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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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Stokke C, Kvassheim M, Blakkisrud J. Radionuclides for Targeted Therapy: Physical Properties. Molecules 2022; 27:molecules27175429. [PMID: 36080198 PMCID: PMC9457625 DOI: 10.3390/molecules27175429] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/19/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
A search in PubMed revealed that 72 radionuclides have been considered for molecular or functional targeted radionuclide therapy. As radionuclide therapies increase in number and variations, it is important to understand the role of the radionuclide and the various characteristics that can render it either useful or useless. This review focuses on the physical characteristics of radionuclides that are relevant for radionuclide therapy, such as linear energy transfer, relative biological effectiveness, range, half-life, imaging properties, and radiation protection considerations. All these properties vary considerably between radionuclides and can be optimised for specific targets. Properties that are advantageous for some applications can sometimes be drawbacks for others; for instance, radionuclides that enable easy imaging can introduce more radiation protection concerns than others. Similarly, a long radiation range is beneficial in targets with heterogeneous uptake, but it also increases the radiation dose to tissues surrounding the target, and, hence, a shorter range is likely more beneficial with homogeneous uptake. While one cannot select a collection of characteristics as each radionuclide comes with an unchangeable set, all the 72 radionuclides investigated for therapy—and many more that have not yet been investigated—provide numerous sets to choose between.
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Affiliation(s)
- Caroline Stokke
- Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4959 Nydalen, 0424 Oslo, Norway
- Department of Physics, University of Oslo, Problemveien 7, 0315 Oslo, Norway
- Correspondence:
| | - Monika Kvassheim
- Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4959 Nydalen, 0424 Oslo, Norway
- Division of Clinical Medicine, University of Oslo, Problemveien 7, 0315 Oslo, Norway
| | - Johan Blakkisrud
- Department of Physics and Computational Radiology, Division of Radiology and Nuclear Medicine, Oslo University Hospital, P.O. Box 4959 Nydalen, 0424 Oslo, Norway
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Le Fur M, Fougère O, Lepareur N, Rousseaux O, Tripier R, Beyler M. Tuning the lipophilic nature of pyclen-based 90Y3+ radiopharmaceuticals for β-radiotherapy. Metallomics 2021; 13:6445036. [PMID: 34850060 DOI: 10.1093/mtomcs/mfab070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/16/2021] [Indexed: 01/31/2023]
Abstract
Pyclen-dipicolinate chelates proved to be very efficient chelators for the radiolabeling with β--emitters such as 90Y. In this study, a pyclen-dipicolinate ligand functionalized with additional C12 alkyl chains was synthesized. The radiolabeling with 90Y proved that the addition of saturated carbon chains does not affect the efficiency of the radiolabeling, whereas a notable increase in lipophilicity of the resulting 90Y radiocomplex was observed. As a result, the compound could be extracted in Lipiodol® and encapsulated in biodegrable pegylated poly(malic acid) nanoparticles demonstrating the potential of lipophilic pyclen-dipicolinate derivatives as platforms for the design of radiopharmaceuticals for the treatment of liver or brain cancers by internal radiotherapy.
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Affiliation(s)
- Mariane Le Fur
- Univ Brest, UMR-CNRS 6521 CEMCA, 6 avenue Victor le Gorgeu, 29238 Brest, France
| | - Olivier Fougère
- Guerbet group, Centre de Recherche d'Aulnay-sous-Bois, BP 57400, 95943 Roissy CdG Cedex, France
| | - Nicolas Lepareur
- Univ Rennes, Centre Eugène Marquis, Inrae, Inserm, Institut NUMECAN [(Nutrition, Métabolismes et Cancer)]-UMR_A 1341, UMR_S 1241, Avenue de la Bataille Flandres, Dunkerque CS 44229, 35042 Rennes Cedex, France
| | - Olivier Rousseaux
- Guerbet group, Centre de Recherche d'Aulnay-sous-Bois, BP 57400, 95943 Roissy CdG Cedex, France
| | - Raphaël Tripier
- Univ Brest, UMR-CNRS 6521 CEMCA, 6 avenue Victor le Gorgeu, 29238 Brest, France
| | - Maryline Beyler
- Univ Brest, UMR-CNRS 6521 CEMCA, 6 avenue Victor le Gorgeu, 29238 Brest, France
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Subramanian S, Mallia MB, Shinto AS, Mathew AS. Clinical Management of Liver Cancer in India and Other Developing Nations: A Focus on Radiation Based Strategies. Oncol Ther 2021; 9:273-295. [PMID: 34046873 PMCID: PMC8593115 DOI: 10.1007/s40487-021-00154-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 05/12/2021] [Indexed: 11/28/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is a global killer with preponderance in Asian and African countries. It poses a challenge for successful management in less affluent or developing nations like India, with large populations and limited infrastructures. This review aims to assess the available options and future directions for management of HCC applicable to such countries. While summarizing current and emerging clinical strategies for detection, staging and therapy of the disease, it highlights radioisotope- and radioactivity-based strategies as part of an overall program. Using the widely accepted Barcelona Clinic Liver Cancer (BCLC) staging system as a base, it evaluates the applicability of different therapeutic approaches and their synergistic combination(s) in the context of a patient-specific dynamic results-based strategy. It distills the conclusions of multiple HCC management-focused consensus recommendations to provide a picture of clinical strategies, especially radiation-related approaches. Additionally, it discusses the logistical and economic feasibility of these approaches in the context of the limitations of the burdened public health infrastructure in India (and like nations) and highlights possible strategies both at the clinical level and in terms of an administrative health policy on HCC to provide the maximum possible benefit to the widest swathe of the affected population.
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Affiliation(s)
- Suresh Subramanian
- Radiopharmaceuticals Division, RLG Building, Bhabha Atomic Research Centre, Trombay, Mumbai, Maharashtra, 400085, India.
| | - Madhava B Mallia
- Radiopharmaceuticals Division, RLG Building, Bhabha Atomic Research Centre, Trombay, Mumbai, Maharashtra, 400085, India
| | - Ajit S Shinto
- Apollo Proton Cancer Centre, Chennai, 600096, Tamil Nadu, India
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