1
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Winter G, Hamp-Goldstein C, Fischer G, Kletting P, Glatting G, Solbach C, Herrmann H, Sala E, Feuring M, Döhner H, Beer AJ, Bunjes D, Prasad V. Optimization of Radiolabeling of a [ 90Y]Y-Anti-CD66-Antibody for Radioimmunotherapy before Allogeneic Hematopoietic Cell Transplantation. Cancers (Basel) 2023; 15:3660. [PMID: 37509321 PMCID: PMC10377894 DOI: 10.3390/cancers15143660] [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: 06/20/2023] [Revised: 07/13/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
For patients with acute myeloid leukemia, myelodysplastic syndrome, or acute lymphoblastic leukemia, allogeneic hematopoietic cell transplantation (HCT) is a potentially curative treatment. In addition to standard conditioning regimens for HCT, high-dose radioimmunotherapy (RIT) offers the unique opportunity to selectively deliver a high dose of radiation to the bone marrow while limiting side effects. Modification of a CD66b-specific monoclonal antibody (mAb) with a DTPA-based chelating agent should improve the absorbed dose distribution during therapy. The stability and radioimmunoreactive fraction of the radiolabeled mAbs were determined. Before RIT, all patients underwent dosimetry to determine absorbed doses to bone marrow, kidneys, liver, and spleen. Scans were performed twenty-four hours after therapy for quality control. A radiochemical purity of >95% and acceptable radioimmunoreactivity was achieved. Absorbed organ doses for the liver and kidney were consequently improved compared to reported historical data. All patients tolerated RIT well with no treatment-related acute adverse events. Complete remission could be observed in 4/5 of the patients 3 months after RIT. Two patients developed delayed liver failure unrelated to the radioimmunotherapy. The improved conjugation and radiolabeling procedure resulted in excellent stability, radiochemical purity, and CD66-specific radioimmunoreactivity of 90Y-labeled anti-CD66 mAb. RIT followed by conditioning and HCT was well tolerated. Based on these promising initial data, further prospective studies of [90Y]Y-DTPA-Bn-CHX-A″-anti-CD66-mAb-assisted conditioning in HCT are warranted.
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Affiliation(s)
- Gordon Winter
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | | | - Gabriel Fischer
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | - Peter Kletting
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | - Gerhard Glatting
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | - Christoph Solbach
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | - Hendrik Herrmann
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | - Elisa Sala
- Department of Internal Medicine III, Ulm University Medical Center, 89081 Ulm, Germany
| | - Michaela Feuring
- Department of Internal Medicine III, Ulm University Medical Center, 89081 Ulm, Germany
| | - Hartmut Döhner
- Department of Internal Medicine III, Ulm University Medical Center, 89081 Ulm, Germany
| | - Ambros J Beer
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
| | - Donald Bunjes
- Department of Internal Medicine III, Ulm University Medical Center, 89081 Ulm, Germany
| | - Vikas Prasad
- Department of Nuclear Medicine, Ulm University Medical Center, 89081 Ulm, Germany
- Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University in St. Louis, St. Louis, MO 63130, USA
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2
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Forster JC, Douglass MJJ, Phillips WM, Bezak E. Stochastic multicellular modeling of x-ray irradiation, DNA damage induction, DNA free-end misrejoining and cell death. Sci Rep 2019; 9:18888. [PMID: 31827107 PMCID: PMC6906404 DOI: 10.1038/s41598-019-54941-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 11/19/2019] [Indexed: 01/26/2023] Open
Abstract
The repair or misrepair of DNA double-strand breaks (DSBs) largely determines whether a cell will survive radiation insult or die. A new computational model of multicellular, track structure-based and pO2-dependent radiation-induced cell death was developed and used to investigate the contribution to cell killing by the mechanism of DNA free-end misrejoining for low-LET radiation. A simulated tumor of 1224 squamous cells was irradiated with 6 MV x-rays using the Monte Carlo toolkit Geant4 with low-energy Geant4-DNA physics and chemistry modules up to a uniform dose of 1 Gy. DNA damage including DSBs were simulated from ionizations, excitations and hydroxyl radical interactions along track segments through cell nuclei, with a higher cellular pO2 enhancing the conversion of DNA radicals to strand breaks. DNA free-ends produced by complex DSBs (cDSBs) were able to misrejoin and produce exchange-type chromosome aberrations, some of which were asymmetric and lethal. A sensitivity analysis was performed and conditions of full oxia and anoxia were simulated. The linear component of cell killing from misrejoining was consistently small compared to values in the literature for the linear component of cell killing for head and neck squamous cell carcinoma (HNSCC). This indicated that misrejoinings involving DSBs from the same x-ray (including all associated secondary electrons) were rare and that other mechanisms (e.g. unrejoined ends) may be important. Ignoring the contribution by the indirect effect toward DNA damage caused the DSB yield to drop to a third of its original value and the cDSB yield to drop to a tenth of its original value. Track structure-based cell killing was simulated in all 135306 viable cells of a 1 mm3 hypoxic HNSCC tumor for a uniform dose of 1 Gy.
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Affiliation(s)
- Jake C Forster
- Department of Nuclear Medicine, South Australia Medical Imaging, The Queen Elizabeth Hospital, Woodville South, SA, 5011, Australia. .,Department of Physics, University of Adelaide, Adelaide, SA, 5005, Australia.
| | - Michael J J Douglass
- Department of Physics, University of Adelaide, Adelaide, SA, 5005, Australia.,Department of Medical Physics, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - Wendy M Phillips
- Department of Physics, University of Adelaide, Adelaide, SA, 5005, Australia.,Department of Medical Physics, Royal Adelaide Hospital, Adelaide, SA, 5000, Australia
| | - Eva Bezak
- Department of Physics, University of Adelaide, Adelaide, SA, 5005, Australia.,Cancer Research Institute and School of Health Sciences, University of South Australia, Adelaide, SA, 5001, Australia
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3
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Kriegs M, Clauditz TS, Hoffer K, Bartels J, Buhs S, Gerull H, Zech HB, Bußmann L, Struve N, Rieckmann T, Petersen C, Betz CS, Rothkamm K, Nollau P, Münscher A. Analyzing expression and phosphorylation of the EGF receptor in HNSCC. Sci Rep 2019; 9:13564. [PMID: 31537844 PMCID: PMC6753061 DOI: 10.1038/s41598-019-49885-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/24/2019] [Indexed: 12/25/2022] Open
Abstract
Overexpression of the epidermal growth factor receptor (EGFR) in head and neck squamous cell carcinomas (HNSCC) is considered to cause increased EGFR activity, which adds to tumorigenicity and therapy resistance. Since it is still unclear, whether EGFR expression is indeed associated with increased activity in HNSCC, we analyzed the relationship between EGFR expression and auto-phosphorylation as a surrogate marker for activity. We used a tissue micro array, fresh frozen HNSCC tumor and corresponding normal tissue samples and a large panel of HNSCC cell lines. While we observed substantial overexpression only in approximately 20% of HNSCC, we also observed strong discrepancies between EGFR protein expression and auto-phosphorylation in HNSCC cell lines as well as in tumor specimens using Western blot and SH2-profiling; for the majority of HNSCC EGFR expression therefore seems not to be correlated with EGFR auto-phosphorylation. Blocking of EGFR activity by cetuximab and erlotinib points to increased EGFR activity in samples with increased basal auto-phosphorylation. However, we could also identify cells with low basal phosphorylation but relevant EGFR activity. In summary, our data demonstrate that EGFR expression and activity are not well correlated. Therefore EGFR positivity is no reliable surrogate marker for EGFR activity, arguing the need for alternative biomarkers or functional predictive tests.
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Affiliation(s)
- Malte Kriegs
- Laboratory of Radiobiology & Experimental Radiation Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany.
| | - Till Sebastian Clauditz
- Institute of Pathology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Konstantin Hoffer
- Laboratory of Radiobiology & Experimental Radiation Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Joanna Bartels
- Department of Otolaryngology and Head and Neck Surgery, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Sophia Buhs
- Research Institute Children's Cancer Center and Department of Pediatric Hematology and Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Helwe Gerull
- Research Institute Children's Cancer Center and Department of Pediatric Hematology and Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Henrike Barbara Zech
- Department of Otolaryngology and Head and Neck Surgery, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Lara Bußmann
- Department of Otolaryngology and Head and Neck Surgery, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Nina Struve
- Laboratory of Radiobiology & Experimental Radiation Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Thorsten Rieckmann
- Laboratory of Radiobiology & Experimental Radiation Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany.,Department of Otolaryngology and Head and Neck Surgery, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Cordula Petersen
- Laboratory of Radiobiology & Experimental Radiation Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Christian Stephan Betz
- Department of Otolaryngology and Head and Neck Surgery, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Kai Rothkamm
- Laboratory of Radiobiology & Experimental Radiation Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
| | - Peter Nollau
- Research Institute Children's Cancer Center and Department of Pediatric Hematology and Oncology, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| | - Adrian Münscher
- Department of Otolaryngology and Head and Neck Surgery, Hubertus Wald Tumorzentrum - University Cancer Center Hamburg, Hamburg, Germany
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4
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Melzig C, Golestaneh AF, Mier W, Schwager C, Das S, Schlegel J, Lasitschka F, Kauczor HU, Debus J, Haberkorn U, Abdollahi A. Combined external beam radiotherapy with carbon ions and tumor targeting endoradiotherapy. Oncotarget 2018; 9:29985-30004. [PMID: 30042828 PMCID: PMC6057461 DOI: 10.18632/oncotarget.25695] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 06/04/2018] [Indexed: 01/05/2023] Open
Abstract
External beam radiotherapy (EBRT) with carbon ions and endoradiotherapy using radiolabeled tumor targeting agents are emerging concepts in precision cancer therapy. We report on combination effects of these two promising strategies. Tumor targeting 131I-labelled anti-EGFR-antibody (Cetuximab) was used in the prototypic EGFR-expressing A431 human squamous cell carcinoma xenograft model. A 131I-labelled melanin-binding benzamide derivative was utilized targeting B16F10 melanoma in an orthotopic syngeneic C57bl6 model. Fractionated EBRT was performed using carbon ions in direct comparison with conventional photon irradiation. Tumor uptake of 131I-Cetuximab and 131I-Benzamide was enhanced by fractionated EBRT as determined by biodistribution studies. This effect was independent of radiation quality and significant for the small molecule 131I-Benzamide, i.e., >30% more uptake in irradiated vs. non-irradiated melanoma was found (p<0.05). Compared to each monotherapy, dual combination with 131I-Cetuximab and EBRT was most effective in inhibiting A431 tumor growth. A similar trend was seen for 131I-Benzamide and EBRT in B16F10 melanoma model. Addition of 131I-Benzamide endoradiotherapy to EBRT altered expression of genes related to DNA-repair, cell cycle and cell death. In contrast, immune-response related pathways such as type 1 interferon response genes (ISG15, MX1) were predominantly upregulated after combined 131I-Cetuximab and EBRT. The beneficial effects of combined 131I-Cetuximab and EBRT was further attributed to a reduced microvascular density (CD31) and decreased proliferation index (Ki-67). Fractionated EBRT could be favorably combined with endoradiotherapy. 131I-Benzamide endoradiotherapy accelerated EBRT induced cytotoxic effects. Activation of immune-response by carbon ions markedly enhanced anti-EGFR based endoradiotherapy suggesting further evaluation of this novel and promising radioimmunotherapy concept.
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Affiliation(s)
- Claudius Melzig
- German Cancer Consortium, Heidelberg, Germany.,Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany.,Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Azadeh Fahim Golestaneh
- German Cancer Consortium, Heidelberg, Germany.,Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Walter Mier
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany
| | - Christian Schwager
- German Cancer Consortium, Heidelberg, Germany.,Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Samayita Das
- German Cancer Consortium, Heidelberg, Germany.,Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Julian Schlegel
- German Cancer Consortium, Heidelberg, Germany.,Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Felix Lasitschka
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Diagnostic and Interventional Radiology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jürgen Debus
- German Cancer Consortium, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, Heidelberg University Hospital, Heidelberg, Germany.,Clinical Cooperation Unit Nuclear Medicine, German Cancer Research Center, Heidelberg, Germany
| | - Amir Abdollahi
- German Cancer Consortium, Heidelberg, Germany.,Translational Radiation Oncology, National Center for Tumor Diseases, German Cancer Research Center, Heidelberg, Germany.,Division of Molecular and Translational Radiation Oncology, Heidelberg Institute of Radiation Oncology, National Center for Radiation Research in Oncology, Heidelberg, Germany.,Heidelberg Ion-Beam Therapy Center, Department of Radiation Oncology, Heidelberg University Hospital, Heidelberg, Germany
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5
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Chakravarty R, Chakraborty S, Sarma HD, Nair KVV, Rajeswari A, Dash A. (90) Y/(177) Lu-labelled Cetuximab immunoconjugates: radiochemistry optimization to clinical dose formulation. J Labelled Comp Radiopharm 2016; 59:354-63. [PMID: 27264196 DOI: 10.1002/jlcr.3413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 05/05/2016] [Accepted: 05/10/2016] [Indexed: 11/06/2022]
Abstract
Radiolabelled monoclonal antibodies (mAbs) are increasingly being utilized in cancer theranostics, which is a significant move toward tailored treatment for individual patients. Cetuximab is a recombinant, human-mouse chimeric IgG1 mAb that binds to the epidermal growth factor receptor with high affinity. We have optimized a protocol for formulation of clinically relevant doses (~2.22 GBq) of (90) Y-labelled Cetuximab and (177) Lu-labelled Cetuximab by conjugation of the mAb with a suitable bifunctional chelator, N-[(R)-2-amino-3-(paraisothiocyanato-phenyl)propyl]-trans-(S,S)-cyclohexane-1,2-diamine-N,N,N',N″,N″-pentaacetic acid (CHX-A″-DTPA). The radioimmunoconjugates demonstrated reasonably high specific activity (1.26 ± 0.27 GBq/mg for (90) Y-CHX-A″-DTPA-Cetuximab and 1.14 ± 0.15 GBq/mg for (177) Lu-CHX-A″-DTPA-Cetuximab), high radiochemical purity (>95%) and appreciable in vitro stability under physiological conditions. Preliminary biodistribution studies with both (90) Y-CHX-A″-DTPA-Cetuximab and (177) Lu-CHX-A″-DTPA-Cetuximab in Swiss mice bearing fibrosarcoma tumours demonstrated significant tumour uptake at 24-h post-injection (p.i.) (~16%ID/g) with good tumour-to-background contrast. The results of the biodistribution studies were further corroborated by ex vivo Cerenkov luminescence imaging after administration of (90) Y-CHX-A″-DTPA-Cetuximab in tumour-bearing mice. The tumour uptake at 24 h p.i. was significantly reduced with excess unlabelled Cetuximab, suggesting that the uptake was receptor mediated. The results of this study hold promise, and this strategy should be further explored for clinical translation.
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Affiliation(s)
- Rubel Chakravarty
- Isotope Production and Applications Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Sudipta Chakraborty
- Isotope Production and Applications Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Haladhar Dev Sarma
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - K V Vimalnath Nair
- Isotope Production and Applications Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Ardhi Rajeswari
- Isotope Production and Applications Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
| | - Ashutosh Dash
- Isotope Production and Applications Division, Bhabha Atomic Research Centre, Trombay, Mumbai, 400085, India
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6
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Leonidova A, Foerster C, Zarschler K, Schubert M, Pietzsch HJ, Steinbach J, Bergmann R, Metzler-Nolte N, Stephan H, Gasser G. In vivo demonstration of an active tumor pretargeting approach with peptide nucleic acid bioconjugates as complementary system. Chem Sci 2015; 6:5601-5616. [PMID: 29861898 PMCID: PMC5949856 DOI: 10.1039/c5sc00951k] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/16/2015] [Indexed: 12/15/2022] Open
Abstract
A novel, promising strategy for cancer diagnosis and therapy is the use of a pretargeting approach. For this purpose, the non-natural DNA/RNA analogues Peptide Nucleic Acids (PNAs) are ideal candidates as in vivo recognition units due to their high metabolic stability and lack of unspecific accumulation. In the pretargeting approach, an unlabeled, highly specific antibody-PNA conjugate has sufficient time to target a tumor before administration of a small fast-clearing radiolabeled complementary PNA that hybridizes with the antibody-PNA conjugate at the tumor site. Herein, we report the first successful application of this multistep process using a PNA-modified epidermal growth factor receptor (EGFR) specific antibody (cetuximab) and a complementary 99mTc-labeled PNA. In vivo studies on tumor bearing mice demonstrated a rapid and efficient in vivo hybridization of the radiolabeled PNA with the antibody-PNA conjugate. Decisively, a high specific tumor accumulation was observed with a tumor-to-muscle ratio of >8, resulting in a clear visualization of the tumor by single photon emission computed tomography (SPECT).
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Affiliation(s)
- Anna Leonidova
- Department of Chemistry , University of Zurich , Winterthurerstrasse 190 , CH-8057 Zurich , Switzerland . ; http://www.gassergroup.com ; Tel: +41 44 635 46 30
| | - Christian Foerster
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Kristof Zarschler
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Maik Schubert
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Hans-Jürgen Pietzsch
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Jörg Steinbach
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Ralf Bergmann
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Nils Metzler-Nolte
- Lehrstuhl für Anorganische Chemie I - Bioanorganische Chemie , Fakultät für Chemie und Biochemie , Ruhr-Universität Bochum , Universitätsstrasse 150 , D-44801 Bochum , Germany
| | - Holger Stephan
- Helmholtz-Zentrum Dresden - Rossendorf , Institute of Radiopharmaceutical Cancer Research , Bautzner Landstraße 400 , D-01328 Dresden , Germany . ; http://www.hzdr.de/NanoscalicSystems ; Tel: +49 351 260-3091
| | - Gilles Gasser
- Department of Chemistry , University of Zurich , Winterthurerstrasse 190 , CH-8057 Zurich , Switzerland . ; http://www.gassergroup.com ; Tel: +41 44 635 46 30
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7
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Elgström E, Ljungberg O, Eriksson SE, Orbom A, Strand SE, Ohlsson TG, Nilsson R, Tennvall J. Change in cell death markers during (177)Lu-mAb radioimmunotherapy-induced rejection of syngeneic rat colon carcinoma. Cancer Biother Radiopharm 2014; 29:143-52. [PMID: 24693940 DOI: 10.1089/cbr.2013.1576] [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] [Indexed: 11/12/2022] Open
Abstract
PURPOSE To monitor cell death in tumors during the rejection process after treatment with an antibody radiolabeled with a β-emitter. METHODS Tumors during rejection after treatment with (177)Lu-labeled antibody BR96 and after administration of unlabeled BR96 were compared with untreated tumors from the same immunocompetent syngeneic rat tumor model. Cell death was monitored with the terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay and immunohistochemical staining of activated caspase-3 and γH2AX. These data were evaluated together with histopathological morphology, BR96-binding antigen expression, and (177)Lu radioactivity distribution imaged by digital autoradiography. RESULTS The untreated tumors showed staining for all the markers, mainly in and around the necrotic areas. One to 2 days p.i. large areas were stained with anti-γH2AX, followed by a slight decrease. Staining of activated caspase-3 was intense and extensive 1-2 days p.i., while found in and around necrotic areas 3-8 days p.i. TUNEL staining was similar to activated caspase-3 staining 1-2 days p.i. but more extensive than activated caspase-3 staining 3-4 days p.i. Digital autoradiography revealed activity concentration in granulation tissue from 1 day p.i. CONCLUSION Following radioimmunotherapy in an immunocompetent syngeneic colon carcinoma model, tumor cells did not only die through caspase-3-dependent apoptosis, but also by other mechanisms.
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Affiliation(s)
- Erika Elgström
- 1 Division of Oncology, Department of Clinical Sciences, Lund University , Lund, Sweden
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8
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Eke I, Ingargiola M, Förster C, Kunz-Schughart LA, Baumann M, Runge R, Freudenberg R, Kotzerke J, Heldt JM, Pietzsch HJ, Steinbach J, Cordes N. Cytotoxic properties of radionuclide-conjugated Cetuximab without and in combination with external irradiation in head and neck cancer cells in vitro. Int J Radiat Biol 2014; 90:678-86. [DOI: 10.3109/09553002.2014.899446] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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9
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Sihver W, Pietzsch J, Krause M, Baumann M, Steinbach J, Pietzsch HJ. Radiolabeled Cetuximab Conjugates for EGFR Targeted Cancer Diagnostics and Therapy. Pharmaceuticals (Basel) 2014; 7:311-38. [PMID: 24603603 PMCID: PMC3978494 DOI: 10.3390/ph7030311] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Revised: 02/11/2014] [Accepted: 02/21/2014] [Indexed: 01/09/2023] Open
Abstract
The epidermal growth factor receptor (EGFR) has evolved over years into a main molecular target for the treatment of different cancer entities. In this regard, the anti-EGFR antibody cetuximab has been approved alone or in combination with: (a) chemotherapy for treatment of colorectal and head and neck squamous cell carcinoma and (b) with external radiotherapy for treatment of head and neck squamous cell carcinoma. The conjugation of radionuclides to cetuximab in combination with the specific targeting properties of this antibody might increase its therapeutic efficiency. This review article gives an overview of the preclinical studies that have been performed with radiolabeled cetuximab for imaging and/or treatment of different tumor models. A particularly promising approach seems to be the treatment with therapeutic radionuclide-labeled cetuximab in combination with external radiotherapy. Present data support an important impact of the tumor micromilieu on treatment response that needs to be further validated in patients. Another important challenge is the reduction of nonspecific uptake of the radioactive substance in metabolic organs like liver and radiosensitive organs like bone marrow and kidneys. Overall, the integration of diagnosis, treatment and monitoring as a theranostic approach appears to be a promising strategy for improvement of individualized cancer treatment.
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Affiliation(s)
- Wiebke Sihver
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße 400, Dresden 01328, Germany.
| | - Jens Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße 400, Dresden 01328, Germany.
| | - Mechthild Krause
- Department of Radiation Oncology and OncoRay, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany.
| | - Michael Baumann
- Department of Radiation Oncology and OncoRay, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany.
| | - Jörg Steinbach
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße 400, Dresden 01328, Germany.
| | - Hans-Jürgen Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Institute of Radiopharmaceutical Cancer Research, Bautzner Landstraße 400, Dresden 01328, Germany.
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Radiolabeled anti-EGFR-antibody improves local tumor control after external beam radiotherapy and offers theragnostic potential. Radiother Oncol 2014; 110:362-9. [PMID: 24440046 DOI: 10.1016/j.radonc.2013.12.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 12/13/2013] [Accepted: 12/15/2013] [Indexed: 12/25/2022]
Abstract
PURPOSE The effect of radioimmunotherapy (RIT) using the therapeutic radionuclide Y-90 bound to the anti-EGFR antibody cetuximab combined with external beam irradiation (EBRT) (EBRIT) on permanent local tumor control in vivo was examined. METHODS Growth delay was evaluated in three human squamous cell carcinoma models after RIT with [(90)Y]Y-(CHX-A''-DTPA)₄-cetuximab (Y-90-cetuximab). The EBRT dose required to cure 50% of the tumors (TCD₅₀) for EBRT alone or EBRIT was evaluated in one RIT-responder (FaDu) and one RIT-non-responder (UT-SCC-5). EGFR expression and microenvironmental parameters were evaluated in untreated tumors, bioavailability was visualized by PET using ([(86)Y]Y-(CHX-A''-DTPA)₄-cetuximab (Y-86-cetuximab) and biodistribution using Y-90-cetuximab. RESULTS In UT-SCC-8 and FaDu but not in UT-SCC-5 radiolabeled cetuximab led to significant tumor growth delay. TCD₅₀ after EBRT was significantly decreased by EGFR-targeted RIT in FaDu but not in UT-SCC-5. In contrast to EGFR expression, parameters of the tumor micromilieu and in particular the Y-90-cetuximab biodistribution or Y-86-cetuximab visualization in PET correlated with the responsiveness to RIT or EBRIT. CONCLUSION EGFR-targeted EBRIT can improve permanent local tumor control compared to EBRT alone. PET imaging of bioavailability of labeled cetuximab appears to be a suitable predictor for response to EBRIT. This theragnostic approach should be further explored for clinical translation.
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Cornelissen B, Waller A, Able S, Vallis KA. Molecular radiotherapy using cleavable radioimmunoconjugates that target EGFR and γH2AX. Mol Cancer Ther 2013; 12:2472-82. [PMID: 23963362 DOI: 10.1158/1535-7163.mct-13-0369] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Many anticancer therapies, including ionizing radiation (IR), cause cytotoxicity through generation of DNA double-strand breaks (DSB). Delivery of therapeutic radionuclides to DNA DSB sites can amplify this DNA damage, for additional therapeutic gain. Herein, we report on two radiopharmaceuticals, radiolabeled with the Auger electron emitter (111)In, with dual specificity for both the intranuclear, DNA damage repair signaling protein γH2AX and the EGF receptor (EGFR). The EGFR ligand EGF was conjugated to a fluorophore- or (111)In-labeled anti-γH2AX antibody, linked via a nuclear localization sequence (NLS) to ensure nuclear translocation. EGF conjugation was achieved either through a noncleavable PEG linker (PEO6) or a cleavable disulfide bond. Both conjugates selectively bound EGFR on fixed cells and γH2AX in cell extracts. Both compounds enter EGFR-expressing cells in an EGF/EGFR-dependent manner. However, only the cleavable compound was seen to associate with γH2AX foci in the nuclei of irradiated cells. Intracellular retention of the cleavable compound was prolonged in γH2AX-expressing cells. Clonogenic survival was significantly reduced when cells were exposed to IR (to induce γH2AX) plus (111)In-labeled cleavable compound compared to either alone and compared to nonspecific controls. In vivo, uptake of (111)In-labeled cleavable compound in MDA-MB-468 xenografts in athymic mice was 2.57 ± 0.47 percent injected dose/g (%ID/g) but increased significantly to 6.30 ± 1.47%ID/g in xenografts where γH2AX was induced by IR (P < 0.01). This uptake was dependent on EGF/EGFR and anti-γH2AX/γH2AX interactions. We conclude that tumor-specific delivery of radiolabeled antibodies directed against intranuclear epitopes is possible using cleavable antibody-peptide conjugates.
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Affiliation(s)
- Bart Cornelissen
- Corresponding Author: Katherine A. Vallis, Gray Institute for Radiation Oncology and Biology, Department of Oncology, University of Oxford, Old Road Campus Research Building, Off Roosevelt Drive, Oxford, OX3 7DQ.
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