| | | | | | - Chandrasekhar Bal
- Department of Nuclear Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Garin E, Palard X, Rolland Y, Le Sourd S, Lepareur N, Ardisson V, Bouvry C, Laffont S, Campillo-Gimenez B, Bellissant E, Edeline J. 188Re-SSS Lipiodol Radioembolization in HCC Patients: Results of a Phase 1 Trial (Lip-Re-01 Study). Cancers (Basel) 2023; 15:cancers15082245. [PMID: 37190173 DOI: 10.3390/cancers15082245] [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: 02/20/2023] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Despite the wide development of 90Y-loaded microspheres, 188Re-labeled lipiodol is still being used for radioembolization of hepatocellular carcinoma (HCC). However, the use of this latter compound is limited by in vivo instability. This study sought to evaluate the safety, bio-distribution, and response to 188Re-SSS lipiodol, a new and more stable compound. METHOD Lip-Re-01 was an activity-escalation Phase 1 study involving HCC patients progressing after sorafenib. The primary endpoint was safety based on Common Terminology Criteria for Adverse Events (AEs) of Grade ≥3 within 2 months. Secondary endpoints included bio-distribution assessed by scintigraphy quantification from 1 to 72 h, tumor to non-tumor uptake ratio (T/NT), as well as blood, urine and feces collection over 72 h, dosimetry, and response evaluation (mRECIST). RESULTS Overall, 14 heavily pre-treated HCC patients were treated using a whole liver approach. The mean injected activity was 1.5 ± 0.4 GBq for activity Level 1 (n = 6), 3.6 ± 0.3 GBq for Level 2 (n = 6), and 5.0 ± 0.4 GBq for Level 3 (n = 2). Safety was acceptable with only 1/6 of Level 1 and 1/6 of Level 2 patients experiencing limiting toxicity (one liver failure; one lung disease). The study was prematurely discontinued unrelated to clinical outcomes. Uptake occurred in the tumor, liver, and lungs, and only sometimes in the bladder. The T/NT ratio was high with a mean of 24.9 ± 23.4. Cumulative urinary elimination and fecal eliminations at 72 h were very low, 4.8 ± 3.2% and 0.7 ± 0.8%, respectively. Partial response occurred in 21% of patients (0% in the first activity level; 37.5% in the others). CONCLUSION The high in vivo stability of 188Re-SSS lipiodol was confirmed, resulting in encouraging responses for a Phase 1 study. As the 3.6 GBq activity proved to be safe, it will be used in a future Phase 2 study.
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Affiliation(s)
- Etienne Garin
- Department of Nuclear Medicine, Cancer Institute Eugène Marquis, F-35042 Rennes, France
- Campus Santé, University of Rennes, F-35042 Rennes, France
- INSERM, INRAE, Nutrition Métabolismes et Cancer U1317, University of Rennes, F-35033 Rennes, France
| | - Xavier Palard
- Department of Nuclear Medicine, Cancer Institute Eugène Marquis, F-35042 Rennes, France
- Campus Santé, University of Rennes, F-35042 Rennes, France
- CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, University of Rennes, F-35000 Rennes, France
| | - Yan Rolland
- CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, University of Rennes, F-35000 Rennes, France
- Department of Radiology, Cancer Institute Eugène Marquis, F-35042 Rennes, France
| | - Samuel Le Sourd
- Department of Medical Oncology, Cancer Institute Eugène Marquis, F-35042 Rennes, France
| | - Nicolas Lepareur
- Department of Nuclear Medicine, Cancer Institute Eugène Marquis, F-35042 Rennes, France
- INSERM, INRAE, Nutrition Métabolismes et Cancer U1317, University of Rennes, F-35033 Rennes, France
| | - Valérie Ardisson
- Department of Nuclear Medicine, Cancer Institute Eugène Marquis, F-35042 Rennes, France
| | - Christelle Bouvry
- Department of Nuclear Medicine, Cancer Institute Eugène Marquis, F-35042 Rennes, France
| | - Sophie Laffont
- Department of Nuclear Medicine, Cancer Institute Eugène Marquis, F-35042 Rennes, France
| | - Boris Campillo-Gimenez
- CLCC Eugène Marquis, Inserm, LTSI-UMR 1099, University of Rennes, F-35000 Rennes, France
- Department of Clinical Research, Cancer Institute Eugène Marquis, F-35042 Rennes, France
| | - Eric Bellissant
- Campus Santé, University of Rennes, F-35042 Rennes, France
- INSERM CIC 1414 (Clinical Investigation Center), F-35033 Rennes, France
- Department of Clinical and Biological Pharmacology and Pharmacovigilance, Pharmaco-Epidemiology and Drug Information Center, Rennes University Hospital, F-35033 Rennes, France
| | - Julien Edeline
- Campus Santé, University of Rennes, F-35042 Rennes, France
- Department of Medical Oncology, Cancer Institute Eugène Marquis, F-35042 Rennes, France
- INSERM, COSS (Chemistry Oncogenesis Stress Signaling)-UMR_S 1242, University of Rennes, F-35042 Rennes, France
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Fundamentals of Rhenium-188 Radiopharmaceutical Chemistry. Molecules 2023; 28:molecules28031487. [PMID: 36771153 PMCID: PMC9921938 DOI: 10.3390/molecules28031487] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 01/29/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
The β- emitter, rhenium-188 (188Re), has long been recognized as an attractive candidate for targeted cancer radionuclide therapy (TRNT). This transition metal shares chemical similarities with its congener element technetium, whose nuclear isomer technetium-99m (99mTc) is the current workhorse of diagnostic nuclear medicine. The differences between these two elements have a significant impact on the radiolabelling methods and should always receive critical attention. This review aims to highlight what needs to be considered to design a successful radiopharmaceutical incorporating 118Re. Some of the most effective strategies for preparing therapeutic radiopharmaceuticals with 188Re are illustrated and rationalized using the concept of the inorganic functional group (core) and a simple ligand field theoretical model combined with a qualitative definition of frontiers orbitals. Of special interest are the Re(V) oxo and Re(V) nitrido functional groups. Suitable ligands for binding to these cores are discussed, successful clinical applications are summarized, and a prediction of viable future applications is presented. Rhenium-188 decays through the emission of a high energy beta particle (2.12 MeV max energy) and a half-life of 16.9 h. An ideal biological target would therefore be a high-capacity target site (transporters, potential gradients, tumour microenvironment) with less emphasis on saturable targets such as overexpressed receptors on smaller metastases.
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Yang Z, Zhong H, Wu Y, Li S, Gong S, Cai Y, Jin J. Design and Preparation of Iodinated Brucea Javanica Oil as Dual Functional Anti-Tumor Agent for Treating Hepatocellular Carcinoma. Pharm Chem J 2022. [DOI: 10.1007/s11094-022-02717-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Uccelli L, Martini P, Urso L, Ghirardi T, Marvelli L, Cittanti C, Carnevale A, Giganti M, Bartolomei M, Boschi A. Rhenium Radioisotopes for Medicine, a Focus on Production and Applications. Molecules 2022; 27:5283. [PMID: 36014521 PMCID: PMC9412410 DOI: 10.3390/molecules27165283] [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: 07/22/2022] [Revised: 08/08/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022] Open
Abstract
In recent decades, the use of alpha; pure beta; or beta/gamma emitters in oncology, endocrinology, and interventional cardiology rheumatology, has proved to be an important alternative to the most common therapeutic regimens. Among radionuclides used for therapy in nuclear medicine, two rhenium radioisotopes are of particular relevance: rhenium-186 and rhenium-188. The first is routinely produced in nuclear reactors by direct neutron activation of rhenium-186 via 185Re(n,γ)186Re nuclear reaction. Rhenium-188 is produced by the decay of the parent tungsten-188. Separation of rhenium-188 is mainly performed using a chromatographic 188W/188Re generator in which tungsten-188 is adsorbed on the alumina column, similar to the 99Mo/99mTc generator system, and the radionuclide eluted in saline solution. The application of rhenium-186 and rhenium-188 depends on their specific activity. Rhenium-186 is produced in low specific activity and is mainly used for labeling particles or diphosphonates for bone pain palliation. Whereas, rhenium-188 of high specific activity can be used for labeling peptides or bioactive molecules. One of the advantages of rhenium is its chemical similarity with technetium. So, diagnostic technetium analogs labeled with radiorhenium can be developed for therapeutic applications. Clinical trials promoting the use of 186/188Re-radiopharmaceuticals is, in particular, are discussed.
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Affiliation(s)
- Licia Uccelli
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Nuclear Medicine Unit, University Hospital, 44124 Ferrara, Italy
| | - Petra Martini
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Luca Urso
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Nuclear Medicine Unit, University Hospital, 44124 Ferrara, Italy
| | - Teresa Ghirardi
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Lorenza Marvelli
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Corrado Cittanti
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Nuclear Medicine Unit, University Hospital, 44124 Ferrara, Italy
| | - Aldo Carnevale
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Radiology Unit, University Hospital, 44124 Ferrara, Italy
| | - Melchiore Giganti
- Department of Translational Medicine, University of Ferrara, 44121 Ferrara, Italy
- Radiology Unit, University Hospital, 44124 Ferrara, Italy
| | - Mirco Bartolomei
- Nuclear Medicine Unit, University Hospital, 44124 Ferrara, Italy
| | - Alessandra Boschi
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy
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Empirical 188Re-HDD/lipiodol intra-arterial therapy based on tumor volume, in patients with solitary inoperable hepatocellular carcinoma. Nucl Med Commun 2021; 42:43-50. [PMID: 32956248 DOI: 10.1097/mnm.0000000000001296] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to assess the potential benefits and tolerability of an empirical dose of approximately 0.8-1.2 mCi (29.6-44.4 MBq) of Re-4-hexadecyl-1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol/lipiodol (Re-HDD/lipiodol) per milliliter of tumor volume, administered after super-selection of the tumor feeding branches of hepatic artery for treatment of inoperable hepatocellular carcinoma (HCC). METHODS Patients with advanced HCC or classified as inoperable, with no demonstrated extrahepatic disease and no significant comorbidities were eligible. The patients selected for this study had a single tumoral lesion, measuring less than 150 cc. The range of total activity administered was between 30 and 100 mCi (1.2-3.7) GBq Re-HDD/lipiodol, administered in the super selected branches of the hepatic artery supplying the tumor in 42 Patients. Whole-body scintigraphies and single-photon emission computed tomography-computed tomography (SPECT-CT) of the liver including tumor were performed at four-time points after injection. Absorbed doses to the various organs were calculated according to the Medical Internal Radiation Dose formalism. Blood and urine samples were collected at multiple time points until 72 h after injection. Hematological, hepatic and pulmonary toxicity was assessed until 12 weeks after administration using the Common Toxicity Criteria for Adverse Events (version 3.0) scale. Responses were evaluated on contrast enhanced computed tomography (CECT) and by alfa-fetoprotein (AFP) level monitoring. RESULTS About 40.6 ± 4.8% of the injected activity was excreted in the urine by 72 h after injection. The mean absorbed dose to the liver, lungs, stomach, kidney and intestine was 14.4 ± 1.8, 4.8 ± 0.6, 5.5 ± 1.1, 5.1 ± 0.7, and 6.5 ± 1.0 Gy (mean ± SD), respectively. Up to 6 days after administration, 26 of 44 patients had adverse events consisting of aggravations of preexisting laboratory changes (24 patients), fatigue (5 patients), vomiting (6 patients), fever (2 patients), right hypochondrial pain (8 patients), and pain at site of femoral catheter insertion (8 patients). Toxicity assessment at weeks 6 and 12 revealed two cases of mild worsening of liver function tests and no lung or hematological toxicity noted. Two patients were lost to follow-up after the 6-week visit. The response was assessed on CECT in all the remaining patients and the classification of results was more standardized when using European Association for the Study of the Liver (EASL) criteria rather than response evaluation criteria in solid tumors (RECIST) criteria. According to EASL criteria, 8 patients had a partial response, 28 patients had a complete response, 4 patients had progressive disease and 4 patients with stable disease were reported. Thirty-six patients had a baseline elevated AFP and on follow-up at 6 weeks, 6 of these patients showed stable AFP, progression in 4 patients and 26 showed a reduction. CONCLUSION After the administration of 1.2-3.7 GBq Re-HDD/lipiodol based on empirical activity calculation of 0.8-1.2 mCi/mL of tumor volume, more than half of the patients in the present study had an objective response on imaging and biochemically. No significant adverse side effects were noted and most of the laboratory markers as well as symptoms returned to normal after 48-72 h post-administration. Selective administration of the radiopharmaceutical into the tumor feeding arteries gives a good anti-tumoral effect with minimal side effects and damage to surrounding normal liver tissue.
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Radhakrishnan ER, Chirayil V, Pandiyan A, Subramanian S, Mallia MB, Kamaleshwaran KK, Shinto A. Preparation of Rhenium-188-Lipiodol Using Freeze-Dried Kits for Transarterial Radioembolization: An Overview and Experience in a Hospital Radiopharmacy. Cancer Biother Radiopharm 2021; 37:63-70. [PMID: 34101501 DOI: 10.1089/cbr.2021.0043] [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: 11/12/2022] Open
Abstract
Background: Rhenium-188-lipiodol is a clinically effective, economically viable radiopharmaceutical for Selective Internal Radiation Therapy of liver cancer. Present study evaluates the performance of three freeze-dried kits with respect to the radiochemistry, quality control, and overall "ease of preparation" aspects in a hospital radiopharmacy. Materials and Methods: Freeze-dried kits of acetylated 4-hexadecyl-4,7-diaza-1,10-decanedithiol (AHDD), super six sulfur (SSS), and diethyl dithiocarbamate (DEDC), obtained commercially or received as gift, were used for the preparation of Rhenium-188-lipiodol using freshly eluted 188Re-sodium perrhenate from commercial Tungsten-188/Rhenium-188 generator following recommended procedures. Results: The overall yield of Rhenium-188-lipiodol prepared using AHDD Kit, SSS Kit, and DEDC Kit was 74.82% ± 3.3%, 87.55% ± 4.8%, and 76.38% ± 4.6%, respectively. Observed radiochemical purity (RCP) of Rhenium-188-lipiodol prepared using these kits was 88.65% ± 2.8%, 92.92% ± 3.0%, and 91.38% ± 3.0%, respectively. Using a modified version of the DEDC Kits, overall yield of 87.17% ± 2.7% and RCP of 95.43% ± 2.3% could be achieved. Conclusions: While all three freeze-dried kits can be used for the preparation of Rhenium-188-lipiodol in >70% overall yield, the modified version of DEDC Kits has some advantages in terms of preparation time and volume of Rhenium-188 activity that can be added to the kit vial. The latter feature of the DEDC Kit is particularly useful for patient dose preparation with Rhenium-188 activity of low radioactive concentration.
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Affiliation(s)
| | - Viju Chirayil
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Arun Pandiyan
- Kovai Medical Centre and Hospital, Coimbatore, India
| | - Suresh Subramanian
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Madhava B Mallia
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India.,Homi Bhabha National Institute, Mumbai, India
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Maryam M, Tan SL, Crouse KA, Mohamed Tahir MI, Chee HY. Synthesis, characterization and evaluation of antidengue activity of enantiomeric Schiff bases derived from S-substituted dithiocarbazate. Turk J Chem 2021; 44:1395-1409. [PMID: 33488239 PMCID: PMC7751940 DOI: 10.3906/kim-2006-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 08/05/2020] [Indexed: 11/03/2022] Open
Abstract
A series of Schiff bases have been successfully synthesized through the acid-catalyzed condensation of S-substituted dithiocarbazates and three enantiomerically pure monoterpenes, (1 R )-(+)-camphor, (1 S )-(-)-camphor, (1 R )-(-)-camphorquinone, (1 S )-(+)-camphorquinone, ( R )-(-)-carvone and ( S )-(+)-carvone. Spectroscopic results revealed that the Schiff bases containing camphor or carvone likely adopted an E -configuration along the characteristic imine bond while those containing camphorquinone assumed a Z -configuration. The antidengue potential of these compounds was evaluated based on DENV 2 caused cytopathic effect (CPE) reduction-based in vitro evaluation. The compounds were validated through secondary foci forming unit reduction assay (FFURA). Compounds were also tested for their cytotoxicity against Vero cells. The compounds showed variable degrees of antiviral activity with the camphor compounds displaying the highest antidengue potential. The enantiomers of the compounds behaved almost similarly during the antiviral evaluation.
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Affiliation(s)
- Maqsood Maryam
- Faculty of Natural Sciences, Sardar Bahadur Khan Women University, Balochistan, Quetta Pakistan.,Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, SerdangSelangor Malaysia
| | - Sang Loon Tan
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang, Selangor Malaysia
| | - Karen Ann Crouse
- Department of Chemistry, Faculty of Science, Universiti Putra Malaysia, Serdang, Selangor Malaysia
| | | | - Hui-Yee Chee
- Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, SerdangSelangor Malaysia
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Lepareur N, Lacœuille F, Bouvry C, Hindré F, Garcion E, Chérel M, Noiret N, Garin E, Knapp FFR. Rhenium-188 Labeled Radiopharmaceuticals: Current Clinical Applications in Oncology and Promising Perspectives. Front Med (Lausanne) 2019; 6:132. [PMID: 31259173 PMCID: PMC6587137 DOI: 10.3389/fmed.2019.00132] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 05/29/2019] [Indexed: 12/14/2022] Open
Abstract
Rhenium-188 (188Re) is a high energy beta-emitting radioisotope with a short 16.9 h physical half-life, which has been shown to be a very attractive candidate for use in therapeutic nuclear medicine. The high beta emission has an average energy of 784 keV and a maximum energy of 2.12 MeV, sufficient to penetrate and destroy targeted abnormal tissues. In addition, the low-abundant gamma emission of 155 keV (15%) is efficient for imaging and for dosimetric calculations. These key characteristics identify 188Re as an important therapeutic radioisotope for routine clinical use. Moreover, the highly reproducible on-demand availability of 188Re from the 188W/188Re generator system is an important feature and permits installation in hospital-based or central radiopharmacies for cost-effective availability of no-carrier-added (NCA) 188Re. Rhenium-188 and technetium-99 m exhibit similar chemical properties and represent a “theranostic pair.” Thus, preparation and targeting of 188Re agents for therapy is similar to imaging agents prepared with 99mTc, the most commonly used diagnostic radionuclide. Over the last three decades, radiopharmaceuticals based on 188Re-labeled small molecules, including peptides, antibodies, Lipiodol and particulates have been reported. The successful application of these 188Re-labeled therapeutic radiopharmaceuticals has been reported in multiple early phase clinical trials for the management of various primary tumors, bone metastasis, rheumatoid arthritis, and endocoronary interventions. This article reviews the use of 188Re-radiopharmaceuticals which have been investigated in patients for cancer treatment, demonstrating that 188Re represents a cost effective alternative for routine clinical use in comparison to more expensive and/or less readily available therapeutic radioisotopes.
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Affiliation(s)
- Nicolas Lepareur
- Comprehensive Cancer Center Eugène Marquis Rennes, France.,Univ Rennes Inra, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer)-UMR_A 1341, UMR_S 1241, Rennes, France
| | - Franck Lacœuille
- Angers University Hospital Angers, France.,Univ Angers Univ Nantes, Inserm, CNRS, CRCINA (Centre de Recherche en Cancérologie et Immunologie Nantes-Angers)-UMR 1232, ERL 6001, Nantes, France
| | - Christelle Bouvry
- Comprehensive Cancer Center Eugène Marquis Rennes, France.,Univ Rennes CNRS, ISCR (Institut des Sciences Chimiques de Rennes)-UMR 6226, Rennes, France
| | - François Hindré
- Univ Angers Univ Nantes, Inserm, CNRS, CRCINA (Centre de Recherche en Cancérologie et Immunologie Nantes-Angers)-UMR 1232, ERL 6001, Nantes, France.,Univ Angers PRIMEX (Plateforme de Radiobiologie et d'Imagerie EXperimentale), Angers, France
| | - Emmanuel Garcion
- Univ Angers Univ Nantes, Inserm, CNRS, CRCINA (Centre de Recherche en Cancérologie et Immunologie Nantes-Angers)-UMR 1232, ERL 6001, Nantes, France.,Univ Angers PRIMEX (Plateforme de Radiobiologie et d'Imagerie EXperimentale), Angers, France
| | - Michel Chérel
- Univ Angers Univ Nantes, Inserm, CNRS, CRCINA (Centre de Recherche en Cancérologie et Immunologie Nantes-Angers)-UMR 1232, ERL 6001, Nantes, France.,ICO (Institut de Cancérologie de l'Ouest) Comprehensive Cancer Center René Gauducheau, Saint-Herblain, France
| | - Nicolas Noiret
- Univ Rennes CNRS, ISCR (Institut des Sciences Chimiques de Rennes)-UMR 6226, Rennes, France.,ENSCR (Ecole Nationale Supérieure de Chimie de Rennes) Rennes, France
| | - Etienne Garin
- Comprehensive Cancer Center Eugène Marquis Rennes, France.,Univ Rennes Inra, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer)-UMR_A 1341, UMR_S 1241, Rennes, France
| | - F F Russ Knapp
- Emeritus Medical Radioisotopes Program, ORNL (Oak Ridge National Laboratory), Oak Ridge, TN, United States
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Preliminary results of the Phase 1 Lip-Re I clinical trial: biodistribution and dosimetry assessments in hepatocellular carcinoma patients treated with 188Re-SSS Lipiodol radioembolization. Eur J Nucl Med Mol Imaging 2019; 46:1506-1517. [PMID: 30715571 DOI: 10.1007/s00259-019-04277-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 01/20/2019] [Indexed: 10/27/2022]
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12
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Bouvry C, Palard X, Edeline J, Ardisson V, Loyer P, Garin E, Lepareur N. Transarterial Radioembolization (TARE) Agents beyond 90Y-Microspheres. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1435302. [PMID: 30687734 PMCID: PMC6330886 DOI: 10.1155/2018/1435302] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 12/19/2018] [Indexed: 12/14/2022]
Abstract
Liver malignancies, either primary tumours (mainly hepatocellular carcinoma and cholangiocarcinoma) or secondary hepatic metastases, are a major cause of death, with an increasing incidence. Among them, hepatocellular carcinoma (HCC) presents with a dark prognosis because of underlying liver diseases and an often late diagnosis. A curative surgical treatment can therefore only be proposed in 20 to 30% of the patients. However, new treatment options for intermediate to advanced stages, such as internal radionuclide therapy, seem particularly attractive. Transarterial radioembolization (TARE), which consists in the use of intra-arterial injection of a radiolabelled embolising agent, has led to very promising results. TARE with 90Y-loaded microspheres is now becoming an established procedure to treat liver tumours, with two commercially available products (namely, SIR-Sphere® and TheraSphere®). However, this technology remains expensive and is thus not available everywhere. The aim of this review is to describe TARE alternative technologies currently developed and investigated in clinical trials, with special emphasis on HCC.
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Affiliation(s)
- C. Bouvry
- Comprehensive Cancer Centre Eugène Marquis, 35042 Rennes, France
- Univ Rennes, CNRS, ISCR (Institut des Sciences Chimiques de Rennes), UMR 6226, 35000 Rennes, France
| | - X. Palard
- Comprehensive Cancer Centre Eugène Marquis, 35042 Rennes, France
- Univ Rennes, Inserm, LTSI (Laboratoire Traitement du Signal et de l'Image), UMR_S 1099, 35000 Rennes, France
| | - J. Edeline
- Comprehensive Cancer Centre Eugène Marquis, 35042 Rennes, France
- Univ Rennes, Inra, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer), UMR_A 1341, UMR_S 1241, 35000 Rennes, France
| | - V. Ardisson
- Comprehensive Cancer Centre Eugène Marquis, 35042 Rennes, France
| | - P. Loyer
- Univ Rennes, Inra, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer), UMR_A 1341, UMR_S 1241, 35000 Rennes, France
| | - E. Garin
- Comprehensive Cancer Centre Eugène Marquis, 35042 Rennes, France
- Univ Rennes, Inra, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer), UMR_A 1341, UMR_S 1241, 35000 Rennes, France
| | - N. Lepareur
- Comprehensive Cancer Centre Eugène Marquis, 35042 Rennes, France
- Univ Rennes, Inra, Inserm, Institut NUMECAN (Nutrition, Métabolismes et Cancer), UMR_A 1341, UMR_S 1241, 35000 Rennes, France
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Esquinas PL, Shinto A, Kamaleshwaran KK, Joseph J, Celler A. Biodistribution, pharmacokinetics, and organ-level dosimetry for 188Re-AHDD-Lipiodol radioembolization based on quantitative post-treatment SPECT/CT scans. EJNMMI Phys 2018; 5:30. [PMID: 30523435 PMCID: PMC6283804 DOI: 10.1186/s40658-018-0227-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 08/08/2018] [Indexed: 12/25/2022] Open
Abstract
Background Rhenium-188-labelled-Lipiodol radioembolization is a safe and cost-effective treatment for primary liver cancer. In order to determine correlations between treatment doses and patient response to therapy, accurate patient-specific dosimetry is required. Up to date, the reported dosimetry of 188Re-Lipiodol has been based on whole-body (WB) planar imaging only, which has limited quantitative accuracy. The aim of the present study is to determine the in vivo pharmacokinetics, bio-distribution, and organ-level dosimetry of 188Re-AHDD-Lipiodol radioembolization using a combination of post-treatment planar and quantitative SPECT/CT images. Furthermore, based on the analysis of the pharmacokinetic data, a practical and relatively simple imaging and dosimetry method that could be implemented in clinics for 188Re-AHDD-Lipiodol radioembolization is proposed. Thirteen patients with histologically proven hepatocellular carcinoma underwent 188Re-AHDD-Lipiodol radioembolization. A series of 2–3 WB planar images and one SPECT/CT scan were acquired over 48 h after the treatment. The time-integrated activity coefficients (TIACs, also known as residence-times) and absorbed doses of tumors and organs at risk (OARs) were determined using a hybrid WB/SPECT imaging method. Results Whole-body imaging showed that 188Re-AHDD-Lipiodol accumulated mostly in the tumor and liver tissue but a non-negligible amount of the pharmaceutical was also observed in the stomach, lungs, salivary glands, spleen, kidneys, and urinary bladder. On average, the measured effective half-life of 188Re-AHDD-Lipiodol was 12.5 ± 1.9 h in tumor. The effective half-life in the liver and lungs (the two organs at risk) was 12.6 ± 1.7 h and 12.0 ± 1.9 h, respectively. The presence of 188Re in other organs was probably due to the chemical separation and subsequent release of the free radionuclide from Lipiodol. The average doses per injected activity in the tumor, liver, and lungs were 23.5 ± 40.8 mGy/MBq, 2.12 ± 1.78 mGy/MBq, and 0.11 ± 0.05 mGy/MBq, respectively. The proposed imaging and dosimetry method, consisting of a single SPECT/CT for activity determination followed by 188Re-AHDD-Lipiodol clearance with the liver effective half-life of 12.6 h, resulted in TIACs estimates (and hence, doses) mostly within ± 20% from the reference TIACs (estimated using three WB images and one SPECT/CT). Conclusions The large inter-patient variability of the absorbed doses in tumors and normal tissue in 188Re-HDD-Lipiodol radioembolization patients emphasizes the importance of patient-specific dosimetry calculations based on quantitative post-treatment SPECT/CT imaging. Electronic supplementary material The online version of this article (10.1186/s40658-018-0227-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pedro L Esquinas
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada. .,Medical Imaging Research Group, Vancouver, British Columbia, Canada.
| | - Ajit Shinto
- Department of Nuclear Medicine, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | | | - Jephy Joseph
- Department of Nuclear Medicine, Kovai Medical Center and Hospital, Coimbatore, Tamil Nadu, India
| | - Anna Celler
- Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.,Medical Imaging Research Group, Vancouver, British Columbia, Canada
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14
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Mallia MB, Chirayil V, Dash A. Improved freeze-dried kit for the preparation of 188ReN-DEDC/lipiodol for the therapy of unresectable hepatocellular carcinoma. Appl Radiat Isot 2018; 137:147-153. [PMID: 29625347 DOI: 10.1016/j.apradiso.2018.03.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/24/2018] [Indexed: 02/02/2023]
Abstract
Rhenium-188-N-(DEDC)2/lipiodol (abbreviated as 188ReN-DEDC, where DEDC = monoanionic diethyldithiocarbamate) is a clinically proven radiopharmaceutical for the therapy of unresectable hepatocellular carcinoma (HCC) through trans arterial radioembolization (TARE). A two-vial freeze-dried kit for the preparation of [188ReN(DEDC)2] complex using sodium perrhenate (Na188ReO4) obtained from a commercial Tungsten-188/Rhenium-188 generator had been reported earlier. This method required addition of stipulated volume of glacial acetic acid into vial 1 by the user for efficient preparation of [188ReN]2+ intermediate. An error in this step can result in low radiochemical yield of [188ReN]2+ intermediate as well as sub-optimal pH of the reaction mixture for the second step, leading to poor radiochemical purity of 188ReN-DEDC complex. In the present work, a solution to this problem was found by including an oxalate buffer of pH = 3 in vial 1, eliminating the need for the addition of glacial acetic acid by the user. This modification not only made the kits more user-friendly, it resulted in significant improvement in the kinetics of formation of [188ReN]2+ intermediate, wherein > 95% radiochemical purity could be achieved within 5 min incubation at ambient temperature. Moreover, the novel route for the preparation of [188ReN]2+ intermediate may be applied to any radiopharmaceutical based on 188ReN-core.
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Affiliation(s)
- Madhava B Mallia
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085, India; Homi Bhabha National Institute, Anushakti Nagar, Mumbai 400094, India.
| | - Viju Chirayil
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai 400085, India
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Stelzner F, Knapp FF, Biersack HJ. Discovery of rhenium and masurium (technetium) by Ida Noddack-Tacke and Walter Noddack. Nuklearmedizin 2018; 54:N50-4. [DOI: 10.3413/nuk2015050001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 08/07/2015] [Indexed: 11/20/2022]
Abstract
SummaryThe history of the early identification of elements and their designation to the Mendeleev Table of the Elements was an important chapter in German science in which Ida (1896-1978) and Walter (1893-1960) Noddack played an important role in the first identification of rhenium (element 75, 1925) and technetium (element 43, 1933). In 1934 Ida Noddack was also the first to predict fission of uranium into smaller atoms. Although the Noddacks did not for some time later receive the recognition for the first identification of technetium-99m, their efforts have appropriately more recently been recognized. The discoveries of these early pioneers are even more astounding in light of the limited technologies and resources which were available during this period. The Noddack discoveries of elements 43 and 75 are related to the sub sequent use of rhenium-188 (beta/ gamma emitter) and technetium-99m (gamma emitter) in nuclear medicine. In particular, the theranostic relationship between these two generator-derived radioisotopes has been demonstrated and offers new opportunities in the current era of personalized medicine.
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Boschi A, Martini P, Uccelli L. 188Re(V) Nitrido Radiopharmaceuticals for Radionuclide Therapy. Pharmaceuticals (Basel) 2017; 10:ph10010012. [PMID: 28106830 PMCID: PMC5374416 DOI: 10.3390/ph10010012] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/09/2017] [Accepted: 01/16/2017] [Indexed: 11/27/2022] Open
Abstract
The favorable nuclear properties of rhenium-188 for therapeutic application are described, together with new methods for the preparation of high yield and stable 188Re radiopharmaceuticals characterized by the presence of the nitride rhenium core in their final chemical structure. 188Re is readily available from an 188W/188Re generator system and a parallelism between the general synthetic procedures applied for the preparation of nitride technetium-99m and rhenium-188 theranostics radiopharmaceuticals is reported. Although some differences between the chemical characteristics of the two metallic nitrido fragments are highlighted, it is apparent that the same general procedures developed for the labelling of biologically active molecules with technetium-99m can be applied to rhenium-188 with minor modification. The availability of these chemical strategies, that allow the obtainment, in very high yield and in physiological condition, of 188Re radiopharmaceuticals, gives a new attractive prospective to employ this radionuclide for therapeutic applications.
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Affiliation(s)
- Alessandra Boschi
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara 44121, Italy.
| | - Petra Martini
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara 44121, Italy.
- Italy and Legnaro National Laboratories, Italian National Institute for Nuclear Physics (LNL-INFN), Legnaro (PD) 35020, Italy.
| | - Licia Uccelli
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara 44121, Italy.
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17
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Lopez A, Noiret N, Garin E, Lepareur N. Mixed-ligand complexes of yttrium-90 dialkyldithiocarbamates with 1,10-phenanthroline as a possible agent for therapy of hepatocellular carcinoma. Appl Radiat Isot 2014; 94:241-246. [PMID: 25238135 DOI: 10.1016/j.apradiso.2014.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Revised: 08/16/2014] [Accepted: 08/26/2014] [Indexed: 11/28/2022]
Abstract
Yttrium-90 is a radioelement which has found wide use in targeted radionuclide therapy because of its attractive physical and chemical properties. Radioembolisation of hepatocellular carcinoma with radiolabelled Lipiodol is a method of choice. We have synthesised a series of alkyldithiocarbamate yttrium complexes, easily extracted into Lipiodol due to their high lipophilicity. Among the prepared series, a new radioconjugate, which is stable over an extended period of time, has been prepared, and could represent a potential treatment procedure for hepatocellular carcinoma.
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Affiliation(s)
- A Lopez
- Centre Eugène Marquis, INSERM UMR-S 991, Avenue de la Bataille Flandres-Dunkerque, CS 44229, F-35042 Rennes, France; ENSCR, CNRS UMR 6226, 11, Allée de Beaulieu, CS 50837, F-35708 Rennes, France
| | - N Noiret
- ENSCR, CNRS UMR 6226, 11, Allée de Beaulieu, CS 50837, F-35708 Rennes, France; Université Européenne de Bretagne, F-35000 Rennes, France
| | - E Garin
- Centre Eugène Marquis, INSERM UMR-S 991, Avenue de la Bataille Flandres-Dunkerque, CS 44229, F-35042 Rennes, France; Université Européenne de Bretagne, F-35000 Rennes, France
| | - N Lepareur
- Centre Eugène Marquis, INSERM UMR-S 991, Avenue de la Bataille Flandres-Dunkerque, CS 44229, F-35042 Rennes, France; Université Européenne de Bretagne, F-35000 Rennes, France.
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Abstract
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.
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19
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Iller E, Wawszczak D, Konior M, Polkowska-Motrenko H, Milczarek JJ, Górski L. Synthesis and structural investigations of gel metal oxide composites WO3–ZrO2, WO3–TiO2, WO3–ZrO2–SiO2, and their evaluation as materials for the preparation of 188W/188Re generator. Appl Radiat Isot 2013; 75:115-27. [DOI: 10.1016/j.apradiso.2013.01.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Revised: 01/22/2013] [Accepted: 01/31/2013] [Indexed: 10/27/2022]
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Rhenium-188 production in hospitals, by w-188/re-188 generator, for easy use in radionuclide therapy. INTERNATIONAL JOURNAL OF MOLECULAR IMAGING 2013; 2013:290750. [PMID: 23653859 PMCID: PMC3638650 DOI: 10.1155/2013/290750] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 03/13/2013] [Indexed: 11/17/2022]
Abstract
Rhenium-188 (Re-188) is a high energy β-emitting radioisotope obtained from the tungsten-188/rhenium-188 (W-188/Re-188) generator, which has shown utility for a variety of therapeutic applications in nuclear medicine, oncology, and interventional radiology/cardiology. Re-188 decay is accompanied by a 155 keV predominant energy γ-emission, which could be detected by γ-cameras, for imaging, biodistribution, or absorbed radiation dose studies. Its attractive physical properties and its potential low cost associated with a long-lived parent make it an interesting option for clinical use. The setup and daily use of W-188/Re-188 generator in hospital nuclear medicine departments are discussed in detail. The clinical efficacy, for several therapeutic applications, of a variety of Re-188-labeled agents is demonstrated. The high energy of the β-emission of Re-188 is particularly well suited for effective penetration in solid tumours. Its total radiation dose delivered to tissues is comparable to other radionuclides used in therapy. Furthermore, radiation safety and shielding requirements are an important subject of matter. In the case of bone metastases treatment, therapeutic ratios are presented in order to describe the efficacy of Re-188 usage.
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Lin WY, Luo TY, Tsai SC, Kao CH, Tang IC, Huang PW. A comparison of Re-188-MN-16ET-lipiodol and transcatheter arterial chemoembolization in the treatment of hepatoma: An animal study. Nucl Med Biol 2013; 40:437-41. [DOI: 10.1016/j.nucmedbio.2012.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Revised: 10/31/2012] [Accepted: 11/19/2012] [Indexed: 01/13/2023]
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Potgieter K, Gerber T, Hosten E. Dimers of the fac-[Re(CO)3]+ core with benzothiazole derivatives of thiourea. INORG CHEM COMMUN 2012. [DOI: 10.1016/j.inoche.2012.07.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Xie T, Liu Q, Zaidi H. Evaluation of S-values and dose distributions for90Y,131I,166Ho, and188Re in seven lobes of the rat liver. Med Phys 2012; 39:1462-72. [DOI: 10.1118/1.3681009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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(188)Re-SSS/Lipiodol: Development of a Potential Treatment for HCC from Bench to Bedside. INTERNATIONAL JOURNAL OF MOLECULAR IMAGING 2012; 2012:278306. [PMID: 22518301 PMCID: PMC3299367 DOI: 10.1155/2012/278306] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 12/08/2011] [Accepted: 12/13/2011] [Indexed: 12/15/2022]
Abstract
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 (Eβmax = 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.
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Treatment of hepatocellular carcinoma (HCC) by intra-arterial infusion of radio-emitter compounds: trans-arterial radio-embolisation of HCC. Cancer Treat Rev 2011; 38:641-9. [PMID: 22169503 DOI: 10.1016/j.ctrv.2011.11.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 11/17/2011] [Accepted: 11/21/2011] [Indexed: 12/17/2022]
Abstract
Traditional radiotherapy is only effective in treating hepatocellular cancer (HCC) in doses above 50 Gy, but this is above the recommended liver radiation exposure of about 35 Gy, which is an important limitation making this treatment unsuitable for routine clinical practice. Trans-arterial radio-embolisation (TARE), consists of delivery of compounds linked to radio-emitter particles which end up in hepatic end-arterioles or show affinity for the neoplasm itself, allowing localised delivery of doses beyond 120 Gy. These are well tolerated in patients treated with this type of internal radiation therapy. TARE for HCC is used for palliative treatment of advanced disease which cannot be treated in other ways, or for tumour down-staging before liver transplantation, or as adjuvant therapy for surgically resected HCC. Tumour response after TARE is between 25% and 60% if assessed by using RECIST criteria, and 80% by EASL criteria. In this review we outline the advantages and limitations of radio-emitter therapy including 131-I, 90-Y and 188-Re. We include several observational, and all comparative studies using these compounds. In particular we compare TARE to trans-arterial chemo-embolisation and other intra-arterial techniques.
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Gerber T, Potgieter K, Mayer P. The reaction of a potentially N2S-donor bis[benzo(thiazole/imidazole)] with the fac-[Re(CO)3]+ and cis-[ReO2]+ cores. INORG CHEM COMMUN 2011. [DOI: 10.1016/j.inoche.2011.04.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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28
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Automation of labelling of Lipiodol with high-activity generator-produced 188Re. Appl Radiat Isot 2010; 69:426-30. [PMID: 21106381 DOI: 10.1016/j.apradiso.2010.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 09/06/2010] [Accepted: 11/01/2010] [Indexed: 01/11/2023]
Abstract
This work describes optimisation of the kit formulation for labelling of Lipiodol with high-activity generator-produced rhenium-188. Radiochemical purity (RCP) was 92.52±2.3% and extraction yield was 98.56±1.2%. The synthesis has been automated with a TADDEO module (Comecer) giving a mean final yield of 52.68±9.6%, and reducing radiation burden to the radiochemist by 80%. Radiolabelled Lipiodol ((188)Re-SSS/Lipiodol) is stable for at least 7 days (RCP=91.07±0.9%).
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Uccelli L, Pasquali M, Boschi A, Giganti M, Duatti A. Automated preparation of Re-188 lipiodol for the treatment of hepatocellular carcinoma. Nucl Med Biol 2010; 38:207-13. [PMID: 21315276 DOI: 10.1016/j.nucmedbio.2010.08.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2010] [Revised: 08/04/2010] [Accepted: 08/25/2010] [Indexed: 01/06/2023]
Abstract
The iodinated oil lipiodol is commonly used as a carrier for in situ delivery of drugs or radioactivity to hepatic tumors. Recently, we reported a new kit formulation for high-activity labeling of lipiodol with the β-emitting radionuclide Re-188. Since the whole preparation involves different steps and complex manipulations of high-activity samples, we describe here an automated synthesis module that allows the easy preparation of sterile and pyrogen-free samples of Re-188 lipiodol ready to be administered to the patient. Important advantages include the possibility to incorporate high Re-188 activity into the lipiodol hydrophobic phase and a sharp reduction of radiation exposure of the operator assisting the labelling procedure. Application of this modular reaction system could be also extended to the preparation of other Re-188 radiopharmaceuticals and to compound labelled with different β-emitting therapeutic radionuclides.
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Affiliation(s)
- Licia Uccelli
- Laboratory of Nuclear Medicine, Department of Radiological Sciences, University of Ferrara, 44121 Ferrara, Italy
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Subramanian S, Das T, Chakraborty S, Sarma HD, Banerjee S, Samuel G, Venkatesh M. Preparation of 177Lu-labeled oxine in lipiodol as a possible agent for therapy of hepatocellular carcinoma: a preliminary animal study. Cancer Biother Radiopharm 2010; 25:539-43. [PMID: 20849309 DOI: 10.1089/cbr.2010.0792] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is one of the most prevalent forms of cancer with high morbidity. (131)I-lipiodol is used clinically and has been found to be effective for the treatment of HCC. However, this preparation has its limitations, including compromised yield and stability of exchange labeling and unnecessary dose burden from gamma emissions. In the present study, (177)Lu-oxine in lipiodol was considered as a possible alternative for radioiodinated lipiodol. Oxine or 8-hydroxyquinoline was labeled with (177)Lu obtained by neutron irradiation of natural lutetium. Under optimized conditions, the radiolabeled complex was obtained with yields >98% and adequate in vitro stability. (177)Lu-oxine dispersed in lipiodol showed appreciable uptake into rat liver cells (normal and HCC-induced) in vitro. (177)Lu-oxine-lipiodol showed initial localization in the liver, but subsequent leakage of radioactivity with deposition in the skeletal tissue was seen. The studies suggest that (177)Lu-oxine dispersed in lipiodol might not be suitable for treatment of HCC.
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Affiliation(s)
- Suresh Subramanian
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
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Meléndez-Alafort L, Nadali A, Zangoni E, Banzato A, Rondina M, Rosato A, Mazzi U. Biokinetic and dosimetric studies of 188Re-hyaluronic acid: a new radiopharmaceutical for treatment of hepatocellular carcinoma. Nucl Med Biol 2009; 36:693-701. [PMID: 19647176 DOI: 10.1016/j.nucmedbio.2009.04.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2008] [Revised: 02/18/2009] [Accepted: 04/10/2009] [Indexed: 01/11/2023]
Abstract
UNLABELLED Hepatocellular carcinoma (HCC) is the most common primary liver cancer and has very limited therapeutic options. Recently, it has been found that hyaluronic acid (HA) shows selective binding to CD44 receptors expressed in most cancer histotypes. Since the trend in cancer treatment is the use of targeted radionuclide therapy, the aim of this research was to label HA with rhenium-188 and to evaluate its potential use as a hepatocarcinoma therapeutic radiopharmaceutical. METHODS (188)Re-HA was prepared by a direct labelling method to produce a ReO(O-COO)(2)-type coordination complex. (188)Re-HA protein binding and its stability in saline, phosphate buffer, human serum and cysteine solutions were determined. Biokinetic and dosimetric data were estimated in healthy mice (n=60) using the Medical Internal Radiation Dose methodology and mouse model beta-absorbed fractions. To evaluate liver toxicity, alanine aminotranferase (AST) and aspartate aminotranferase (ALT) levels in mice were assessed and the liver maximum tolerated dose (MTD) of (188)Re-HA was determined. RESULTS A stable complex of (188)Re-HA was obtained with high radiochemical purity (>90%) and low serum protein binding (2%). Biokinetic studies showed a rapid blood clearance (T(1/2)alpha=21 min). Four hours after administration, (188)Re-HA was almost totally removed from the blood by the liver due to the selective uptake via HA-specific receptors (73.47+/-5.11% of the injected dose). The liver MTD in mice was approximately 40 Gy after 7.4 MBq of (188)Re-HA injection. CONCLUSIONS (188)Re-HA complex showed good stability, pharmacokinetic and dosimetric characteristics that confirm its potential as a new agent for HCC radiation therapy.
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Affiliation(s)
- Laura Meléndez-Alafort
- Dipartimento di Scienze Farmaceutiche, Università degli Studi di Padova, 35131 Padua, Italy
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Dosimetric evaluation and therapeutic response to internal radiation therapy of hepatocarcinomas using iodine-131-labelled lipiodol. Nucl Med Commun 2008; 29:815-25. [DOI: 10.1097/mnm.0b013e32830439c6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Ferro-Flores G, Arteaga de Murphy C. Pharmacokinetics and dosimetry of 188 Re-pharmaceuticals. Adv Drug Deliv Rev 2008; 60:1389-401. [PMID: 18547675 DOI: 10.1016/j.addr.2008.04.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Accepted: 04/16/2008] [Indexed: 01/08/2023]
Abstract
The main objective of this review is to apportion current and new insight into the biodistribution, radiopharmacokinetics, dosimetry and cell targeting of rhenium-188 labeled radiopharmaceuticals used as therapeutic drugs. The emphasis lies on the generator obtained rhenium-188, its physical, therapeutic, dosimetric and coordinated compounds. Its use in radioimmunotherapy for lymphoma and other hematological diseases with monoclonal antibodies is discussed. Radiolabeled peptides to target cell receptors are an important field in nuclear medicine and in some research facilities are already being used, especially, somatostatin, bombesin and other peptides. Small molecules labeled with 188 Re are promising as therapeutic drugs. A review about some of the non-specific targeting molecules with therapeutic or pain palliation effect such as phosphonates, lipiodol, microparticles and other interesting molecules is included. Research on the labeling of biomolecules with the versatile rhenium-188 has contributed to the development of therapeutics with favorable pharmacokinetic and dosimetric properties for cancer treatment.
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Affiliation(s)
- Guillermina Ferro-Flores
- Gerencia de Aplicaciones Nucleares en la Salud, Instituto Nacional de Investigaciones Nucleares, México
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34
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Jeong JM, Knapp F. Use of the Oak Ridge National Laboratory Tungsten-188/Rhenium-188 Generator for Preparation of the Rhenium-188 HDD/Lipiodol Complex for Trans-Arterial Liver Cancer Therapy. Semin Nucl Med 2008; 38:S19-29. [DOI: 10.1053/j.semnuclmed.2007.10.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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35
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Garin E, Bourguet P. Intra-arterial Therapy of Liver Tumours. Clin Nucl Med 2008. [DOI: 10.1007/978-3-540-28026-2_27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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36
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Lambert B, De Ridder L, De Vos F, Slegers G, de Gelder V, Van de Wiele C, Thierens H. Assessment of supra-additive effects of cytotoxic drugs and low dose rate irradiation in an in vitro model for hepatocellular carcinoma. Can J Physiol Pharmacol 2007; 84:1021-8. [PMID: 17218968 DOI: 10.1139/y06-055] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The use of 5-fluorouracil, topotecan, or gemcitabine was tested for enhancement of the effects of low dose rate (LDR) irradiation in an in vitro model for hepatocellular carcinoma. For comparison, all drugs were tested in combination with high dose rate (HDR) gamma-irradiation as well. Multicellular spheroids of HepG2 cells were exposed to HDR or LDR irradiation by means of external beam cobalt-60 or rhenium-188 (188Re), respectively, dissolved in the culture medium. Secondly, exposure to irradiation was combined with the cytotoxic drug. Toxicity was evaluated by means of a quantitative spheroid outgrowth assay and histology. For 5-fluorouracil, supra-additive effects were observed in combination with HDR irradiation. With 188Re, the supra-additive toxicity was only transient. For topotecan and 188Re, no supra-additive effects were seen, whereas the addition of HDR irradiation at the end of the topotecan exposure yielded lasting supra-additive effects. Incubation with gemcitabine followed by exposure to HDR irradiation, induced a synergistic toxicity on the outgrowth. No supra-additive effects were observed when HDR irradiation was added at the start of the incubation with gemcitabine or combined with LDR irradiation. For all drugs tested, supra-additive effects were observed with HDR irradiation if the timing of the irradiation was appropriate. For 188Re, no lasting supra-additive effects were observed.
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Affiliation(s)
- Bieke Lambert
- Department of Nuclear Medicine, De Pintelaan 185, Ghent University Hospital, 9000 Ghent, Belgium
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Lambert B, de Klerk JMH. Clinical applications of 188Re-labelled radiopharmaceuticals for radionuclide therapy. Nucl Med Commun 2006; 27:223-9. [PMID: 16479241 DOI: 10.1097/00006231-200603000-00004] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
188Re is a radionuclide in which there is widespread interest for therapeutic purposes because of its favourable physical characteristics. Moreover, it can be eluted from an on-site installable 188W/188Re generator, which has a useful shelf-life of several months. Most of the clinical experiences gained with 188Re concern the use of 188Re-1,1-hydroxyethylidenediphosphonate (188Re-HEDP) for bone pain palliation in patients suffering prostate cancer. The maximum tolerated activity was 3.3 GBq 188Re-HEDP and if the platelet count exceeded 200 x 10(9) l(-1), the administration of 4.4 GBq appeared safe. Evidence for repeated administrations of 188Re-HEDP rather than single injections was established. In general, pain palliation occurs in 60-92% of patients with only moderate transient toxicity, mainly related to changes in blood counts. Also in haematology, radioimmunotherapy by means of 188Re might play a role by selectively targeting the bone marrow in patients undergoing conditioning prior to haematopoetic stem cell transplantation. The feasibility of such an approach was proven using a Re-labelled monoclonal antibody directed toward the CD66-antigen. More recently, encouraging safety data on locoregional treatment of primary liver tumours using 188Re-labelled lipiodol were reported. The normal organs at greatest risk for toxicity are the normal liver and the lungs. About 50% of the patients reported mild and transient side effects, mainly consisting of low grade fever, right hypochondrial discomfort or aggravation of pre-existing liver impairment. Besides the applications in oncology 188Re-based therapies have also been pioneered for benign condition such as prevention of re-stenosis following angioplasty and for radiosynovectomy in cases of refractory arthritis.
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Affiliation(s)
- Bieke Lambert
- Division of Nuclear Medicine, Ghent University Hospital, Belgium.
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Garin E, Rakotonirina H, Lejeune F, Denizot B, Roux J, Noiret N, Mesbah H, Herry JY, Bourguet P, Lejeune JJ. Effect of a 188Re-SSS lipiodol/131I-lipiodol mixture, 188Re-SSS lipiodol alone or 131I-lipiodol alone on the survival of rats with hepatocellular carcinoma. Nucl Med Commun 2006; 27:363-9. [PMID: 16531923 DOI: 10.1097/00006231-200604000-00008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIM It has been shown that the use of a cocktail of isotopes of different ranges of action leads to an increase in the effectiveness of metabolic radiotherapy. The purpose of the present study was to compare with a control group the effectiveness of three different treatments in rats bearing hepatocellular carcinoma (HCC), using (1) a mixture of lipiodol labelled with both I and Re, (2) lipiodol labelled with I alone and (3) lipiodol labelled with Re alone. MATERIAL AND METHODS Four groups were made up, each containing 14 rats with the N1-S1 tumour cell line. Group 1 received a mixture composed of 22 MBq of Re-SSS lipiodol and 7 MBq I-lipiodol. Group 2 received 14 MBq I-lipiodol. Group 3 received 44 MBq of Re-SSS lipiodol and group 4 acted as the control. The survival of the various groups was compared by a non-parametric test of log-rank, after a follow-up of 60, 180 and 273 days. RESULTS Compared with the controls, the rats treated with a mixture of Re-SSS lipiodol and I-lipiodol show an increase in survival, but only from day 60 onwards (P=0.05 at day 60 and 0.13 at days 180 and 273). For the rats treated with I-lipiodol, there was a highly significant increase in survival compared with the controls at day 60, day 180 and day 273 (P=0.03, 0.04 and 0.04, respectively). There is no significant increase in survival for the rats treated with Re-SSS lipiodol, irrespective of the follow-up duration (P=0.53 at day 60, 0.48 at day 180, and 0.59 at day 273). CONCLUSIONS In this study, I-lipiodol is the most effective treatment in HCC-bearing rats, because this is the only method that leads to a prolonged improvement of survival. These results cannot necessarily be extrapolated to humans because of the relatively small size and unifocal nature of the lesions in this study. It appears necessary to carry out a study in humans with larger tumours in order to compare these three treatments, particularly with a view to replacing I-labelled lipiodol by Re-labelled lipiodol. However, this study clearly demonstrated that, for small tumours, as in an adjuvant setting for example, I-labelled lipiodol should be a better option than Re-labelled lipiodol.
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Affiliation(s)
- Elienne Garin
- UPRES EA 3890/Service de Médecine Nucléaire, Centre Eugène Marquis, Rennes, France.
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Lambert B, Van de Wiele C. Treatment of hepatocellular carcinoma by means of radiopharmaceuticals. Eur J Nucl Med Mol Imaging 2005; 32:980-9. [PMID: 16032439 DOI: 10.1007/s00259-005-1859-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Several techniques have been developed for radionuclide therapy of hepatocellular carcinoma (HCC). Medical literature databases (Pubmed, Medline) were screened for available literature and articles were critically analysed as to their scientific relevance. In a palliative setting, intra-arterial administration of 131I-Lipiodol yields responses in 17-92% of patients. According to a randomised study, 131I-Lipiodol was far better tolerated than classic chemo-embolisation. The additive value of a single 131I-Lipiodol administration following partial liver resection for HCC was evaluated and evidence is available that adjuvant radionuclide treatment reduces the recurrence rate. Data concerning the role of 131I-Lipiodol in bridging patient to liver transplantation are scarce but suggest a potential benefit in terms of reducing the drop-out rate while patients are listed for transplantation. 188Re- and 90Y-labelled conjugates are emerging and initial clinical data are promising. Treatment of HCC with 90Y-labelled microspheres is likely as efficacious as treatment with radiolabelled Lipiodol but pretreatment 99mTc-MAA scintigraphy is required in order to exclude patients with significant lung shunting. Several antibodies targeting antigens expressed on HCC have been radiolabelled, almost exclusively with 131I, and evaluated in a preclinical or clinical setting. The use of radiolabelled Lipiodol and microspheres allows for selective targeting of HCC with limited toxicity. Prospective, randomised controlled trials demonstrating that both treatment modalities may provide a survival benefit in a palliative setting are mandatory. In addition, future research should focus on the complementary role of radionuclide treatment in patients at risk for recurrent disease following partial liver resection or while awaiting liver transplantation.
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Affiliation(s)
- Bieke Lambert
- Nuclear Medicine Division, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium
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Lambert B, Bacher K, Defreyne L, Van Vlierberghe H, Jeong JM, Wang RF, van Meerbeeck J, Smeets P, Troisi R, Thierens H, De Vos F, Van de Wiele C. (188)Re-HDD/lipiodol therapy for hepatocellular carcinoma: an activity escalation study. Eur J Nucl Med Mol Imaging 2005; 33:344-52. [PMID: 16333675 DOI: 10.1007/s00259-005-1954-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2005] [Accepted: 08/12/2005] [Indexed: 01/23/2023]
Abstract
PURPOSE The aim of this study was to investigate the feasibility of administering increasing activities of (188)Re-4-hexadecyl-1-2,9,9-tetramethyl-4,7-diaza-1,10-decanethiol/lipiodol ((188)Re-HDD/lipiodol) for the treatment of hepatocellular carcinoma (HCC) in patients with well-compensated cirrhosis. METHODS The activity levels were increased by 1.1 GBq/step after a 6-week interval without unacceptable adverse events in at least five consecutive patients. Absorbed doses to the various organs were calculated according to the MIRD formalism, based on three gamma-scintigraphic studies. Response was assessed by means of MRI and alpha-fetoprotein (AFP) monitoring. RESULTS Thirty-five treatments were carried out in 28 patients. Activities from 4.8 to 7.0 GBq (188)Re-HDD/lipiodol were administered via a transfemoral catheter. The mean absorbed dose to the liver (including tumour) was 7.6+/-2.2, 9.8+/-4.9 and 15.2+/-4.9 Gy for the 4.8-, 5.9- and 7.0-GBq groups, respectively. Treatment was well tolerated at all activity levels. Further escalation of the administered activity was not feasible owing to limitations related to the radiolabelling procedure. Response assessment on MRI showed partial response, stable disease and disease progression in 1, 28 and 2 assessable treatments, respectively. In 8 of 17 treatment sessions with an initially elevated AFP, a reduction ranging from 19% to 97% was observed 6 weeks later. CONCLUSION Following the intra-arterial administration of 4.8-7.0 GBq (188)Re-HDD/lipiodol in patients with HCC and well-compensated liver cirrhosis, no severe adverse events occurred. Further escalation was not feasible owing to limitations in the radiolabelling procedure.
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Affiliation(s)
- Bieke Lambert
- Nuclear Medicine Division, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
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Raoul JL, Boucher E, Olivie D, Guillygomarc'h A, Boudjema K, Garin E. Association of cisplatin and intra-arterial injection of 131I-lipiodol in treatment of hepatocellular carcinoma: results of phase II trial. Int J Radiat Oncol Biol Phys 2005; 64:745-50. [PMID: 16289908 DOI: 10.1016/j.ijrobp.2005.09.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2005] [Revised: 09/02/2005] [Accepted: 09/04/2005] [Indexed: 01/03/2023]
Abstract
PURPOSE Intra-arterial injections of 131I-lipiodol (131I-Lip) provide an effective treatment for hepatocellular carcinoma. In hepatocellular carcinoma cell cultures, concurrent administration of cisplatin increases the cytotoxicity of 131I. The efficacy and tolerance of intra-arterial injections of 131I-Lip combined with systemic cisplatin was tested in a phase II trial. METHODS AND MATERIALS The inclusion criteria were proven unresectable nonmetastatic hepatocellular carcinoma, compensated liver disease, and adequate laboratory test findings. Treatment comprised the combination of intra-arterial injection of 131I-Lip (2.2 GBq) with intravenous infusion of low-dose cisplatin. The combined treatment could be repeated. RESULTS A total of 41 patients were included; 37 had cirrhosis and 38 had measurable tumors. One to four treatments (median, two) were given. The cisplatin dose was 75 mg for the first course and 72 mg for the second. Grade 3-4 (n/n) adverse effects were observed in 14 patients, polymorphonuclear leukocytes (3/0), platelets (5/1), asthenia (1/0), pain (1/0), and vomiting (1/0). Four patients developed pulmonary toxicity; 2 cases were likely related to 131I-Lip administration and 1 was fatal. The response rate was 47% (18 of 38), and the 1- and 2-year survival rate was 73% +/- 7% and 48% +/- 9%, respectively. CONCLUSION This combination had a tolerable toxicity profile and provided an objective response rate, warranting a phase III trial.
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Affiliation(s)
- Jean-Luc Raoul
- Department of Medical Oncology, Centre E Marquis, Rennes, France.
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Garin E, Denizot B, Roux J, Noiret N, Lepareur N, Moreau M, Mesba A, Laurent JF, Herry JY, Bourguet P, Benoit JP, Lejeune JJ. Effect of Stabilized Iodized Oil Emulsion on Experimentally Induced Hepatocellular Carcinoma in Rats. J Vasc Interv Radiol 2005; 16:841-8. [PMID: 15947048 DOI: 10.1097/01.rvi.0000156192.89569.0c] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Previous studies have shown that the use of Lipiodol UltraFluid (LUF) emulsified with water leads to an increase in the tumoral uptake of iodine I 131-labeled LUF and reduced pulmonary uptake. Although emulsions containing LUF are currently used for chemoembolization of hepatocellular carcinomas (HCCs), this approach is impossible with intraarterial radiation therapy (RT) because of the problems of radiation protection linked to instability of the emulsions. The aims of this study were to develop stabilized emulsions of radiolabeled LUF of different particle sizes and viscosities and to study its biodistribution in rats with HCC. MATERIALS AND METHODS An emulsifier made of polyethylene glycol and hydrogenated castor oil was used to stabilize emulsions containing water and technetium Tc 99m-labeled Super Six Sulfur LUF. The various emulsions were injected in the hepatic arteries of rats with HCC. Twenty-four hours after injection, the rats were killed and the liver, tumor, and lungs were removed to perform ex-vivo gamma-counting to quantify tumoral, hepatic, and pulmonary uptake. RESULTS Emulsions of oil in water and water in oil of different viscosities (0.68-1.06 Pa.S) and particle size distributions (21-45 mum) were prepared and kept stable for more than 24 hours. Whatever the type of emulsion, the observed effect on tumoral uptake was the opposite of that expected. Indeed, a decrease in tumoral activity was observed (P < .05 in three of five cases) and a tendency toward increased pulmonary activity was observed (P < .05 in two of five cases) rather than any significant decrease. CONCLUSIONS This study made it possible to develop emulsions of radiolabeled iodized oil that remain stable for more than 24 hours. However, studies of biodistribution in rats with HCC failed to demonstrate any improvement in tumoral targeting, but rather showed a decrease in tumoral uptake that renders this approach impractical for intraarterial radiolabeled iodized oil RT as well as for intraarterial iodized oil chemoembolization. These results may possibly be explained by the use of an emulsifier containing lipophilic and hydrophilic components that modify the properties of LUF.
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Affiliation(s)
- Etienne Garin
- UPRES EA 3890/Nuclear Medicine Service, Centre Eugène Marquis, rue de la Bataille Flanders Dunkerque, CS 44229, 35042 Rennes Cedex, France.
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