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Shah A, Dabhade A, Bharadia H, Parekh PS, Yadav MR, Chorawala MR. Navigating the landscape of theranostics in nuclear medicine: current practice and future prospects. Z NATURFORSCH C 2024; 0:znc-2024-0043. [PMID: 38807355 DOI: 10.1515/znc-2024-0043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 05/10/2024] [Indexed: 05/30/2024]
Abstract
Theranostics refers to the combination of diagnostic biomarkers with therapeutic agents that share a specific target expressed by diseased cells and tissues. Nuclear medicine is an exciting component explored for its applicability in theranostic concepts in clinical and research investigations. Nuclear theranostics is based on the employment of radioactive compounds delivering ionizing radiation to diagnose and manage certain diseases employing binding with specifically expressed targets. In the realm of personalized medicine, nuclear theranostics stands as a beacon of potential, potentially revolutionizing disease management. Studies exploring the theranostic profile of radioactive compounds have been presented in this review along with a detailed explanation of radioactive compounds and their theranostic applicability in several diseases. It furnishes insights into their applicability across diverse diseases, elucidating the intricate interplay between these compounds and disease pathologies. Light is shed on the important milestones of nuclear theranostics beginning with radioiodine therapy in thyroid carcinomas, MIBG labelled with iodine in neuroblastoma, and several others. Our perspectives have been put forth regarding the most important theranostic agents along with emerging trends and prospects.
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Affiliation(s)
- Aayushi Shah
- Department of Pharmacology and Pharmacy Practice, L. M. College of Pharmacy, Ahmedabad 380009, Gujarat, India
| | - Akshada Dabhade
- Department of Pharmacology and Pharmacy Practice, L. M. College of Pharmacy, Ahmedabad 380009, Gujarat, India
| | - Hetvi Bharadia
- Department of Pharmacology and Pharmacy Practice, L. M. College of Pharmacy, Ahmedabad 380009, Gujarat, India
| | - Priyajeet S Parekh
- AV Pharma LLC, 1545 University Blvd N Ste A, Jacksonville, FL, 32211, USA
| | - Mayur R Yadav
- Department of Pharmacy Practice and Administration, Western University of Health Science, 309 E Second St, Pomona, CA, 91766, USA
| | - Mehul R Chorawala
- Department of Pharmacology and Pharmacy Practice, L. M. College of Pharmacy, Ahmedabad 380009, Gujarat, India
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Li H, Pei W, Yang X, Qu G, Hua Q, Liu L, Wang Y, Xu T, Chen Y. Biodistribution and dosimetry of 177Lu-DOTA-IBA for therapy of bone metastases. EJNMMI Res 2024; 14:30. [PMID: 38517637 PMCID: PMC10959900 DOI: 10.1186/s13550-024-01094-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 03/12/2024] [Indexed: 03/24/2024] Open
Abstract
BACKGROUND We designed and synthesized a novel bisphosphonate radiopharmaceutical (68 Ga- or 177Lu-labeled DOTA-ibandronate [68 Ga/177Lu-DOTA-IBA]) for the targeted diagnosis and treatment of bone metastases. The biodistribution and internal dosimetry of a single therapeutic dose of 177Lu-DOTA-IBA were evaluated using a series of single-photon emission computerized tomography (SPECT) images and blood samples. Five patients with multiple bone metastases were included in this prospective study. After receiving 1110 MBq 177Lu-DOTA-IBA, patients underwent whole-body planar, SPECT/CT imaging and venous blood sampling over 7 days. Dosimetric evaluation was performed for the main organs and tumor lesions. Safety was assessed using blood biomarkers. RESULTS 177Lu-DOTA-IBA showed fast uptake, high retention in bone lesions, and rapid clearance from the bloodstream in all patients. In this cohort, the average absorbed doses (ADs) in the bone tumor lesions, kidneys, liver, spleen, red marrow, bladder-wall, and osteogenic cells were 5.740, 0.114, 0.095, 0.121, 0.095, and 0.333 Gy/GBq, respectively. Although no patient reached the predetermined dose thresholds, the red marrow will be the dose-limiting organ. There were no adverse reactions recorded after the administration of 1110 MBq 177Lu-DOTA-IBA. CONCLUSION Dosimetric results show that the ADs for critical organs and total body are within the safety limit and with high bone retention. It is a promising radiopharmaceutical alternative for the targeted treatment of bone metastases, controlling its progression, and improving the survival and quality of life of patients with advanced bone metastasis.
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Affiliation(s)
- Hongmei Li
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Wenjie Pei
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Xiqun Yang
- Department of Dermatology, Affiliated Hospital of Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Gengcuo Qu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Qingchu Hua
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Lin Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Yudi Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China
| | - Tingting Xu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China.
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, No 25 TaiPing St, Jiangyang District, Luzhou, 646000, Sichuan, People's Republic of China.
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, 646000, Sichuan, People's Republic of China.
- Institute of Nuclear Medicine, Southwest Medical University, Luzhou, 646000, Sichuan, People's Republic of China.
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Deng J, Yang J, Wang Y, Liu G, Chen Y. Comparison of the relative diagnostic performance of 68Ga-DOTA-IBA and 18F-NaF for the detection of bone metastasis. Front Oncol 2024; 14:1364311. [PMID: 38585006 PMCID: PMC10995215 DOI: 10.3389/fonc.2024.1364311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024] Open
Abstract
Purpose We aimed to compare the relative diagnostic efficacy of 68Ga-Labeled DOTA-ibandronic acid (68Ga-DOTA-IBA) to that of18F-NaF PET/CT as a mean of detecting bone metastases in patients with a range of cancer types. Methods This study retrospectively enrolled patients with bone metastases associated with various underlying malignancies. All patients underwent both 68Ga-DOTA-IBA and 18F-NaF PET/CT scans. Histopathology and follow-up CT or MRI imaging results were used as reference criteria, with a minimum follow-up period of 3 months. The maximum Standardized Uptake Value (SUVmax) and number of bone metastases were recorded. The Target-Background Ratio (TBR) was calculated along with the detection rate, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 68Ga-DOTA-IBA and 18F-NaF PET/CT imaging for overall and partial primary solid tumor bone metastases. Pearson chi-square test, McNemar test, and Kappa test was conducted to assess the correlation and consistency of diagnostic efficiency between the two imaging agents. Receiver Operating Characteristic curve (ROC curve) was performed to compare diagnostic performance and the area under the curve of the two imaging agents, determining optimal critical values for SUVmax and TBR in diagnosing bone metastasis. Differences in SUVmax and TBR values between the two imaging agents for detecting bone metastases were analyzed using the Wilcoxon signed rank test. The difference was statistically significant when P < 0.05. Results A total of 24 patients (13 women and 11 men) were included in this study, with a mean age of 52 (interquartile range, 49-64 years). The detection rate, sensitivity, specificity, PPV, NPV, accuracy, and AUC of 68Ga-DOTA-IBA and 18F-NaF PET/CT for bone metastases were 81%, 90%, 62%, 95%, 43%, 88%, 0.763, and 89%, 99%, 59%, 95%, 89%, 95%, 0.789, respectively. There was no significant difference between the two imaging methods (P < 0.01), and there was a significant correlation (X2=168.43, P < 0.001) and a strong consistency (Kappa=0.774,P < 0.001) between the diagnostic results of the two imaging agents. The SUVmax values of lesions measured by 68Ga-DOTA-IBA and 18F-NaF imaging in 22 patients with bone metastasis were 5.1 ± 5.4 and 19.6 ± 15.1, respectively, with statistically significant differences (P<0.05). The TBR values of the two imaging methods were 5.0 ± 5.0 and 6.7 ± 6.4, respectively, with statistically significant differences (P<0.05). The AUC of the SUVmax of 68Ga-DOTA-IBA and 18F-NaF curves were 0.824 and 0.862, respectively, with no statistically significant difference (P=0.490). No significant difference was found in the AUC of the TBR of 68Ga-DOTA-IBA and 18F-NaF (0.832 vs 0.890; P=0.248). Subgroup analysis showed significant correlation between the two imaging agents in the diagnosis of bone metastases in lung cancer and breast cancer, with consistent diagnostic results. However, in the diagnosis of bone metastases in prostate cancer, there was a significant difference (P<0.001) and lack of consistency (P=0.109). Conclusion The diagnostic efficacy of 68Ga-DOTA-IBA for bone metastasis lesions is comparable to that of 18F-NaF. This finding holds significant clinical importance in terms of diagnosis of bone metastasis and selecting treatment plans for patients with malignant tumors.
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Affiliation(s)
- Jia Deng
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Nuclear Medicine Institute of Southwest Medical University, Luzhou, Sichuan, China
| | - Jian Yang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Nuclear Medicine Institute of Southwest Medical University, Luzhou, Sichuan, China
| | - Yingwei Wang
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Nuclear Medicine Institute of Southwest Medical University, Luzhou, Sichuan, China
| | - Guangfu Liu
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Nuclear Medicine Institute of Southwest Medical University, Luzhou, Sichuan, China
| | - Yue Chen
- Department of Nuclear Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, Sichuan, China
- Nuclear Medicine Institute of Southwest Medical University, Luzhou, Sichuan, China
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Bellido T. Bisphosphonates for osteoporosis: from bench to clinic. J Clin Invest 2024; 134:e179942. [PMID: 38488010 PMCID: PMC10940084 DOI: 10.1172/jci179942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2024] Open
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Jin W, Zhao R, Wang R, Choi SR, Ploessl K, Alexoff D, Wu Z, Zhu L, Kung HF. Theranostic Agent Targeting Bone Metastasis: A Novel [ 68Ga]Ga/[ 177Lu]Lu-DOTA-HBED-bisphosphonate. J Med Chem 2024. [PMID: 38450559 DOI: 10.1021/acs.jmedchem.3c02372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Bone metastasis in cancer patients is a major disease advancement for various types of cancer. Previously, [68Ga]Ga-HBED-CC-bisphosphonate ([68Ga]Ga-P15-041) showed excellent bone uptake and efficient detection of bone metastasis in patients. To accommodate different α- or β--emitting metals for radionuclide therapy, a novel DOTA-HBED-CC-bisphosphonate (P15-073, 1) was prepared and the corresponding [68Ga]Ga-1 and [177Lu]Lu-1 were successfully synthesized in high yields and purity. Gallium-68 conjugation to HBED-CC at room temperature and lutetium-177 conjugation to DOTA at 95 °C were verified in model compounds through secondary mass confirmation. These bisphosphonates, [68Ga]Ga-1 and [177Lu]Lu-1, displayed high binding affinity to hydroxyapatite in vitro. After an iv injection, it showed excellent uptake in the spine of normal mice, and micro-PET/CT imaging of nude mice model of bone metastasis showed high bone uptake in tumor tissue. The results indicated that [68Ga]Ga/[177Lu]Lu-1 holds promise as a theranostic radioligand agent for managing cancer bone metastases.
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Affiliation(s)
- Wenbin Jin
- College of Chemistry, Beijing Normal University, Beijing 100875, China
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, Guangdong 518000, China
| | - Ruiyue Zhao
- Department of Nuclear Medicine, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510120, China
| | - Ran Wang
- College of Chemistry, Beijing Normal University, Beijing 100875, China
| | - Seok Rye Choi
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Karl Ploessl
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - David Alexoff
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Zehui Wu
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Lin Zhu
- College of Chemistry, Beijing Normal University, Beijing 100875, China
- Institute of Biomedical Engineering, Shenzhen Bay Laboratory, Shenzhen, Guangdong 518000, China
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
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Chakraborty S, Chatterjee S, Chakravarty R, Sarma HD, Nanabala R, Goswami D, Joy A, Pillai MRA. Synthesis, Quality Control, and Bench-to-Bed Translation of a New [ 68Ga]Ga-Labeled NOTA-Conjugated Bisphosphonate for Imaging Skeletal Metastases by Positron Emission Tomography. Cancer Biother Radiopharm 2024; 39:92-101. [PMID: 38335449 DOI: 10.1089/cbr.2023.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024] Open
Abstract
Background: Early detection of skeletal metastasis is of great interest to determine the prognosis of cancer. Positron emission tomography-computed tomography (PET-CT) imaging provides a better temporal and spectral resolution than single photon emission computed tomography-computed tomography (SPECT-CT) imaging, and hence is more suitable to detect small metastatic lesions. Although [18F]NaF has been approved by U.S. FDA for a similar purpose, requirement of a medical cyclotron for its regular formulation restricts its extensive utilization. Efforts have been made to find suitable alternative molecules that can be labeled with 68Ga and used in PET-CT imaging. Objective: The main objective of this study is to synthesize and evaluate a new [68Ga]Ga-labeled NOTA-conjugated geminal bisphosphonate for its potential use in early detection of skeletal metastases using PET-CT. Methods: The authors performed a multistep synthesis of a new NOTA-conjugated bisphosphonic acid using thiourea linker and radiolabeled the molecule with 68Ga. The radiolabeled formulation was evaluated for its in vitro stability, affinity for hydroxyapatite (HA) particles, preclinical biodistribution in animal models, and PET-CT imaging in patients. Results: The bifunctional chelator (NOTA)-conjugated bisphosphonate was synthesized with 97.8% purity and radiolabeled with 68Ga in high yield (>98%). The radiolabeled formulation was found to retain its stability in vitro to the extent of >95% up to 4 h in physiological saline and human serum. The formulation also showed high affinity for HA particles in vitro with Kd = 907 ± 14 mL/g. Preclinical biodistribution studies in normal Wistar rats demonstrated rapid and almost exclusive skeletal accumulation of the complex. PET-CT imaging in a patient confirmed its ability to detect small metastatic skeletal lesions. Conclusions: The newly synthesized [68Ga]Ga-labeled NOTA-conjugated bisphosphonate is a promising radiotracer for PET-CT imaging for skeletal metastases.
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Affiliation(s)
- Sudipta Chakraborty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Sucheta Chatterjee
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Bio Organic Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - Rubel Chakravarty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
- Homi Bhabha National Institute (HBNI), Mumbai, India
| | - Haldhar D Sarma
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | | | - Dibakar Goswami
- Homi Bhabha National Institute (HBNI), Mumbai, India
- Bio Organic Division, Bhabha Atomic Research Centre (BARC), Mumbai, India
| | - Ajith Joy
- Molecular Group of Companies, Ernakulam, India
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Souche C, Fouillet J, Rubira L, Donzé C, Deshayes E, Fersing C. Bisphosphonates as Radiopharmaceuticals: Spotlight on the Development and Clinical Use of DOTAZOL in Diagnostics and Palliative Radionuclide Therapy. Int J Mol Sci 2023; 25:462. [PMID: 38203632 PMCID: PMC10779041 DOI: 10.3390/ijms25010462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 12/25/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Bisphosphonates are therapeutic agents that have been used for almost five decades in the treatment of various bone diseases, such as osteoporosis, Paget disease and prevention of osseous complications in cancer patients. In nuclear medicine, simple bisphosphonates such as 99mTc-radiolabelled oxidronate and medronate remain first-line bone scintigraphic imaging agents for both oncology and non-oncology indications. In line with the growing interest in theranostic molecules, bifunctional bisphosphonates bearing a chelating moiety capable of complexing a variety of radiometals were designed. Among them, DOTA-conjugated zoledronate (DOTAZOL) emerged as an ideal derivative for both PET imaging (when radiolabeled with 68Ga) and management of bone metastases from various types of cancer (when radiolabeled with 177Lu). In this context, this report provides an overview of the main medicinal chemistry aspects concerning bisphosphonates, discussing their roles in molecular oncology imaging and targeted radionuclide therapy with a particular focus on bifunctional bisphosphonates. Particular attention is also paid to the development of DOTAZOL, with emphasis on the radiochemistry and quality control aspects of its preparation, before outlining the preclinical and clinical data obtained so far with this radiopharmaceutical candidate.
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Affiliation(s)
- Céleste Souche
- Nuclear Medicine Department, Institut Régional du Cancer de Montpellier (ICM), University Montpellier, 34298 Montpellier, France
| | - Juliette Fouillet
- Nuclear Medicine Department, Institut Régional du Cancer de Montpellier (ICM), University Montpellier, 34298 Montpellier, France
| | - Léa Rubira
- Nuclear Medicine Department, Institut Régional du Cancer de Montpellier (ICM), University Montpellier, 34298 Montpellier, France
| | - Charlotte Donzé
- Nuclear Medicine Department, Institut Régional du Cancer de Montpellier (ICM), University Montpellier, 34298 Montpellier, France
| | - Emmanuel Deshayes
- Nuclear Medicine Department, Institut Régional du Cancer de Montpellier (ICM), University Montpellier, 34298 Montpellier, France
- Institut de Recherche en Cancérologie de Montpellier (IRCM), INSERM U1194, University Montpellier, Institut Régional du Cancer de Montpellier (ICM), 34298 Montpellier, France
| | - Cyril Fersing
- Nuclear Medicine Department, Institut Régional du Cancer de Montpellier (ICM), University Montpellier, 34298 Montpellier, France
- IBMM, University Montpellier, CNRS, ENSCM, 34293 Montpellier, France
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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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Hong H, Zha Z, Zhao R, Luo Y, Jin W, Li L, Wang R, Yan L, Wang H, Ploessl K, Qiao J, Zhu L, Kung HF. [ 68Ga]Ga-HBED-CC-FAPI Derivatives with Improved Radiolabeling and Specific Tumor Uptake. Mol Pharm 2023; 20:2159-2169. [PMID: 36942924 DOI: 10.1021/acs.molpharmaceut.2c01112] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Fibroblast activation protein (FAP) is selectively expressed in tumors and highly important for maintaining the microenvironment in malignant tumors. Radioisotope-labeled FAP inhibitors (FAPIs) were proven to be useful for diagnosis and radionuclide therapy of cancer and are under active clinical investigations. Ga-HBED complex displays a higher in vivo stability constant (log KGaL: 38.5), compared to that of Ga-DOTA (log KGaL: 21.3). Such advantage in stability constant suggests that it may be useful for development of alternative FAPI imaging agents. In this study, previously reported [68Ga]Ga-DOTA-FAPI-02 and -04 were converted to the corresponding [68Ga]Ga-HBED-CC-FAPI-02 and -04 derivatives ([68Ga]Ga-4, [68Ga]Ga-5, [68Ga]Ga-6, and [68Ga]Ga-7). It was found that substituting the DOTA chelating group with HBED-CC led to several unique and desirable tumor-targeting properties: (1) robust, fast, and high yield labeling─readily adaptable to a kit formulation; (2) high stabilities in vitro; (3) excellent FAP binding affinities (IC50 ranging between 4 and 7 nM) and improved cell uptake and retention (in HT1080 (FAP+) cells); and (4) excellent selective in vivo tumor uptake in nude mice bearing U87MG tumor. It appeared that Ga(III) chelation with HBED-CC improved the in vivo kinetics favoring higher tumor uptake and retention compared to the corresponding Ga-DOTA complex. Out of the four tested ligands the new [68Ga]Ga-HBED-CC-FAPI dimer, [68Ga]Ga-6, displayed the best tumor localization properties, and further studies are warranted to demonstrate that it is an alternative FAP imaging agent for cancer patients.
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Affiliation(s)
- Haiyan Hong
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Zhihao Zha
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Ruiyue Zhao
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Yang Luo
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Wenbin Jin
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Linlin Li
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Ran Wang
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Li Yan
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Hui Wang
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Karl Ploessl
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Jinping Qiao
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Lin Zhu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing 100875, P. R. China
| | - Hank F Kung
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
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10
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Radiometal-theranostics: the first 20 years*. J Radioanal Nucl Chem 2022. [DOI: 10.1007/s10967-022-08624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AbstractThis review describes the basic principles of radiometal-theranostics and its dawn based on the development of the positron-emitting 86Y and 86Y-labeled radiopharmaceuticals to quantify biodistribution and dosimetry of 90Y-labeled analogue therapeutics. The nuclear and inorganic development of 86Y (including nuclear and cross section data, irradiation, radiochemical separation and recovery) led to preclinical and clinical evaluation of 86Y-labeled citrate and EDTMP complexes and yielded organ radiation doses in terms of mGy/MBq 90Y. The approach was extended to [86/90Y]Y-DOTA-TOC, yielding again yielded organ radiation doses in terms of mGy/MBq 90Y. The review further discusses the consequences of this early development in terms of further radiometals that were used (68Ga, 177Lu etc.), more chelators that were developed, new biological targets that were addressed (SSTR, PSMA, FAP, etc.) and subsequent generations of radiometal-theranostics that resulted out of that.
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11
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Xiao D, Jiang Y, Feng J, Ruan Q, Wang Q, Yin G, Zhang J. Novel 99mTc labeled complexes with bisphosphonate isocyanide: radiosynthesis and evaluation as potential bone-seeking agents. Bioorg Med Chem Lett 2022; 73:128918. [DOI: 10.1016/j.bmcl.2022.128918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/28/2022] [Accepted: 07/28/2022] [Indexed: 11/02/2022]
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12
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Pazderová L, Benešová M, Havlíčková J, Vojtíčková M, Kotek J, Lubal P, Ullrich M, Walther M, Schulze S, Neuber C, Rammelt S, Pietzsch HJ, Pietzsch J, Kubíček V, Hermann P. Cyclam with a phosphinate-bis(phosphonate) pendant arm is a bone-targeting carrier of copper radionuclides. Dalton Trans 2022; 51:9541-9555. [PMID: 35670322 DOI: 10.1039/d2dt01172g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Ligands combining a bis(phosphonate) group with a macrocycle function as metal isotope carriers for radionuclide-based imaging and for treating bone metastases associated with several cancers. However, bis(phosphonate) pendant arms often slow down complex formation and decrease radiochemical yields. Nevertheless, their negative effect on complexation rates may be mitigated by using a suitable spacer between bis(phosphonate) and the macrocycle. To demonstrate the potential of bis(phosphonate) bearing macrocyclic ligands as a copper radioisotope carrier, we report the synthesis of a new cyclam derivative bearing a phosphinate-bis(phosphonate) pendant (H5te1PBP). The ligand showed a high selectivity to CuII over ZnII and NiII ions, and the bis(phosphonate) group was not coordinated in the CuII complex, strongly interacting with other metal ions in solution. The CuII complex formed quickly, in 1 s, at pH 5 and at a millimolar scale. The complexation rates significantly differed under a ligand or metal ion excess due to the formation of reaction intermediates differing in their metal-to-ligand ratio and protonation state, respectively. The CuII-te1PBP complex also showed a high resistance to acid-assisted hydrolysis (t1/2 2.7 h; 1 M HClO4, 25 °C) and was effectively adsorbed on the hydroxyapatite surface. H5te1PBP radiolabeling with [64Cu]CuCl2 was fast and efficient, with specific activities of approximately 30 GBq 64Cu per 1 μmol of ligand (pH 5.5, room temperature, 30 min). In a pilot experiment, we further demonstrated the excellent suitability of [64Cu]CuII-te1PBP for imaging active bone compartments by dedicated small animal PET/CT in healthy mice and subsequently in a rat femoral defect model, in direct comparison with [18F]fluoride. Moreover, [64Cu]CuII-te1PBP showed a higher uptake in critical bone defect regions. Therefore, our study highlights the potential of [64Cu]CuII-te1PBP as a PET radiotracer for evaluating bone healing in preclinical and clinical settings with a diagnostic value similar to that of [18F]fluoride, albeit with a longer half-life (12.7 h) than 18F (1.8 h), thereby enabling extended observation times.
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Affiliation(s)
- Lucia Pazderová
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic.
| | - Martina Benešová
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic. .,Research Group Molecular Biology of Systemic Radiotherapy, German Cancer Research Center, Im Neuenheimer Feld 223, 69120 Heidelberg, Germany
| | - Jana Havlíčková
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic.
| | - Margareta Vojtíčková
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic.
| | - Jan Kotek
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic.
| | - Přemysl Lubal
- Department of Chemistry, Faculty of Science, Masaryk University, Kamenice 5, 625 00 Brno, Czech Republic
| | - Martin Ullrich
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - Martin Walther
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - Sabine Schulze
- Technische Universität Dresden, Faculty of Medicine, Centre for Translational Bone, Joint and Soft Tissue Research, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Christin Neuber
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstrasse 400, 01328 Dresden, Germany
| | - Stefan Rammelt
- Technische Universität Dresden, University Hospital Carl Gustav Carus, University Center for Orthopaedics and Traumatology, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Hans-Jürgen Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstrasse 400, 01328 Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, 01069 Dresden, Germany
| | - Jens Pietzsch
- Helmholtz-Zentrum Dresden-Rossendorf, Institute of Radiopharmaceutical Cancer Research, Bautzner Landstrasse 400, 01328 Dresden, Germany.,Technische Universität Dresden, School of Science, Faculty of Chemistry and Food Chemistry, 01069 Dresden, Germany
| | - Vojtěch Kubíček
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic.
| | - Petr Hermann
- Department of Inorganic Chemistry, Faculty of Science, Charles University, Hlavova 8, 128 40 Prague 2, Czech Republic.
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Eryilmaz K, Bakar HE, Kilbas B. Novel developed HPLC analyses of [
68
Ga]Ga/[
177
Lu]Lu‐EDTMP and [
68
Ga]Ga/[
177
Lu]Lu‐DOTA‐Zoledronate. J Labelled Comp Radiopharm 2022; 65:178-186. [DOI: 10.1002/jlcr.3972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 01/31/2022] [Accepted: 04/20/2022] [Indexed: 11/10/2022]
Affiliation(s)
| | | | - Benan Kilbas
- Moltek A. S. Gebze Organize Sanayi Kocaeli Turkey
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14
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Chakravarty R, Chakraborty S. A review of advances in the last decade on targeted cancer therapy using 177Lu: focusing on 177Lu produced by the direct neutron activation route. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2021; 11:443-475. [PMID: 35003885 PMCID: PMC8727880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/09/2021] [Indexed: 06/14/2023]
Abstract
Lutetium-177 [T½ = 6.76 d; Eβ (max) = 0.497 MeV; maximum tissue range ~2.5 mm; 208 keV γ-ray] is one of the most important theranostic radioisotope used for the management of various oncological and non-oncological disorders. The present review chronicles the advancement in the last decade in 177Lu-radiopharmacy with a focus on 177Lu produced via direct 176Lu (n, γ) 177Lu nuclear reaction in medium flux research reactors. The specific nuances of 177Lu production by various routes are described and their pros and cons are discussed. Lutetium, is the last element in the lanthanide series. Its chemistry plays a vital role in the preparation of a wide variety of radiopharmaceuticals which demonstrate appreciable in vivo stability. Traditional bifunctional chelators (BFCs) that are used for 177Lu-labeling are discussed and the upcoming ones are highlighted. Research efforts that resulted in the growth of various 177Lu-based radiopharmaceuticals in preclinical and clinical settings are provided. This review also summarizes the results of clinical studies with potent 177Lu-based radiopharmaceuticals that have been prepared using medium specific activity 177Lu produced by direct neutron activation route in research reactors. Overall, the review amply demonstrates the practicality of the medium specific activity 177Lu towards formulation of various clinically useful radiopharmaceuticals, especially for the benefit of millions of cancer patients in developing countries with limited reactor facilities.
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Affiliation(s)
- Rubel Chakravarty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre Trombay, Mumbai 400085, India
- Homi Bhabha National Institute Anushaktinagar, Mumbai 400094, India
| | - Sudipta Chakraborty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre Trombay, Mumbai 400085, India
- Homi Bhabha National Institute Anushaktinagar, Mumbai 400094, India
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15
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Guo R, Meng X, Wang F, Yu J, Xie Q, Zhao W, Zhu L, Kung HF, Yang Z, Li N. 68Ga-P15-041, A Novel Bone Imaging Agent for Diagnosis of Bone Metastases. Front Oncol 2021; 11:766851. [PMID: 34900716 PMCID: PMC8654731 DOI: 10.3389/fonc.2021.766851] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives 68Ga-P15-041 (68Ga-HBED-CC-BP) is a novel bone-seeking PET radiotracer, which can be readily prepared by using a simple kit formulation and an in-house 68Ga/68Ge generator. The aim of this study is to assess the potential human application of 68Ga-P15-041 for clinical PET/CT imaging and to compare its efficacy to detect bone metastases of different cancers with 99mTc-MDP whole-body bone scintigraphy (WBBS). Methods Initial kinetic study using Patlak analysis and parametric maps were performed in five histopathologically proven cancer patients (three males, two females) using 68Ga-P15-041 PET/CT scan only. Another group of 51 histopathologically proven cancer patients (22 males, 29 females) underwent both 99mTc-MDP WBBS and 68Ga-P15-041 PET/CT scans within a week, sequentially. Using either pathology examination or follow-up CT or MRI scans as the gold standard, the diagnostic efficacy and receiver operating characteristic curve (ROC) of the two methods in identifying bone metastases were compared (p <0.05, statistically significant). Results Fifty-one patients were imaged, and 174 bone metastatic sites were identified. 68Ga-P15-041 PET/CT and 99mTc-MDP WBBS detected 162 and 81 metastases, respectively. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 68Ga-P15-041 PET/CT and 99mTc-MDP WBBS were 93.1% vs 81.8%, 89.8% vs 90.7%, 77.5% vs 69.2%, 97.2% vs 93.4% and 90.7% vs 88.4%, respectively. Our results showed that the mean of SUVmax was significantly higher in metastases than that in benign lesions, 15.1 ± 6.9 vs. 5.6 ± 1.3 (P <0.001). Using SUVmax = 7.6 as the cut-off value by PET/CT, it was possible to predict the occurrence of metastases (AUC = 0.976; P <0.001; 95% CI: 0.946–0.999). However, it was impossible to distinguish osteoblastic bone metastases from osteolytic bone lesions. Parametric maps based on Patlak analysis provided excellent images and highly valuable quantitative information. Conclusions 68Ga-P15-041 PET/CT, offering a rapid bone scan and high contrast images in minutes, is superior to the current method of choice in detecting bone metastases. It is reasonable to suggest that 68Ga-P15-041 PET/CT could become a valuable routine nuclear medicine procedure in providing excellent images for detecting bone metastases in cancer patients. 68Ga-P15-041 could become a valuable addition expanding the collection of 68Ga-based routine nuclear medicine procedures where 18F fluoride is not currently available.
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Affiliation(s)
- Rui Guo
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Xiangxi Meng
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Fei Wang
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jiangyuan Yu
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Qing Xie
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Wei Zhao
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lin Zhu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, China
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
| | - Nan Li
- Key Laboratory of Carcinogenesis and Translational Research, (Ministry of Education, Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, China
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16
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Pereira NC, de Oliveira Silva J, De Sousa FB, Miranda SEM, Soares DCF, de Barros ALB. [99mTc]Tc-Phosphate-buffer system as a potential tracer for bone imaging. J Radioanal Nucl Chem 2021. [DOI: 10.1007/s10967-021-07869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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17
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Keeling GP, Sherin B, Kim J, San Juan B, Grus T, Eykyn TR, Rösch F, Smith GE, Blower PJ, Terry SYA, T M de Rosales R. [ 68Ga]Ga-THP-Pam: A Bisphosphonate PET Tracer with Facile Radiolabeling and Broad Calcium Mineral Affinity. Bioconjug Chem 2021; 32:1276-1289. [PMID: 32786371 PMCID: PMC7611355 DOI: 10.1021/acs.bioconjchem.0c00401] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Calcium minerals such as hydroxyapatite (HAp) can be detected noninvasively in vivo using nuclear imaging agents such as [18F]NaF (available from cyclotrons), for positron emission tomography (PET) and 99mTc-radiolabeled bisphosphonates (BP; available from 99mTc generators for single photon emission computed tomography (SPECT) or scintigraphy). These two types of imaging agents allow detection of bone metastases (based on the presence of HAp) and vascular calcification lesions (that contain HAp and other calcium minerals). With the aim of developing a cyclotron-independent PET radiotracer for these lesions, with broad calcium mineral affinity and simple one-step radiolabeling, we developed [68Ga]Ga-THP-Pam. Radiolabeling with 68Ga is achieved using a mild single-step kit (5 min, room temperature, pH 7) to high radiochemical yield and purity (>95%). NMR studies demonstrate that Ga binds via the THP chelator, leaving the BP free to bind to its biological target. [68Ga]Ga-THP-Pam shows high stability in human serum. The calcium mineral binding of [68Ga]Ga-THP-Pam was compared in vitro to two other 68Ga-BPs which have been successfully evaluated in humans, [68Ga]Ga-NO2APBP and [68Ga]Ga-BPAMD, as well as [18F]NaF. Interestingly, we found that all 68Ga-BPs have a high affinity for a broad range of calcium minerals implicated in vascular calcification disease, while [18F]NaF is selective for HAp. Using healthy young mice as a model of metabolically active growing calcium mineral in vivo, we compared the pharmacokinetics and biodistribution of [68Ga]Ga-THP-Pam with [18F]NaF as well as [68Ga]NO2APBP. These studies revealed that [68Ga]Ga-THP-Pam has high in vivo affinity for bone tissue (high bone/muscle and bone/blood ratios) and fast blood clearance (t1/2 < 10 min) comparable to both [68Ga]NO2APBP and [18F]NaF. Overall, [68Ga]Ga-THP-Pam shows high potential for clinical translation as a cyclotron-independent calcium mineral PET radiotracer, with simple and efficient radiochemistry that can be easily implemented in any radiopharmacy.
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Affiliation(s)
- George P Keeling
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Billie Sherin
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Jana Kim
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Belinda San Juan
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Tilmann Grus
- Department of Nuclear Chemistry, Johannes Gutenberg University Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany
| | - Thomas R Eykyn
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Frank Rösch
- Department of Nuclear Chemistry, Johannes Gutenberg University Mainz, Fritz-Strassmann-Weg 2, D-55128 Mainz, Germany
| | - Gareth E Smith
- Theragnostics Ltd, 2 Arlington Square, Bracknell, Berkshire RG12 1WA, U.K
| | - Philip J Blower
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Samantha Y A Terry
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
| | - Rafael T M de Rosales
- School of Biomedical Engineering & Imaging Sciences, King's College London, St Thomas' Hospital, London SE1 7EH, U.K
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Vahidfar N, Eppard E, Farzanehfar S, Yordanova A, Fallahpoor M, Ahmadzadehfar H. An Impressive Approach in Nuclear Medicine: Theranostics. PET Clin 2021; 16:327-340. [PMID: 34053577 DOI: 10.1016/j.cpet.2021.03.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Radiometal-based theranostics or theragnostics, first used in the early 2000s, is the combined application of diagnostic and therapeutic agents that target the same molecule, and represents a considerable advancement in nuclear medicine. One of the promising fields related to theranostics is radioligand therapy. For instance, the concepts of targeting the prostate-specific membrane antigen (PSMA) for imaging and therapy in prostate cancer, or somatostatin receptor targeted imaging and therapy in neuroendocrine tumors (NETs) are part of the field of theranostics. Combining targeted imaging and therapy can improve prognostication, therapeutic decision-making, and monitoring of the therapy.
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Affiliation(s)
- Nasim Vahidfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Elisabeth Eppard
- Positronpharma SA, Santiago, Chile; Department of Nuclear Medicine, University Hospital Magdeburg, Germany
| | - Saeed Farzanehfar
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Maryam Fallahpoor
- Department of Nuclear Medicine, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Eryilmaz K, Kilbas B. Detailed Chemistry Studies of 225Actinium Labeled Radiopharmaceuticals. Curr Radiopharm 2021; 15:76-83. [PMID: 34053430 DOI: 10.2174/1874471014666210528123936] [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: 10/30/2020] [Revised: 02/19/2021] [Accepted: 02/25/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Synthesis of 225Actinium derivatives using PSMA-617, DOTATATE peptides and EDTMP ligand was afforded. Detailed experimental, quality control (QC) and stability studies were well described. The radiolabelling reactions were performed in mild conditions with desirable radiochemical yields and high radiochemical purities. METHODS PSMA-617, and DOTATATE were radiolabelled with 225Actinium in 0.1 M HCl in the presence of ascorbate buffer solution and passed through the C-18 light cartridge for purification and the product was eluted by ethanol-water solution. EDTMP was also radiolabelled with 225Actinium without using any stabilizer and purification step. All products were well analyzed by R-TLC and R-HPLC. The stability of those compounds was also studied within the valid time. RESULTS 225Ac-DOTATATE and 225Ac-PSMA-617 were obtained at the same condition. The radiochemical yield of 225Ac-DOTATATE was less than 225Ac-PSMA 617. Stability experiments indicated decay daughters of 225Actinium appeared after T0 +1 h due to the recoil effect radiolysis. On the other hand, 225Ac-EDTMP was more stable than DOTA-peptide radiolabelled compounds. 225Ac-EDTMP was produced with more than 95% radiochemical yield and 99% radiochemical purity. CONCLUSION A detailed chemistry study was presented for the synthesis of 225Actinium derivatives in mild conditions with absolute radiochemical purities and high yields. Experimental results showed that 225Ac-EDTMP could be a suitable alternative radiopharmaceutical for bone metastases arising from primer tumors as a cocktail therapy.
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Affiliation(s)
| | - Benan Kilbas
- Moltek A. S. Gebze Organize Sanayi, 41400 Gebze, Kocaeli, Turkey
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20
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Samal S, Dash P, Dash M. Drug Delivery to the Bone Microenvironment Mediated by Exosomes: An Axiom or Enigma. Int J Nanomedicine 2021; 16:3509-3540. [PMID: 34045855 PMCID: PMC8149288 DOI: 10.2147/ijn.s307843] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 03/30/2021] [Indexed: 12/12/2022] Open
Abstract
The increasing incidence of bone-related disorders is causing a burden on the clinical scenario. Even though bone is one of the tissues that possess tremendous regenerative potential, certain bone anomalies need therapeutic intervention through appropriate delivery of a drug. Among several nanosystems and biologics that offer the potential to contribute towards bone healing, the exosomes from the class of extracellular vesicles are outstanding. Exosomes are extracellular nanovesicles that, apart from the various advantages, are standing out of the crowd for their ability to conduct cellular communication. The internal cargo of the exosomes is leading to its potential use in therapeutics. Exosomes are being unraveled in terms of the mechanism as well as application in targeting various diseases and tissues. Through this review, we have tried to understand and review all that is already established and the gap areas that still exist in utilizing them as drug delivery vehicles targeting the bone. The review highlights the potential of the exosomes towards their contribution to the drug delivery scenario in the bone microenvironment. A comparison of the pros and cons of exosomes with other prevalent drug delivery systems is also done. A section on the patents that have been generated so far from this field is included.
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Affiliation(s)
- Sasmita Samal
- Institute of Life Sciences, Nalco Square, Bhubaneswar, Odisha, 751023, India
- School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, Odisha, 751024, India
| | - Pratigyan Dash
- Institute of Life Sciences, Nalco Square, Bhubaneswar, Odisha, 751023, India
- School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, Odisha, 751024, India
| | - Mamoni Dash
- Institute of Life Sciences, Nalco Square, Bhubaneswar, Odisha, 751023, India
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21
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Prognostic and Theranostic Applications of Positron Emission Tomography for a Personalized Approach to Metastatic Castration-Resistant Prostate Cancer. Int J Mol Sci 2021; 22:ijms22063036. [PMID: 33809749 PMCID: PMC8002334 DOI: 10.3390/ijms22063036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/02/2021] [Accepted: 03/04/2021] [Indexed: 01/25/2023] Open
Abstract
Metastatic castration-resistant prostate cancer (mCRPC) represents a condition of progressive disease in spite of androgen deprivation therapy (ADT), with a broad spectrum of manifestations ranging from no symptoms to severe debilitation due to bone or visceral metastatization. The management of mCRPC has been profoundly modified by introducing novel therapeutic tools such as antiandrogen drugs (i.e., abiraterone acetate and enzalutamide), immunotherapy through sipuleucel-T, and targeted alpha therapy (TAT). This variety of approaches calls for unmet need of biomarkers suitable for patients’ pre-treatment selection and prognostic stratification. In this scenario, imaging with positron emission computed tomography (PET/CT) presents great and still unexplored potential to detect specific molecular and metabolic signatures, some of whom, such as the prostate specific membrane antigen (PSMA), can also be exploited as therapeutic targets, thus combining diagnosis and therapy in the so-called “theranostic” approach. In this review, we performed a web-based and desktop literature research to investigate the prognostic and theranostic potential of several PET imaging probes, such as 18F-FDG, 18F-choline and 68Ga-PSMA-11, also covering the emerging tracers still in a pre-clinical phase (e.g., PARP-inhibitors’ analogs and the radioligands binding to gastrin releasing peptide receptors/GRPR), highlighting their potential for defining personalized care pathways in mCRPC.
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22
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Liu P, Shi X, Zhong S, Peng Y, Qi Y, Ding J, Zhou W. Metal-phenolic networks for cancer theranostics. Biomater Sci 2021; 9:2825-2849. [PMID: 33688863 DOI: 10.1039/d0bm02064h] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Metal-phenolic networks (MPNs) have shown promising potential in biomedical applications since they provide a rapid, simple and robust way to construct multifunctional nanoplatforms. As a novel nanomaterial self-assembled from metal ions and polyphenols, MPNs can be prepared to assist the theranostics of cancer owing to their bio-adhesiveness, good biocompatibility, versatile drug loading, and stimuli-responsive profile. This Critical Review aims to summarize recent progress in MPN-based nanoplatforms for multimodal tumor therapy and imaging. First, the advantages of MPNs as drug carriers are summarized. Then, various tumor therapeutic modalities based on MPNs are introduced. Next, MPN-based theranostic systems are reviewed. In terms of in vivo applications, specific attention is paid to their biosafety, biodistribution, as well as excretion. Finally, some problems and limitations of MPNs are discussed, along with a future perspective on the field.
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Affiliation(s)
- Peng Liu
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, China.
| | - Xinyi Shi
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, China.
| | - Shenghui Zhong
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, China. and School of Medicine, Yichun University, Yichun, Jiangxi 336000, China
| | - Ying Peng
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, China.
| | - Yan Qi
- Department of Pathology, Shihezi University School of Medicine & the First Affiliated Hospital to Shihezi University School of Medicine, Shihezi, Xinjiang 832002, China
| | - Jinsong Ding
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, China.
| | - Wenhu Zhou
- Xiangya School of Pharmaceutical Sciences, Central South University, Changsha, Hunan 410013, China.
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Fernández R, Eppard E, Lehnert W, Jiménez-Franco LD, Soza-Ried C, Ceballos M, Ribbeck J, Kluge A, Rösch F, Meckel M, Zhernosekov K, Kramer V, Amaral H. Evaluation of Safety and Dosimetry of 177Lu-DOTA-ZOL for Therapy of Bone Metastases. J Nucl Med 2021; 62:1126-1132. [PMID: 33419945 PMCID: PMC8833870 DOI: 10.2967/jnumed.120.255851] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/01/2020] [Indexed: 12/18/2022] Open
Abstract
Palliative treatment of bone metastasis using radiolabeled bisphosphonates is a well-known concept proven to be safe and effective. A new therapeutic radiopharmaceutical for bone metastasis is 177Lu-DOTA-zoledronic acid (177Lu-DOTA-ZOL). In this study, the safety and dosimetry of a single therapeutic dose of 177Lu-DOTA-ZOL were evaluated on the basis of a series of SPECT/CT images and blood samples. Methods: Nine patients with exclusive bone metastases from metastatic castration-resistant prostate cancer (mCRPC) (70.8 ± 8.4 y) and progression under conventional therapies participated in this prospective study. After receiving 5,780 ± 329 MBq 177Lu-DOTA-ZOL, patients underwent 3-dimensional whole-body SPECT/CT imaging and venous blood sampling over 7 d. Dosimetric evaluation was performed for main organs and tumor lesions. Safety was assessed by blood biomarkers. Results: 177Lu-DOTA-ZOL showed fast uptake and high retention in bone lesions and fast clearance from the bloodstream in all patients. The average retention in tumor lesions was 0.02% injected activity per gram at 6 h after injection and approximately 0.01% at 170 h after injection. In this cohort, the average absorbed doses in bone tumor lesions, kidneys, red bone marrow, and bone surfaces were 4.21, 0.17, 0.36, and 1.19 Gy/GBq, respectively. The red marrow was found to be the dose-limiting organ for all patients. A median maximum tolerated injected activity of 6.0 GBq may exceed the defined threshold of 2 Gy for the red bone marrow in individual patients (4/8). Conclusion: 177Lu-DOTA-ZOL is safe and has a favorable therapeutic index compared with other radiopharmaceuticals used in the treatment of osteoblastic bone metastases. Personalized dosimetry, however, should be considered to avoid severe hematotoxicity for individual patients.
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Affiliation(s)
- René Fernández
- Center for Nuclear Medicine and PET/CT, PositronMed, Santiago, Chile
| | | | - Wencke Lehnert
- ABX-CRO, Dresden, Germany.,Department of Nuclear Medicine, University Medical Center, Hamburg, Germany
| | | | | | - Matías Ceballos
- Center for Nuclear Medicine and PET/CT, PositronMed, Santiago, Chile
| | | | | | - Frank Rösch
- Institute of Nuclear Chemistry, Johannes Gutenberg-University, Mainz, Germany; and
| | | | | | - Vasko Kramer
- Center for Nuclear Medicine and PET/CT, PositronMed, Santiago, Chile.,Positronpharma SA, Santiago, Chile
| | - Horacio Amaral
- Center for Nuclear Medicine and PET/CT, PositronMed, Santiago, Chile.,Positronpharma SA, Santiago, Chile
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24
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Hong H, Ploessl K, Zha Z, Wang H, Guo R, Xie Q, Zhu H, Yang Z, Zhu L, Kung HF. Development and validation of a kit formulation of [ 68Ga]Ga-P15-041 as a bone imaging agent. Appl Radiat Isot 2020; 169:109485. [PMID: 33360838 DOI: 10.1016/j.apradiso.2020.109485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 09/28/2020] [Accepted: 10/16/2020] [Indexed: 10/22/2022]
Abstract
One of the commonly performed studies in nuclear medicine are bone scans with [99mTc]Tc-methylene diphosphonate (MDP) for detecting various bone lesions, including cancer metastasis. The recent emergence of commercially available 68Ge/68Ga radionuclide generators makes it possible to provide 68Ga-labelled bisphosphonates as positron emission tomography (PET) tracers for bone imaging. Preliminary human studies suggested that [68Ga]Ga-HBED-CC-BP ([68Ga]Ga-P15-041) in conjunction with PET/computed tomography (CT) showed accumulation in known bone lesions, fast clearance from blood and soft tissue, and an ability to provide high contrast images. A simple and efficient lyophilized P15-041 kit formulation for the rapid production of [68Ga]Ga-P15-041 with excellent radiochemical purity (RCP) under ambient temperature without the need for purification is described. It is demonstrated that clinical doses of [68Ga]Ga-P15-041 can be prepared manually within minutes with an excellent purity (> 90%) and readily meet the dose release criteria. When [68Ga]Ga-P15-041 was evaluated in a patient with cancer, the imaging agent clearly showed accumulations in multiple lesions. In conclusion, [68Ga]Ga-P15-041, prepared by a lyophilized kit, might be an excellent bone imaging agent for widespread clinical application.
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Affiliation(s)
- Haiyan Hong
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, 100875, China
| | - Karl Ploessl
- Five Eleven Pharma Inc., Philadelphia, PA, 19104, USA
| | - Zhihao Zha
- Five Eleven Pharma Inc., Philadelphia, PA, 19104, USA
| | - Hui Wang
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, 100875, China
| | - Rui Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Qing Xie
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Hua Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, Beijing, 100142, China
| | - Lin Zhu
- Key Laboratory of Radiopharmaceuticals, Ministry of Education, College of Chemistry, Beijing Normal University, Beijing, 100875, China.
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, 19104, USA; Five Eleven Pharma Inc., Philadelphia, PA, 19104, USA.
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25
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Yadav MP, Ballal S, Meckel M, Roesch F, Bal C. [ 177Lu]Lu-DOTA-ZOL bone pain palliation in patients with skeletal metastases from various cancers: efficacy and safety results. EJNMMI Res 2020; 10:130. [PMID: 33113035 PMCID: PMC7593375 DOI: 10.1186/s13550-020-00709-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/21/2020] [Indexed: 12/29/2022] Open
Abstract
Background [177Lu]Lu-DOTA-ZOL has shown promising results from the dosimetry and preclinical aspects, but data on its role in the clinical efficacy are limited. The objective of this study is to evaluate the efficacy and safety of [177Lu]Lu-DOTA-ZOL as a bone pain palliation agent in patients experiencing pain due to skeletal metastases from various cancers. Methods In total, 40 patients experiencing bone pain due to skeletal metastases were enrolled in this study. The patients were treated with a mean cumulative dose of 2.1 ± 0.6 GBq (1.3–2.7 GBq) [177Lu]Lu-DOTA-ZOL in a median follow-up duration of 10 months (IQR 8–14 months). The primary outcome endpoint was response assessment according to the visual analogue score (VAS). Secondary endpoints included analgesic score (AS), global pain assessment score, Eastern Cooperative Oncology Group Assessment performance status (ECOG), Karnofsky performance status, overall survival, and safety assessment by the National Cancer Institute’s Common Toxicity Criteria V5.0. Results In total, 40 patients (15 males and 25 females) with a mean age of 46.6 ± 15.08 years (range 24–78 years) were treated with either 1 (N = 15) or 2 (N = 25) cycles of [177Lu]Lu-DOTA-ZOL. According to the VAS response assessment criteria, complete, partial, and minimal responses were observed in 11 (27.5%), 20 (50%), and 5 patients (12.5%), respectively with an overall response rate of 90%. Global pain assessment criteria revealed complete, partial, minimal, and no response in 2 (5%), 25 (62.5%), 9 (22.5%), and 4 (10%) patients, respectively. Twenty-eight patients died and the estimated median overall survival was 13 months (95% CI 10–14 months). A significant improvement was observed in the VAS, AS, and ECOG status when compared to baseline. None of the patients experienced grade III/IV haematological, kidney, or hepatotoxicity due to [177Lu]Lu-DOTA-ZOL therapy. Conclusion [177Lu]Lu-DOTA-ZOL shows promising results and is an effective radiopharmaceutical in the treatment of bone pain due to skeletal metastases from various cancers.
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Affiliation(s)
- Madhav Prasad Yadav
- Department of Nuclear Medicine, Room No: 59-A, Thyroid Clinic, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India
| | - Sanjana Ballal
- Department of Nuclear Medicine, Room No: 59-A, Thyroid Clinic, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India
| | - Marian Meckel
- Department of Nuclear Chemistry, Johannes Gutenberg University, Fritz-Strassmann-Weg 2, 55126, Mainz, Germany
| | - Frank Roesch
- Department of Nuclear Chemistry, Johannes Gutenberg University, Fritz-Strassmann-Weg 2, 55126, Mainz, Germany
| | - Chandrasekhar Bal
- Department of Nuclear Medicine, Room No: 59-A, Thyroid Clinic, All India Institute of Medical Sciences (AIIMS), Ansari Nagar, New Delhi, 110029, India.
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Chauhan K, Mann G, Jaswal AP, Ojha H, Mishra AK, Datta A. 68Ga-Labeled bismacrocyclic methylene phosphonate as potential bone seeking PET radiopharmaceutical. Bioorg Chem 2020; 104:104185. [PMID: 32911200 DOI: 10.1016/j.bioorg.2020.104185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 06/21/2020] [Accepted: 07/28/2020] [Indexed: 11/16/2022]
Abstract
Phosphonates-based agents are well-known bone-seeking radiopharmaceuticals with application in detection and therapy. With higher sensitivity and resolution offered by Positron Emission Tomography (PET), tracers based on this technique are gaining huge attention. 68Ga-based generator and radiotracers render independence from the on-site cyclotron. We report the development of 68Ga-labeled DOTA-based bismacrocyclic phosphonate derivative, for bone PET imaging. The synthesis and characterization of 68Ga- DO3P-AME-DO3P was carried out in > 95% purity. The radiotracer displayed high stability and low binding affinity (<3%) to blood serum. High in vitro binding affinity were observed for synthetic hydroxyapatite, SAOS-2, osteoclast and osteoblast cells. In vivo pharmacokinetics revealed fast washout with biphasic release pattern. The deposition of radiotracer in osseous tissues was high (Bone/Muscle ratio:18), as studied from the biodistribution studies. In vivo PET/CT and biodistribution analyses revealed the ability of 68Ga-DO3P-AME-DO3P to target and accumulate in bone, thus displaying its potential as a PET bone imaging agent.
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Affiliation(s)
- Kanchan Chauhan
- Institute of Nuclear Medicine & Allied Sciences, DRDO, Brig. SK Mazumdar Marg, Delhi 110054, India; Department of Bionanotechnology, Centro de Nanociencias y Nanotecnología, Universidad Nacional Autónoma de México, Km. 107 carretera Tijuana-Ensenada, 22860 Ensenada, Baja California, Mexico
| | - Garima Mann
- Institute of Nuclear Medicine & Allied Sciences, DRDO, Brig. SK Mazumdar Marg, Delhi 110054, India
| | - Ambika Parmar Jaswal
- Institute of Nuclear Medicine & Allied Sciences, DRDO, Brig. SK Mazumdar Marg, Delhi 110054, India
| | - Himanshu Ojha
- Institute of Nuclear Medicine & Allied Sciences, DRDO, Brig. SK Mazumdar Marg, Delhi 110054, India
| | - Anil K Mishra
- Institute of Nuclear Medicine & Allied Sciences, DRDO, Brig. SK Mazumdar Marg, Delhi 110054, India.
| | - Anupama Datta
- Institute of Nuclear Medicine & Allied Sciences, DRDO, Brig. SK Mazumdar Marg, Delhi 110054, India.
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Chakraborty S, Shetty P, Chakravarty R, Vimalnath KV, Kumar C, Sarma HD, Vatsa R, Shukla J, Mittal BR, Dash A. Formulation of ‘ready-to-use’ human clinical doses of 177Lu-labeled bisphosphonate amide of DOTA using moderate specific activity 177Lu and its preliminary evaluation in human patient. RADIOCHIM ACTA 2020. [DOI: 10.1515/ract-2019-3219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Radiolabeled macrocyclic bisphosphonate ligands have recently been demonstrated to be highly efficacious in treatment of patients with painful bone metastases. Herein, we report a robust protocol for formulation of therapeutically relevant doses of 177Lu-labeled bisphosphonate amide of DOTA (BPAMD) using moderate specific activity 177Lu produced by direct (n,γ) route and its preliminary investigation in human patients. Doses (2.8 ± 0.2 GBq) were formulated with high radiochemical purity (98.3 ± 0.4 %) using a protocol optimized after extensive radiochemical studies. In vitro binding studies with mineralized osteosarcoma cells demonstrated specific binding of the radiotracer. Biodistribution studies in healthy Wistar rats demonstrated rapid skeletal accumulation with fast clearance from the non-target organs. In a patient administered with 555 MBq dose of 177Lu-BPAMD, intense radiotracer uptake was observed in the metastatic skeletal lesions with insignificant uptake in any other major non-targeted organs. Preliminary clinical investigations carried out after administration of 2.6 GBq of 177Lu-BPAMD revealed significant reduction in pain after 1 week without any adverse effects. The developed protocol for formulation of 177Lu-BPAMD doses using moderate specific activity carrier added 177Lu has been found to be effective and warrants wider investigations in patients with painful skeletal metastases.
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Affiliation(s)
- Sudipta Chakraborty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
- Homi Bhabha National Institute , Anushaktinagar, Mumbai – 400094 , India
| | - Priyalata Shetty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
| | - Rubel Chakravarty
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
- Homi Bhabha National Institute , Anushaktinagar, Mumbai – 400094 , India
| | - K. V. Vimalnath
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
| | - Chandan Kumar
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
| | - H. D. Sarma
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
| | - Rakhee Vatsa
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research , Chadigarh – 160012 , India
| | - Jaya Shukla
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research , Chadigarh – 160012 , India
| | - B. R. Mittal
- Department of Nuclear Medicine, Post Graduate Institute of Medical Education and Research , Chadigarh – 160012 , India
| | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre , Trombay, Mumbai – 400085 , India
- Homi Bhabha National Institute , Anushaktinagar, Mumbai – 400094 , India
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28
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DOTA-ZOL: A Promising Tool in Diagnosis and Palliative Therapy of Bone Metastasis-Challenges and Critical Points in Implementation into Clinical Routine. Molecules 2020; 25:molecules25132988. [PMID: 32629930 PMCID: PMC7412164 DOI: 10.3390/molecules25132988] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 01/17/2023] Open
Abstract
The novel compound 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA)-ZOL (DOTA-conjugated zoledronic acid) is a promising candidate for the diagnosis and therapy of bone metastasis. The combination of the published methodology for this bisphosphonate with pharmaceutical and regulatory requirements turned out to be unexpectedly challenging. The scope of this work is the presentation and discussion of problems encountered during this process. Briefly, the radiolabelling process and purification, as well as the quality control published, did not meet the expectations. The constant effort setting up an automated radiolabelling procedure resulted in (a) an enhanced manual method using coated glass reactors, (b) a combination of three different reliable radio thin-layer chromatography (TLC) methods instead of the published and (c) a preliminary radio high-pressure liquid chromatography (HPLC) method for identification of the compound. Additionally, an automated radiolabelling process was developed, but it requires further improvement, e.g., in terms of a reactor vessel or purification of the crude product. The published purification method was found to be unsuitable for clinical routine, and an intense screening did not lead to a satisfactory result; here, more research is necessary. To sum up, implementation of DOTA-ZOL was possible but revealed a lot of critical points, of which not all could be resolved completely yet.
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29
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Ashhar Z, Yusof NA, Ahmad Saad FF, Mohd Nor SM, Mohammad F, Bahrin Wan Kamal WH, Hassan MH, Ahmad Hassali H, Al-Lohedan HA. Preparation, Characterization, and Radiolabeling of [ 68Ga]Ga-NODAGA-Pamidronic Acid: A Potential PET Bone Imaging Agent. Molecules 2020; 25:molecules25112668. [PMID: 32526838 PMCID: PMC7321328 DOI: 10.3390/molecules25112668] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/24/2022] Open
Abstract
Early diagnosis of bone metastases is crucial to prevent skeletal-related events, and for that, the non-invasive techniques to diagnose bone metastases that make use of image-guided radiopharmaceuticals are being employed as an alternative to traditional biopsies. Hence, in the present work, we tested the efficacy of a gallium-68 (68Ga)-based compound as a radiopharmaceutical agent towards the bone imaging in positron emitting tomography (PET). For that, we prepared, thoroughly characterized, and radiolabeled [68Ga]Ga-NODAGA-pamidronic acid radiopharmaceutical, a 68Ga precursor for PET bone cancer imaging applications. The preparation of NODAGA-pamidronic acid was performed via the N-Hydroxysuccinimide (NHS) ester strategy and was characterized using liquid chromatography-mass spectrometry (LC-MS) and tandem mass spectrometry (MSn). The unreacted NODAGA chelator was separated using the ion-suppression reverse phase-high performance liquid chromatography (RP-HPLC) method, and the freeze-dried NODAGA-pamidronic acid was radiolabeled with 68Ga. The radiolabeling condition was found to be most optimum at a pH ranging from 4 to 4.5 and a temperature of above 60 °C. From previous work, we found that the pamidronic acid itself has a good bone binding affinity. Moreover, from the analysis of the results, the ionic structure of radiolabeled [68Ga]Ga-NODAGA-pamidronic acid has the ability to improve the blood clearance and may exert good renal excretion, enhance the bone-to-background ratio, and consequently the final image quality. This was reflected by both the in vitro bone binding assay and in vivo animal biodistribution presented in this research.
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Affiliation(s)
- Zarif Ashhar
- Chemistry Department, Faculty of Science, Putra Malaysia University, Selangor, Serdang 43400, Malaysia; (Z.A.); (S.M.M.N.)
- Pharmacy Department, National Cancer Institute, Putrajaya 62250, Malaysia
| | - Nor Azah Yusof
- Chemistry Department, Faculty of Science, Putra Malaysia University, Selangor, Serdang 43400, Malaysia; (Z.A.); (S.M.M.N.)
- Correspondence: (N.A.Y.); (F.M.); Tel.: +966-11-467-5998 (F.M.); Fax: +966-11-467-9972 (F.M.)
| | - Fathinul Fikri Ahmad Saad
- Centre for Diagnostic Nuclear Imaging (CDNI), Faculty of Medicine and Health Sciences, Putra Malaysia University, Selangor, Serdang 43400, Malaysia; (F.F.A.S.); (M.H.H.)
| | - Siti Mariam Mohd Nor
- Chemistry Department, Faculty of Science, Putra Malaysia University, Selangor, Serdang 43400, Malaysia; (Z.A.); (S.M.M.N.)
| | - Faruq Mohammad
- Surfactants Research Chair, Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
- Correspondence: (N.A.Y.); (F.M.); Tel.: +966-11-467-5998 (F.M.); Fax: +966-11-467-9972 (F.M.)
| | | | - Muhammad Hishar Hassan
- Centre for Diagnostic Nuclear Imaging (CDNI), Faculty of Medicine and Health Sciences, Putra Malaysia University, Selangor, Serdang 43400, Malaysia; (F.F.A.S.); (M.H.H.)
| | - Hazlina Ahmad Hassali
- Bahagian Teknologi Perubatan, Malaysia Nuclear Agency, Selangor, Kajang 43600, Malaysia; (W.H.B.W.K.); (H.A.H.)
| | - Hamad A. Al-Lohedan
- Surfactants Research Chair, Chemistry, College of Science, King Saud University, Riyadh 11451, Saudi Arabia;
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30
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Lawal IO, Mokoala KMG, Mahapane J, Kleyhans J, Meckel M, Vorster M, Ebenhan T, Rösch F, Sathekge MM. A prospective intra-individual comparison of [ 68Ga]Ga-PSMA-11 PET/CT, [ 68Ga]Ga-NODAGA ZOL PET/CT, and [ 99mTc]Tc-MDP bone scintigraphy for radionuclide imaging of prostate cancer skeletal metastases. Eur J Nucl Med Mol Imaging 2020; 48:134-142. [PMID: 32424485 DOI: 10.1007/s00259-020-04867-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 05/12/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE Prostate cancer (PCa) commonly metastasizes to the bones. There are several radionuclide techniques for imaging PCa skeletal metastases. We aimed to compare the lesion detection rate of [68Ga]Ga-PSMA-11 PET/CT, [68Ga]Ga-NODAGA-zoledronate ([68Ga]Ga-NODAGAZOL) PET/CT, and [99mTc]Tc-MDP bone scan in the assessment of bone metastases in patients with advanced PCa. METHODS We prospectively recruited two cohorts of patients (staging and re-staging cohorts) with advanced prostate cancer. The staging cohort was treatment-naïve PCa patients who showed skeletal metastases on bone scan. These patients were subsequently imaged with [68Ga]Ga-PSMA-11 PET/CT and [68Ga]Ga-NODAGAZOL PET/CT. Re-staging cohort was patients who were previously treated with PSMA-based radioligand therapy and were experiencing PSA progression. The re-staging cohort was imaged with [68Ga]Ga-PSMA-11 PET/CT and [68Ga]Ga-NODAGAZOL PET/CT. We performed a per-patient and per-lesion analysis of skeletal metastases in both cohorts and made a comparison between scan findings. RESULTS Eighteen patients were included with a median age of 68 years (range = 48-80) and a median Gleason score of 8. There were ten patients in the staging cohort with a median PSA of 119.26 ng/mL (range = 4.63-18,948.00) and eight patients in the re-staging cohort with a median PSA of 48.56 ng/mL (range = 6.51-3175.00). In the staging cohort, skeletal metastases detected by [68Ga]Ga-PSMA-11 PET/CT, [68Ga]Ga-NODAGAZOL PET/CT, and bone scan were 322, 288, and 261, respectively, p = 0.578. In the re-staging cohort, [68Ga]Ga-PSMA-11 PET/CT and [68Ga]Ga-NODAGAZOL PET/CT detected 152 and 191 skeletal metastases, respectively, p = 0.529. In two patients with negative [68Ga]Ga-PSMA-11 PET/CT findings, [68Ga]Ga-NODAGAZOL detected one skeletal metastasis in one patient and 12 skeletal metastases in the other. CONCLUSION In patients with advanced prostate cancer, [68Ga]Ga-PSMA-11 PET/CT may detect more lesions than [68Ga]Ga-NODAGAZOL PET/CT and [99mTc]Tc-MDP bone scan for the staging of skeletal metastases. In patients who experience PSA progression on PSMA-based radioligand therapy, [68Ga]Ga-NODAGA PET/CT is a more suitable imaging modality for the detection of skeletal lesions not expressing PSMA. In the setting of re-staging, [68Ga]Ga-NODAGAZOL PET/CT may detect more lesions than [68Ga]Ga-PSMA-11 PET/CT.
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Affiliation(s)
- Ismaheel O Lawal
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| | - Kgomotso M G Mokoala
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Johncy Mahapane
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa
| | - Janke Kleyhans
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| | - Marian Meckel
- Department of Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mariza Vorster
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| | - Thomas Ebenhan
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa.,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa
| | - Frank Rösch
- Department of Chemistry, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Mike M Sathekge
- Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Private Bag X169, Pretoria, 0001, South Africa. .,Nuclear Medicine Research Infrastructure (NuMeRI), Steve Biko Academic Hospital, Pretoria, South Africa.
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Zha Z, Wu Z, Choi SR, Ploessl K, Smith M, Alexoff D, Zhu L, Kung HF. A New [ 68Ga]Ga-HBED-CC-Bisphosphonate as a Bone Imaging Agent. Mol Pharm 2020; 17:1674-1684. [PMID: 32251600 DOI: 10.1021/acs.molpharmaceut.0c00103] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Positron emission tomography (PET) imaging using 68Ga-labeled bisphosphonates to target bone metastasis could be a valuable tool in cancer diagnosis and monitoring therapeutic treatment. A 68Ga labeled ligand, N,N'-bis[2-hydroxy-5-(carboxyethyl)benzyl]ethylenediamine-N,N'-diacetic acid (HBED-CC) containing one bisphosphonate group (HBED-CC-BP, 1) was prepared and evaluated. The new ligand, 1, reacted rapidly to form [68Ga]Ga-1, via complexing with [68Ga]GaCl3 eluted from a commercially available 68Ge/68Ga generator (in a sodium acetate buffer at pH 4, reaching >95% labeling yield at room temperature in 5 min). The resulting [68Ga]Ga-1 showed excellent stability in vitro and in vivo. [68Ga]Ga-1 displayed high binding affinity to hydroxyapatite and good uptake in the tibia and femur bone of normal mice. Biodistribution and MicroPET imaging studies of [68Ga]Ga-1 in normal mice and rats showed excellent bone uptake and retention comparable to that of Na[18F]F. The results suggested that [68Ga]Ga-1 might be suitable as a bone imaging agent in humans and it could be useful as a convenient alternative to the current bone imaging PET agent, Na[18F]F, without the need of a near-by cyclotron. Also, an automated synthesis module was developed to produce clinical doses of [68Ga]Ga-1 in a consistent and reproducible manner. Currently, the investigation new drug application (IND) for [68Ga]Ga-HBED-CC-BP, [68Ga]Ga-1, has received FDA approval, and it is currently under clinical trial (IND #129870).
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Affiliation(s)
- Zhihao Zha
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Zehui Wu
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Seok Rye Choi
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Karl Ploessl
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Megan Smith
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - David Alexoff
- Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
| | - Lin Zhu
- College of Chemistry, Beijing Normal University, Beijing 100875, PR China
| | - Hank F Kung
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States.,Five Eleven Pharma Inc., Philadelphia, Pennsylvania 19104, United States
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Tosato M, Verona M, Doro R, Dalla Tiezza M, Orian L, Andrighetto A, Pastore P, Marzaro G, Di Marco V. Toward novel sulphur-containing derivatives of tetraazacyclododecane: synthesis, acid–base properties, spectroscopic characterization, DFT calculations, and cadmium( ii) complex formation in aqueous solution. NEW J CHEM 2020. [DOI: 10.1039/d0nj00310g] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
New sulphur derivatives of cyclen, with potential complementary properties with respect to known compounds, have been synthesized and studied.
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Affiliation(s)
- Marianna Tosato
- Department of Chemical Sciences
- University of Padova
- 35131 Padova
- Italy
| | - Marco Verona
- Department of Pharmaceutical Sciences
- University of Padova
- 35131 Padova
- Italy
| | - Riccardo Doro
- Department of Chemical Sciences
- University of Padova
- 35131 Padova
- Italy
| | | | - Laura Orian
- Department of Chemical Sciences
- University of Padova
- 35131 Padova
- Italy
| | - Alberto Andrighetto
- Italian Institute of Nuclear Physics
- Legnaro National Laboratories
- 35020 Legnaro (Padova)
- Italy
| | - Paolo Pastore
- Department of Chemical Sciences
- University of Padova
- 35131 Padova
- Italy
| | - Giovanni Marzaro
- Department of Pharmaceutical Sciences
- University of Padova
- 35131 Padova
- Italy
| | - Valerio Di Marco
- Department of Chemical Sciences
- University of Padova
- 35131 Padova
- Italy
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Khawar A, Eppard E, Roesch F, Ahmadzadehfar H, Kürpig S, Meisenheimer M, Gaertner FC, Essler M, Bundschuh RA. Biodistribution and post-therapy dosimetric analysis of [ 177Lu]Lu-DOTA ZOL in patients with osteoblastic metastases: first results. EJNMMI Res 2019; 9:102. [PMID: 31781962 PMCID: PMC6882969 DOI: 10.1186/s13550-019-0566-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Accepted: 10/14/2019] [Indexed: 11/28/2022] Open
Abstract
Background Preclinical biodistribution and dosimetric analysis of [177Lu]Lu-DOTAZOL suggest the bisphosphonate zoledronate as a promising new radiopharmaceutical for therapy of bone metastases. We evaluated biodistribution and normal organ absorbed doses resulting from therapeutic doses of [177Lu]Lu-DOTAZOL in patients with metastatic skeletal disease. Method Four patients with metastatic skeletal disease (age range, 64–83 years) secondary to metastatic castration-resistant prostate carcinoma or bronchial carcinoma were treated with a mean dose of 5968 ± 64 MBq (161.3 mCi) of [177Lu]Lu-DOTAZOL. Biodistribution was assessed with serial planar whole body scintigraphy at 20 min and 3, 24, and 167 h post injection (p.i.) and blood samples at 20 min and 3, 8, 24, and 167 h p.i. Percent of injected activity in the blood, kidneys, urinary bladder, skeleton, and whole body was determined. Bone marrow self-dose was determined by an indirect blood-based method. Urinary bladder wall residence time was calculated using Cloutier’s dynamic urinary bladder model with a 4-h voiding interval. OLINDA/EXM version 2.0 (Hermes Medical Solutions, Stockholm, Sweden) software was used to determine residence times in source organs by applying biexponential curve fitting and to calculate organ absorbed dose. Results Qualitative biodistribution analysis revealed early and high uptake of [177Lu]Lu-DOTAZOL in the kidneys with fast clearance showing minimal activity by 24 h p.i. Activity in the skeleton increased gradually over time. Mean residence times were found to be highest in the skeleton followed by the kidneys. Highest mean organ absorbed dose was 3.33 mSv/MBq for osteogenic cells followed by kidneys (0.490 mSv/MBq), red marrow (0.461 mSv/MBq), and urinary bladder wall (0.322 mSv/MBq). The biodistribution and normal organ absorbed doses of [177Lu]Lu-DOTAZOL are consistent with preclinical data. Conclusion [177Lu]Lu-DOTAZOL shows maximum absorbed doses in bone and low kidney doses, making it a promising agent for radionuclide therapy of bone metastasis. Further studies are warranted to evaluate the efficacy and safety of radionuclide therapy with [177Lu]Lu-DOTAZOL in the clinical setting.
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Affiliation(s)
- Ambreen Khawar
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany.
| | - Elisabeth Eppard
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
| | - Frank Roesch
- Institute of Nuclear Chemistry, Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | - Stefan Kürpig
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
| | | | - Florian C Gaertner
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
| | - Markus Essler
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
| | - Ralph A Bundschuh
- Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
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Baranyai Z, Tircsó G, Rösch F. The Use of the Macrocyclic Chelator DOTA in Radiochemical Separations. Eur J Inorg Chem 2019. [DOI: 10.1002/ejic.201900706] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Zsolt Baranyai
- Bracco Research Centre Bracco Imaging spa Via Ribes 5 10010 Colleretto Giacosa (TO) Italy
| | - Gyula Tircsó
- Department of Physical Chemistry Faculty of Science and Technology University of Debrecen Egyetem tér 1 Debrecen 4032 Hungary
| | - Frank Rösch
- Institute of Nuclear Chemistry Johannes Gutenberg‐University of Mainz Fritz‐Strassmann‐Weg 2 55128 Mainz Germany
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Vaz S, Usmani S, Gnanasegaran G, Van den Wyngaert T. Molecular imaging of bone metastases using bone targeted tracers. THE QUARTERLY JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING : OFFICIAL PUBLICATION OF THE ITALIAN ASSOCIATION OF NUCLEAR MEDICINE (AIMN) [AND] THE INTERNATIONAL ASSOCIATION OF RADIOPHARMACOLOGY (IAR), [AND] SECTION OF THE SOCIETY OF RADIOPHARMACEUTICAL CHEMISTRY AND BIOLOGY 2019; 63:112-128. [PMID: 31286752 DOI: 10.23736/s1824-4785.19.03198-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Molecular imaging using bone targeted tracers has been used in clinical practice for almost fifty years and still plays an essential role in the diagnosis and follow-up of bone metastases. It includes both [99mTc]bisphosphonates for bone scan and [18F]NaF for positron emission tomography/computed tomography (PET/CT) which are very sensitive to detect osteoblastic activity, but it is important to consider several aspects to increase the specificity of reported findings (such as specific tracer characteristics and mechanism of action, patient's clinical history, common metastatic patterns, changes after treatment, limitations of the technique, variations and pitfalls). This will enable useful information for clinical management being provided in the report. Furthermore, iatrogenic skeletal adverse events are common and they should also be identified, as they have impact on patient's quality of life. This review makes a brief summary of the mechanism of action of bone targeted tracers, followed by a discussion of classic patterns of bone metastasis, treatment response assessment and iatrogenic skeletal complications. The value of hybrid imaging techniques with bone targeted tracers, including single photon emission computed tomography and PET/CT is also explored. The final part summarizes new bone targeted tracers with superior imaging characteristics that are being developed, and which may further enhance the applications of radionuclide bone imaging.
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Affiliation(s)
- Sofia Vaz
- Department of Nuclear Medicine Radiopharmacology, Champalimaud Center for the Unknown, Lisbon, Portugal -
| | - Sharjeel Usmani
- Department of Nuclear Medicine, Kuwait Cancer Control Center (KCCC), Khaitan, Kuwait City, Kuwait
| | | | - Tim Van den Wyngaert
- Department of Nuclear Medicine, Antwerp University Hospital, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Belgium
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Zhang J, Singh A, Kulkarni HR, Schuchardt C, Müller D, Wester HJ, Maina T, Rösch F, van der Meulen NP, Müller C, Mäcke H, Baum RP. From Bench to Bedside-The Bad Berka Experience With First-in-Human Studies. Semin Nucl Med 2019; 49:422-437. [PMID: 31470935 DOI: 10.1053/j.semnuclmed.2019.06.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Precision oncology is being driven by rapid advances in novel diagnostics and therapeutic interventions, with treatments targeted to the needs of individual patients on the basis of genetic, biomarker, phenotypic, or psychosocial characteristics that distinguish a given patient from other patients with similar clinical presentations. Inherent in the theranostics paradigm is the assumption that diagnostic test results can precisely determine whether an individual is likely to benefit from a specific treatment. As part and integral in the current era of precision oncology, theranostics in the context of nuclear medicine aims to identify the appropriate molecular targets in neoplasms (diagnostic tool), so that the optimal ligands and radionuclides (therapeutic tool) with favorable labeling chemistry can be selected for personalized management of a specific disease, taking into consideration the specific patient, and subsequently monitor treatment response. Over the past two decades, the use of gallium-68 labeled peptides for somatostatin receptor (SSTR)-targeted PET/CT (or PET/MRI) imaging followed by lutetium-177 and yttrium-90 labeled SSTR-agonist for peptide receptor radionuclide therapy has demonstrated remarkable success in the management of neuroendocrine neoplasms, and paved the way to other indications of theranostics. Rapid advances are being made in the development of other peptide-based radiopharmaceuticals, small molecular-weight ligands and with newer radioisotopes with more favorable kinetics, potentially useful for theranostics strategies for the clinical application. The present review features the Bad Berka experience with first-in-human studies of new radiopharmaceuticals, for example, prostate-specific membrane antigen ligand, gastrin-releasing peptide receptor, neurotensin receptor 1 ligand, novel SSTR-targeting peptides and nonpeptide, and bone-seeking radiopharmaceuticals. Also new radioisotopes, for example, actinium (225Ac), copper (64Cu), scandium (44Sc), and terbium (152Tb/161Tb) will be discussed briefly demonstrating the development from basic science to precision oncology in the clinical setting.
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Affiliation(s)
- Jingjing Zhang
- THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Aviral Singh
- THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Harshad R Kulkarni
- THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Christiane Schuchardt
- THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Dirk Müller
- THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany
| | - Hans-J Wester
- Institute for Radiopharmaceutical Chemistry, Technische Universität München, Garching, Germany
| | - Theodosia Maina
- Molecular Radiopharmacy, INRASTES, NCSR "Demokritos", Athens, Greece
| | - Frank Rösch
- Institute of Nuclear Chemistry, Johannes Gutenberg-University, Mainz, Germany
| | - Nicholas P van der Meulen
- Center for Radiopharmaceutical Sciences, ETH-PSI-USZ, Paul Scherrer Institute, Villigen, Switzerland; (
- )Laboratory of Radiochemistry, Paul Scherrer Institute, Villigen, Switzerland
| | - Cristina Müller
- Center for Radiopharmaceutical Sciences, ETH-PSI-USZ, Paul Scherrer Institute, Villigen, Switzerland
| | - Helmut Mäcke
- Department of Nuclear Medicine, University Hospital of Freiburg, Freiburg, Germany
| | - Richard P Baum
- THERANOSTICS Center for Molecular Radiotherapy and Precision Oncology, Zentralklinik Bad Berka, Bad Berka, Germany.
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Preliminary results of biodistribution and dosimetric analysis of [ 68Ga]Ga-DOTA ZOL: a new zoledronate-based bisphosphonate for PET/CT diagnosis of bone diseases. Ann Nucl Med 2019; 33:404-413. [PMID: 30877560 DOI: 10.1007/s12149-019-01348-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 02/25/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Pre-clinical studies with gallium-68 zoledronate ([68Ga]Ga-DOTAZOL) have proposed it to be a potent bisphosphonate for PET/CT diagnosis of bone diseases and diagnostic counterpart to [177Lu]Lu-DOTAZOL and [225Ac]Ac-DOTAZOL. This study aims to be the first human biodistribution and dosimetric analysis of [68Ga]Ga-DOTAZOL. METHODS Five metastatic skeletal disease patients (mean age: 72 years, M: F; 4:1) were injected with 150-190 MBq (4.05-5.14 mCi) of [68Ga]Ga-DOTAZOL i.v. Biodistribution of [68Ga]Ga-DOTAZOL was studied with PET/CT initial dynamic imaging for 30 min; list mode over abdomen (reconstructed as six images of 300 s) followed by static (skull to mid-thigh) imaging at 45 min and 2.5 h with Siemens Biograph 2 PET/CT camera. Also, blood samples (8 time points) and urine samples (2 time points) were collected over a period of 2.5 h. Total activity (MBq) in source organs was determined using interview fusion software (MEDISO Medical Imaging Systems, Budapest, Hungary). A blood-based method for bone marrow self-dose determination and a trapezoidal method for urinary bladder contents residence time calculation were used. OLINDA/EXM version 2.0 software (Hermes Medical Solutions, Stockholm, Sweden) was used to generate residence times for source organs, organ absorbed doses and effective doses. RESULTS High uptake in skeleton as target organ, kidneys and urinary bladder as organs of excretion and faint uptake in liver, spleen and salivary glands were seen. Qualitative and quantitative analysis supported fast blood clearance, high bone to soft tissue and lesion to normal bone uptake with [68Ga]Ga-DOTAZOL. Urinary bladder with the highest absorbed dose of 0.368 mSv/MBq presented the critical organ, followed by osteogenic cells, kidneys and red marrow receiving doses of 0.040, 0.031 and 0.027 mSv/MBq, respectively. The mean effective dose was found to be 0.0174 mSv/MBq which results in an effective dose of 2.61 mSv from 150 MBq. CONCLUSIONS Biodistribution of [68Ga]Ga-DOTAZOL was comparable to [18F]NaF, [99mTc]Tc-MDP and [68Ga]Ga-PSMA-617. With proper hydration and diuresis to reduce urinary bladder and kidney absorbed doses, it has clear advantages over [18F]NaF owing to its onsite, low-cost production and theranostic potential of personalized dosimetry for treatment with [177Lu]Lu-DOTAZOL and [225Ac]Ac-DOTAZOL.
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Guleria M, Das T, Amirdhanayagam J, Shinto AS, Kamaleshwaran KK, Pandian A, Sarma HD, Dash A. Convenient Formulation of 68Ga-BPAMD Patient Dose Using Lyophilized BPAMD Kit and 68Ga Sourced from Different Commercial Generators for Imaging of Skeletal Metastases. Cancer Biother Radiopharm 2019; 34:67-75. [DOI: 10.1089/cbr.2018.2605] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mohini Guleria
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Tapas Das
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India
| | | | - Ajit S. Shinto
- Department of Nuclear Medicine and PET, Kovai Medical Center and Hospital, Coimbatore, India
| | | | - Arun Pandian
- Department of Nuclear Medicine and PET, Kovai Medical Center and Hospital, Coimbatore, India
| | - Haladhar D. Sarma
- Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre, Mumbai, India
| | - Ashutosh Dash
- Radiopharmaceuticals Division, Bhabha Atomic Research Centre, Mumbai, India
- Homi Bhabha National Institute, Anushaktinagar, Mumbai, India
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Molecular Imaging with 68Ga Radio-Nanomaterials: Shedding Light on Nanoparticles. APPLIED SCIENCES-BASEL 2018. [DOI: 10.3390/app8071098] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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40
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Chakraborty S, Goswami D, Chakravarty R, Mohammed SK, Sarma HD, Dash A. Syntheses and evaluation of 68
Ga- and 153
Sm-labeled DOTA-conjugated bisphosphonate ligand for potential use in detection of skeletal metastases and management of pain arising from skeletal metastases. Chem Biol Drug Des 2018; 92:1618-1626. [DOI: 10.1111/cbdd.13327] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/12/2018] [Accepted: 04/06/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Sudipta Chakraborty
- Radiopharmaceuticals Division; Bhabha Atomic Research Centre (BARC); Trombay, Mumbai Maharashtra India
- Homi Bhabha National Institute; Anushakti Nagar, Mumbai Maharashtra India
| | - Dibakar Goswami
- Homi Bhabha National Institute; Anushakti Nagar, Mumbai Maharashtra India
- Bio Organic Division; Bhabha Atomic Research Centre (BARC); Trombay, Mumbai Maharashtra India
| | - Rubel Chakravarty
- Radiopharmaceuticals Division; Bhabha Atomic Research Centre (BARC); Trombay, Mumbai Maharashtra India
- Homi Bhabha National Institute; Anushakti Nagar, Mumbai Maharashtra India
| | - Sahiralam Khan Mohammed
- Radiopharmaceuticals Division; Bhabha Atomic Research Centre (BARC); Trombay, Mumbai Maharashtra India
| | - Haladhar Deb Sarma
- Radiation Biology and Health Sciences Division; Bhabha Atomic Research Centre (BARC); Trombay, Mumbai Maharashtra India
| | - Ashutosh Dash
- Radiopharmaceuticals Division; Bhabha Atomic Research Centre (BARC); Trombay, Mumbai Maharashtra India
- Homi Bhabha National Institute; Anushakti Nagar, Mumbai Maharashtra India
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Virgolini I, Decristoforo C, Haug A, Fanti S, Uprimny C. Current status of theranostics in prostate cancer. Eur J Nucl Med Mol Imaging 2018; 45:471-495. [PMID: 29282518 PMCID: PMC5787224 DOI: 10.1007/s00259-017-3882-2] [Citation(s) in RCA: 100] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 11/07/2017] [Indexed: 12/25/2022]
Abstract
The aim of this review is to report on the current status of prostate-specific membrane antigen (PSMA)-directed theranostics in prostate cancer (PC) patients. The value of 68Ga-PSMA-directed PET imaging as a diagnostic procedure for primary and recurrent PC as well as the role of evolving PSMA radioligand therapy (PRLT) in castration-resistant (CR)PC is assessed. The most eminent data from mostly retrospective studies currently available on theranostics of prostate cancer are discussed. The current knowledge on 68Ga-PSMA PET/CT implicates that primary staging with PET/CT is meaningful in patients with high-risk PC and that the combination with pelvic multi parametric (mp)MR (or PET/mpMR) reaches the highest impact on patient management. There may be a place for 68Ga-PSMA PET/CT in intermediate-risk PC patients as well, however, only a few data are available at the moment. In secondary staging for local recurrence, 68Ga-PSMA PET/mpMR is superior to PET/CT, whereas for distant recurrence, PET/CT has equivalent results and is faster and cheaper compared to PET/mpMR. 68Ga-PSMA PET/CT is superior to 18F / 11Choline PET/CT in primary staging as well as in secondary staging. In patients with biochemical relapse, PET/CT positivity is directly associated with prostate-specific antigen (PSA) increase and amounts to roughly 50% when PSA is raised to ≤0.5 ng/ml and to ≥90% above 1 ng/ml. Significant clinical results have so far been achieved with the subsequent use of radiolabeled PSMA ligands in the treatment of CRPC. Accumulated activities of 30 to 50 GBq of 177Lu-PSMA ligands seem to be clinically safe with biochemical response and PERCIST/RECIST response in around 75% of patients along with xerostomia in 5-10% of patients as the only notable side effect. On the basis of the current literature, we conclude that PSMA-directed theranostics do have a major clinical impact in diagnosis and therapy of PC patients. We recommend that 68Ga-PSMA PET/CT should be performed in primary staging together with pelvic mpMR in high-risk patients and in all patients for secondary staging, and that PSMA-directed therapy is a potent strategy in CRPC patients when other treatment options have failed. The combination of PSMA-directed therapy with existing therapy modalities (such as 223Ra-chloride or androgen deprivation therapy) has to be explored, and prospective clinical multicenter trials with theranostics are warranted.
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Affiliation(s)
- Irene Virgolini
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - Alexander Haug
- Department of Radiology and Nuclear Medicine, Medical University of Vienna, 18-20 Währinger Gürtel, 1090, Vienna, Austria
| | - Stefano Fanti
- Nuclear Medicine Unit, University of Bologna, S. Orsola Hospital Bologna, Massarenti 9, 40138, Bologna, Italy
| | - Christian Uprimny
- Department of Nuclear Medicine, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
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