1
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Mazzarello AN, Gugiatti E, Cossu V, Bertola N, Bagnara D, Carta S, Ravera S, Salvetti C, Ibatici A, Ghiotto F, Colombo M, Cutrona G, Marini C, Sambuceti G, Fais F, Bruno S. Unexpected chronic lymphocytic leukemia B cell activation by bisphosphonates. Cancer Immunol Immunother 2024; 73:27. [PMID: 38280019 PMCID: PMC10821833 DOI: 10.1007/s00262-023-03588-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/25/2023] [Indexed: 01/29/2024]
Abstract
Chronic lymphocytic leukemia (CLL) is a disease of the elderly, often presenting comorbidities like osteoporosis and requiring, in a relevant proportion of cases, treatment with bisphosphonates (BPs). This class of drugs was shown in preclinical investigations to also possess anticancer properties. We started an in vitro study of the effects of BPs on CLL B cells activated by microenvironment-mimicking stimuli and observed that, depending on drug concentration, hormetic effects were induced on the leukemic cells. Higher doses induced cytotoxicity whereas at lower concentrations, more likely occurring in vivo, the drugs generated a protective effect from spontaneous and chemotherapy-induced apoptosis, and augmented CLL B cell activation/proliferation. This CLL-activation effect promoted by the BPs was associated with markers of poor CLL prognosis and required the presence of bystander stromal cells. Functional experiments suggested that this phenomenon involves the release of soluble factors and is increased by cellular contact between stroma and CLL B cells. Since CLL patients often present comorbidities such as osteoporosis and considering the diverse outcomes in both CLL disease progression and CLL response to treatment among patients, illustrating this phenomenon holds potential significance in driving additional investigations.
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Affiliation(s)
- Andrea N Mazzarello
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
| | - Elena Gugiatti
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
| | - Vanessa Cossu
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
| | - Nadia Bertola
- Molecular Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Davide Bagnara
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
| | - Sonia Carta
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Ravera
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
| | - Chiara Salvetti
- Clinic of Hematology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Adalberto Ibatici
- Division of Hematology and Bone Marrow Transplant, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fabio Ghiotto
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
- Molecular Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Monica Colombo
- Molecular Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giovanna Cutrona
- Molecular Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Institute of Molecular Bioimaging and Physiology (IBFM), National Research Council (CNR), Milan, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Franco Fais
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy
- Molecular Pathology Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Silvia Bruno
- Department of Experimental Medicine (DIMES), University of Genoa, Via De Toni 14, 16132, Genoa, Italy.
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Qiu L, Wang Y, Liu H, Wang Q, Chen L, Liu L, Wang L, Feng Y, Chen Y. Safety and Efficacy of 68 Ga- or 177 Lu-Labeled DOTA-IBA as a Novel Theranostic Radiopharmaceutical for Bone Metastases : A Phase 0/I Study. Clin Nucl Med 2023; 48:489-496. [PMID: 36976706 DOI: 10.1097/rlu.0000000000004634] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Abstract
PURPOSE We designed and synthesized a novel theranostic bisphosphonate radiopharmaceutical ( 68 Ga- or 177 Lu-labeled DOTA-ibandronic acid [ 68 Ga/ 177 Lu-DOTA-IBA]) for bone metastasis. In this study, the dosimetry, safety, and efficacy of 68 Ga/ 177 Lu-DOTA-IBA as a theranostic radiopharmaceutical for bone metastases were evaluated in patients with malignancy based on 68 Ga- and 177 Lu-DOTA-IBA images, blood samples, and dosimetric analysis. PATIENTS AND METHODS Eighteen patients with bone metastasis and progression under conventional therapies were included in this study. Baseline 99m Tc-MDP SPECT and 68 Ga-DOTA-IBA PET/CT were performed for comparative purposes within 3 days. After receiving 891.5 ± 301.3 MBq 177 Lu-DOTA-IBA, serial 177 Lu-DOTA-IBA SPECT bone scan was performed over 14 days. Dosimetric evaluation was performed for main organs and tumor lesions. Safety was assessed by blood biomarkers. Karnofsky Performance Status, pain score, and follow-up 68 Ga-DOTA-IBA PET/CT were performed for response evaluation. RESULTS Baseline 68 Ga-DOTA-IBA PET demonstrated a higher efficacy for detecting bone metastases compared with 99m Tc-MDP SPECT. The time-activity curves showed fast uptake and high retention of 177 Lu-DOTA-IBA in bone metastases (24 hours: 9.43 ± 2.75 %IA; 14 days: 5.45 ± 2.52 %IA). Liver, kidneys, and red marrow time-activity curves revealed a low uptake and fast clearance. The radiation-absorbed dose in bone metastasis lesions (6.40 ± 2.13 Gy/GBq) was significantly higher than that in red marrow (0.47 ± 0.19 Gy/GBq), kidneys (0.56 ± 0.19 Gy/GBq), or liver (0.28 ± 0.07 Gy/GBq), with all P 's < 0.001. Compared with baseline level, only one patient developed new grade 1 leukopenia (toxicity rate, 6%). The 177 Lu-DOTA-IBA therapy had no statistically significant effect on bone marrow hematopoietic function, liver function, and kidney function at any follow-up visit. Bone pain palliation was achieved in 82% (14/17) of patients. The 8-week follow-up 68 Ga-DOTA-IBA PET/CT demonstrated partial response in 3 patients, disease progression in 1 patient, and stable disease in 14 patients. CONCLUSIONS 68 Ga/ 177 Lu-DOTA-IBA provides a set of potential theranostic radiopharmaceuticals and may have a good prospect for the management of bone metastasis.
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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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Faizan A, Takeda M, Yoshitake H. Effective adsorption of perrhenate ions on the filamentous sheath‐forming bacteria,
Sphaerotilus montanus
,
Sphaerotilus natans
and
Thiothrix fructosivorans. J Appl Microbiol 2022; 133:607-618. [DOI: 10.1111/jam.15590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Arshad Faizan
- Graduate School of Engineering Yokohama National University, 79‐5 Tokiwadai, 240‐8501, Hodogaya‐ku Yokohama
| | - Minoru Takeda
- Graduate School of Engineering Yokohama National University, 79‐5 Tokiwadai, 240‐8501, Hodogaya‐ku Yokohama
| | - Hideaki Yoshitake
- Graduate School of Engineering Yokohama National University, 79‐5 Tokiwadai, 240‐8501, Hodogaya‐ku Yokohama
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Therapy of bone metastases with beta emitters. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00158-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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6
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Liepe K, Murray I, Flux G. Dosimetry of bone seeking beta emitters for bone pain palliation metastases. Semin Nucl Med 2021; 52:178-190. [PMID: 34895886 DOI: 10.1053/j.semnuclmed.2021.11.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Amongst cancer patients, bone pain due to skeletal metastases is a major cause of morbidity. A number of beta-emitting radiopharmaceuticals have been used to provide internal radiotherapy of bone metastases and provide palliative pain relief. In this article we describe the different physical characteristics of the various beta emitting radionuclides which have been used in this clinical setting and the potential impact of differences in dose-rate on radiobiological outcomes. A detailed review of the biodistribution of these treatments, based on both in-vivo clinical investigations and post mortem autoradiography assessments is provided. These treatments result in physiological delivery of radiation doses to the target disease as well as to critical healthy organs. Particular attention is paid to the radiation doses received by normal bone tissue, bone marrow as well as metastatic bone disease. The underlying models of radiation transport within bone and bone marrow are reviewed alongside the practical steps that must be taken to acquire and analyse the information require for clinical dosimetry assessments. The role of whole body measurements, blood and faecal assays as well as both planar and tomographic gamma camera imaging are considered. In addition we review the rationale for allocating measured bone uptake between trabecular and cortical bone tissue. The difference between bone volume and bone surface seeking radiopharmaceuticals are also discussed. This review also extends to the development of preclinical models of bone metastases which may inform future dosimetric calculations. Finally, we also present a comprehensive review of the dosimetry of the established treatments 89Strontium-chloride; 32Phosphorus; 188Rhenium-hydroxyethylidine disphosphonate; 186Rhenium-1,1-hydroxyethylidene disphosphonate (186Re-HEDP); 153Samarium-ethylenediaminetetramethylene phosphonate; as well as the emerging treatments 188Rhenium-zoledronic acid; 188Rhenium-ibedronat; 177Lutetium-zoledronic acid; and 177Lutetium ethylenediaminetetramethylene phosphonate. This review highlights not only the inter treatment differences in the radiation absorbed doses delivered to metastatic disease by different radiopharmaceuticals but also the intra treatment differences which result in a large range of observed doses between patients.
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Affiliation(s)
- K Liepe
- Department of Nuclear Medicine, Klinikum Frankfurt (Oder), Brandenburg, Germany.
| | - I Murray
- Department of Physics, Royal Marsden Hospital, Sutton, UK
| | - G Flux
- Department of Physics, Royal Marsden Hospital, Sutton, UK
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Chen P, Li J, Gui J, Liu C, Wang Y, Zhang G, Kuai D, Wu Y, Liu Z, Zuo C, Lv Z, ZhangLi YB, Liu X. Efficacy and safety of 188Re-HEDP in lung cancer patients with bone metastases: a randomized, multicenter, multiple-dose phase IIa study. Int J Clin Oncol 2021; 26:1212-1220. [PMID: 33847856 DOI: 10.1007/s10147-021-01906-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 03/20/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To investigate the pain-relieving effect and safety of three different doses of 188Re-hydroxyethylidine diphosphonate (HEDP) in patients with lung cancer and bone metastases. METHODS For this randomised, phase 2 and multicenter trial, we enrolled patients with lung carcinoma and multifocal bone metastases and excluded patients who had received bisphosphonates or external-beam radiotherapy within the previous 4 weeks. Fifty-four patients were randomized to receive a single injection of 188Re-HEDP, at doses of 30, 40 or 50 MBq/kg (interval, 12 weeks). Patients were followed-up by assessment of numerical rating scale (NRS) score, global quality of life (QOL) score and adverse events (AEs). ANOVA analysis, Chi-Squared test and LSD-t test were used in this study. RESULTS Significantly decreased NRS scores relative to baseline were observed in 40 MBq/kg group (Week 0 vs. Week 12: 6.0 ± 1.4 vs. 4.8 ± 2.5, P = 0.033) and 50 MBq/kg group (Week 0 vs. Week 12: 5.5 ± 1.5 vs. 4.5 ± 2.9, P = 0.046). Significant change of global QOL score from baseline was observed in 40 MBq/kg group at week 8 (global QOL score: P = 0.024, pain score: P = 0.041) and 50 MBq/kg group (pain score: P = 0.021) at week 12. No patients withdrew trial because of AEs in three groups. CONCLUSIONS 188Re-HEDP at dose of 40 and 50 MBq/kg was generally effective to alleviate pain and improve QOL in lung cancer patients with painful bone metastases. 188Re-HEDP was safe and well-tolerated.
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Affiliation(s)
- Ping Chen
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China.,Department of Nuclear Medicine, Pudong Hospital, Fudan University, Shanghai, China
| | - Jun Li
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China
| | - Jicong Gui
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China
| | - Congjin Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China
| | - Yuankai Wang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China
| | - Guangming Zhang
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China
| | - Dayu Kuai
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China
| | - Yiwei Wu
- Department of Nuclear Medicine, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Zengli Liu
- Department of Nuclear Medicine, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Changjing Zuo
- Department of Nuclear Medicine, Shanghai Changhai Hospital, Navy Military Medical University, Shanghai, China
| | - Zhongwei Lv
- Department of Nuclear Medicine, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yingjian Biao ZhangLi
- Department of Nuclear Medicine, Shanghai Cancer Center, Fudan University, Shanghai, China.,Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xingdang Liu
- Department of Nuclear Medicine, Huashan Hospital, Fudan University, Jing'an District, No.12 Urumchi Middle Road, Shanghai, 200040, China. .,Department of Nuclear Medicine, Pudong Hospital, Fudan University, Shanghai, China.
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8
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Targeted Palliative Radionuclide Therapy for Metastatic Bone Pain. J Clin Med 2020; 9:jcm9082622. [PMID: 32806765 PMCID: PMC7464823 DOI: 10.3390/jcm9082622] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 07/22/2020] [Accepted: 07/31/2020] [Indexed: 12/13/2022] Open
Abstract
Bone metastasis develops in multiple malignancies with a wide range of incidence. The presence of multiple bone metastases, leading to a multitude of complications and poorer prognosis. The corresponding refractory bone pain is still a challenging issue managed through multidisciplinary approaches to enhance the quality of life. Radiopharmaceuticals are mainly used in the latest courses of the disease. Bone-pain palliation with easy-to-administer radionuclides offers advantages, including simultaneous treatment of multiple metastatic foci, the repeatability and also the combination with other therapies. Several β¯- and α-emitters as well as pharmaceuticals, from the very first [89Sr]strontium-dichloride to recently introduced [223Ra]radium-dichloride, are investigated to identify an optimum agent. In addition, the combination of bone-seeking radiopharmaceuticals with chemotherapy or radiotherapy has been employed to enhance the outcome. Radiopharmaceuticals demonstrate an acceptable response rate in pain relief. Nevertheless, survival benefits have been documented in only a limited number of studies. In this review, we provide an overview of bone-seeking radiopharmaceuticals used for bone-pain palliation, their effectiveness and toxicity, as well as the results of the combination with other therapies. Bone-pain palliation with radiopharmaceuticals has been employed for eight decades. However, there are still new aspects yet to be established.
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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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10
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Dash A, Das T, Knapp FFR. Targeted Radionuclide Therapy of Painful Bone Metastases: Past Developments, Current Status, Recent Advances and Future Directions. Curr Med Chem 2019; 27:3187-3249. [PMID: 30714520 DOI: 10.2174/0929867326666190201142814] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 10/29/2018] [Accepted: 12/06/2018] [Indexed: 12/13/2022]
Abstract
Bone pain arising from secondary skeletal malignancy constitutes one of the most common types of chronic pain among patients with cancer which can lead to rapid deterioration of the quality of life. Radionuclide therapy using bone-seeking radiopharmaceuticals based on the concept of localization of the agent at bone metastases sites to deliver focal cytotoxic levels of radiation emerged as an effective treatment modality for the palliation of symptomatic bone metastases. Bone-seeking radiopharmaceuticals not only provide palliative benefit but also improve clinical outcomes in terms of overall and progression-free survival. There is a steadily expanding list of therapeutic radionuclides which are used or can potentially be used in either ionic form or in combination with carrier molecules for the management of bone metastases. This article offers a narrative review of the armamentarium of bone-targeting radiopharmaceuticals based on currently approved investigational and potentially useful radionuclides and examines their efficacy for the treatment of painful skeletal metastases. In addition, the article also highlights the processes, opportunities, and challenges involved in the development of bone-seeking radiopharmaceuticals. Radium-223 is the first agent in this class to show an overall survival advantage in Castration-Resistant Prostate Cancer (CRPC) patients with bone metastases. This review summarizes recent advances, current clinical practice using radiopharmaceuticals for bone pain palliation, and the expected future prospects in this field.
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Affiliation(s)
- Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India.,Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
| | - Tapas Das
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085, India.,Homi Bhabha National Institute, Anushaktinagar, Mumbai 400094, India
| | - Furn F Russ Knapp
- Medical Isotopes Program, Isotope Development Group, MS 6229, Bldg. 4501, Oak Ridge National Laboratory, PO Box 2008, 1 Bethel Valley Road, Oak Ridge, TN 37831, United States
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Tsebrikova GS, Ragulin VV, Baulin VE, German KE, Malysheva AO, Klement’eva OE, Kodina GE, Larenkov AA, Lyamtseva EA, Taratonenkova NA, Zhukova MV, Tsivadze AY. 2,5-Diamino-5,5-diphosphonovaleric Acid as a Ligand for an Osteotropic 188Re Radiopharmaceutical. RUSS J GEN CHEM+ 2018. [DOI: 10.1134/s1070363218090037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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12
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Abstract
For bone-targeted radionuclide therapy (BTRT), different commercial radiopharmaceuticals are available such as strontium-89, 186Rhenium-hydroxyethylidene diphosphonate (186Re-HEDP), Samarium-153-ethylenediamine tetramethylene phosphonic acid, and radium-223. Unfortunately, the commercial available radiopharmaceuticals are very expensive (from 1,200 to 36,000€ per patient in Europe). The 188W/188Re generator is an ideal source for the long-term (4-6 months) continuous availability of 188Re suitable for the preparation of radiopharmaceuticals for different radionuclide therapies. Labeling at HEDP, it can use cost-effective for BTRT, if enough patients are available for therapy. And so, 188Re-HEDP is the ideal candidate in developing countries which high population to replace the other agents. Two German groups documented a response rate of 80% without any severe side effects and similar bone marrow toxicity compared to the other compounds for 188Re-HEDP. Using 188Re-HEDP in repeated treatments, a prolonged overall survival of repeated to single application was observed (from 4.5 months for single to 15.7 months using ≥≥3 applications).
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Affiliation(s)
- Knut Liepe
- Department of Nuclear Medicine, Klinikum Frankfurt (Oder), 15236 Frankfurt (Oder), Germany
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13
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Nano-technology contributions towards the development of high performance radioisotope generators: The future promise to meet the continuing clinical demand. Appl Radiat Isot 2017; 129:67-75. [DOI: 10.1016/j.apradiso.2017.08.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 07/21/2017] [Accepted: 08/07/2017] [Indexed: 11/17/2022]
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14
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Azadbakht B, Afarideh H, Ghannadi-Maragheh M, Asgari M, Bahrami-Samani A. Development of an electrochemical 188W/ 188Re generator as a technique for separation and purification of 188Re in radiopharmaceutical applications. Appl Radiat Isot 2016; 118:331-337. [PMID: 27750109 DOI: 10.1016/j.apradiso.2016.09.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 09/06/2016] [Accepted: 09/07/2016] [Indexed: 10/20/2022]
Abstract
In this study, a simple electrochemical procedure adaptable for using low specific activity 188W for separation and purification of 188Re from 188W to obtain no carrier added (NCA) 188Re is developed. The electrochemical parameters were optimized to maximize the 188Re electrodeposition yield with minimal 188W contamination. Two cycle electrolysis procedure was developed. The first electrochemical cell was used for separation of 188Re and in the second electrochemical cell, separation and purification of 188Re with >90% deposition yield of 188Re and minimal contamination of 188W (<10-4%) was achieved. The overall electrodeposition yield of 188Re was >90% with >99% radionuclidic purity and >99% radiochemical purity suitable for radiopharmaceutical applications. Furthermore, the performance of the generator remained consistent during a period of 69 days, one half-life of 188W, when the electrochemical separation procedure was performed frequently, at least once in 5 days.
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Affiliation(s)
- Bakhtiar Azadbakht
- Department of Energy Engineering and Physics, Amirkabir University of Technology, 15875-4413 Tehran, Iran
| | - Hossein Afarideh
- Department of Energy Engineering and Physics, Amirkabir University of Technology, 15875-4413 Tehran, Iran.
| | | | - Mehdi Asgari
- Nuclear Science and Technology Research Institute (NSTRI), P.O. Box:14395-836, Tehran, Iran
| | - Ali Bahrami-Samani
- Nuclear Science and Technology Research Institute (NSTRI), P.O. Box:14395-836, Tehran, Iran
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Knapp FF, Pillai MRA, Osso JA, Dash A. Re-emergence of the important role of radionuclide generators to provide diagnostic and therapeutic radionuclides to meet future research and clinical demands. J Radioanal Nucl Chem 2014. [DOI: 10.1007/s10967-014-3642-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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16
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Dash A, Chakravarty R. Electrochemical Separation: Promises, Opportunities, and Challenges To Develop Next-Generation Radionuclide Generators To Meet Clinical Demands. Ind Eng Chem Res 2014. [DOI: 10.1021/ie404369y] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Ashutosh Dash
- Isotope Applications and
Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai 400 085, India
| | - Rubel Chakravarty
- Isotope Applications and
Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai 400 085, India
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Chakravarty R, Dash A. Nanomaterial-based adsorbents: the prospect of developing new generation radionuclide generators to meet future research and clinical demands. J Radioanal Nucl Chem 2013. [DOI: 10.1007/s10967-013-2823-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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18
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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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Radionuclide Therapy of Bone Metastases Using Rhenium-188 Hydroxyethylidene Diphosphonate. ACTA ACUST UNITED AC 2012. [DOI: 10.1007/174_2012_675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
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20
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Liepe K, Kotzerke J. Internal radiotherapy of painful bone metastases. Methods 2011; 55:258-70. [DOI: 10.1016/j.ymeth.2011.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 06/16/2011] [Accepted: 07/07/2011] [Indexed: 02/03/2023] Open
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Chakravarty R, Dash A, Kothari K, Pillai MRA, Venkatesh M. A novel 188W/188Re electrochemical generator with potential for medical applications. RADIOCHIM ACTA 2009. [DOI: 10.1524/ract.2009.1612] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Ghorbanzadeh Mashkani S, Tajer Mohammad Ghazvini P, Agha Aligol D. Uptake of Re(VII) from aqueous solutions by Bacillus sp. GT-83-23. BIORESOURCE TECHNOLOGY 2009; 100:603-608. [PMID: 18752935 DOI: 10.1016/j.biortech.2008.06.065] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2008] [Revised: 06/30/2008] [Accepted: 06/30/2008] [Indexed: 05/26/2023]
Abstract
Thirty-eight water samples were collected from various areas of Anzali lagoon, Iran. Initial screening of a total of 100 bacterial isolates, resulted in the selection of one isolate with maximum adsorption capacity. It was tentatively identified as Bacillus sp. and named strain GT-83-23. The optimum pH of the medium was found to be 2.0 for Re(VII) adsorption. Uptakes of Re(VII) increased with increasing Re(VII) concentration and decreased sharply by the presence of increasing concentrations of NaCl. The kinetic of Re(VII) sorption by Bacillus sp. GT-83-23 was fast, reaching more than 62% of the total sorption capacity within 5 min. As the cell concentration increased, the amount of Re(VII) adsorbed by each cell (specific uptake) decreased, whereas the total amount of Re(VII) adsorbed enhanced. Cells immobilized in calcium alginate gel took up 77% of the Re(VII). The binding of Re(VII) on the Bacillus sp. GT-83-23 was studied with micro-PIXE.
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Affiliation(s)
- Saeid Ghorbanzadeh Mashkani
- Department of Nuclear Biotechnology, Nuclear Science Research School, Nuclear Science and Technology Research Institute, North Karegar Street, P.O. Box 11365-3486, Tehran, Iran.
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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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Bucerius J, Wallny T, Brackmann HH, Joe AY, Roedel R, Biersack HJ, Palmedo H. Rhenium-186 Hydroxyethylidenediphosphonate (186Re HEDP) for the Treatment of Hemophilic Arthropathy. Clin J Pain 2007; 23:612-8. [PMID: 17710012 DOI: 10.1097/ajp.0b013e318123fd4e] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the efficacy of a systemic application of rhenium-186 hydroxyethylidenediphosphonate (Re HEDP) for pain treatment in patients with hemophilic arthropathies. METHODS Twelve patients with hemophilic arthropathy with at least 3 involved joints with persistent pain were included in this prospective study. A single dose of 15 mCi (555 MBq) Re HEDP was administered intravenously. Before and 12 weeks after treatment, pain assessment was performed using the visual analog scale (VAS). The pain status assessment included the general status, pain of all joints affected, and pain of the 3 mostly involved joints. Furthermore, quality of life was assessed. RESULTS With regard to the 3 most involved joints, an improvement of the pain symptoms in 25 of 36 (69.4%) joints was observed. With regard to all involved joints a median of 3 joints per patient improved after Re HEDP therapy. General pain status after treatment was 2.0 VAS points lower as compared with pretreatment. The total number of involved joints remained unchanged in 7 patients, increased in 1 patient, and decreased in the remaining 4 patients. CONCLUSIONS The results of this study show an improvement of the pain symptoms of the involved joints 12 weeks after therapy with Re HEDP in patients with hemophilic arthropathy. The only moderate success regarding a reduction of the total number of involved joints is by the fact that despite this improvement most affected joints remained still painful on a lower level after the therapy or due to newly affected joints not painful before initiation of the radionuclide therapy.
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Affiliation(s)
- Jan Bucerius
- Department of Nuclear Medicine, University of Bonn, Bonn, Germany.
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Jeong JM, Chung JK. Therapy with 188Re-Labeled Radiopharmaceuticals: An Overview of Promising Results from Initial Clinical Trials. Cancer Biother Radiopharm 2003; 18:707-17. [PMID: 14629819 DOI: 10.1089/108497803770418256] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The development of an in-house 188W/188Re-generator has greatly increased the use of 188Re for treating various diseases. 188Re is of widespread interest due to its attractive physical and chemical properties. Many new radiopharmaceuticals labeled with 188Re have been developed and are currently in clinical trials, such as: 188Re-labeled renal excreting agents like 188Re-mercaptoacetylglycylglycylglycine (MAG3) and 188Re-diethylenetriamine pentaacetic acid (DTPA) for prevention of coronary arterial restenosis; 188Re-labeled phosphonates such as 188Re-hydroxyethylidene diphosphonate (HEDP), 188Re-alendronate (ABP), and 188Re-ethylenediamine-N,N,N',N'-tetrakis(methylene phosphoric) acid (EDTMP) for palliation of metastatic bone pain; 188Re-labeled lipiodol such as 188Re-n-hexyldiaminedithiol (HDD)-lipiodol for treatment of liver cancer; and 188Re-labeled colloids and microspheres for treatment of diseases such as rheumatoid arthritis, peritoneal effusion, and other solid tumors. However, there is still a need to develop new 188Re-labeled radiopharmaceuticals that are more specific for target lesions such as cancer-specific monoclonal antibodies and peptides. The availability of 188Re from a generator at a reasonable cost may help increase not only the research activities but also the clinical applications of 188Re-labeled radiopharmaceuticals.
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Affiliation(s)
- Jae Min Jeong
- Department of Nuclear Medicine, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea
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