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Kraihammer M, Garnuszek P, Bauman A, Maurin M, Alejandre Lafont M, Haubner R, von Guggenberg E, Gabriel M, Decristoforo C. Improved quality control of [ 177Lu]Lu-PSMA I&T. EJNMMI Radiopharm Chem 2023; 8:7. [PMID: 36971890 PMCID: PMC10043144 DOI: 10.1186/s41181-023-00191-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Targeted radionuclide therapy with [177Lu]Lu-PSMA I&T (zadavotide guraxetan) has proven high efficacy and safety in treating patients with advanced prostate cancer worldwide. Several methods to determine the radiochemical purity have been reported but also limitations in the HPLC analysis due to retention of the sample and tailing effects when using standard gradients containing trifluoroacetic acid (TFA). We here report on the validation of a method for quality control of [177Lu]Lu-PSMA I&T including determination of radiochemical purity, identity testing and limit test for PSMA I&T by HPLC using a Phosphate buffer /Acetonitrile gradient system, complemented with a TLC system with 0.1N Citrate buffer pH 5 as mobile phase including validation of the methods, batch and stability data as well as identification of the main radiochemical impurity by mass spectrometry. RESULTS The described HPLC method met the defined acceptance criteria in terms of accuracy, specificity, robustness, linearity, range and LOQ. HPLC analysis revealed symmetrical peaks and quantitative recovery from the column. Batch data showed a radiochemical purity > 95% as determined by HPLC, stability data a pronounced degradation due to radiolysis, which could be limited by addition of ascorbic acid, dilution and storage at low temperatures. The main radiochemical impurity was found to be the de-iodinated form of [177Lu]Lu-PSMA I&T. TLC analysis allowed to determine the amount of free Lu-177 even in the presence of DTPA in the final formulation. CONCLUSION Overall the described combination of HPLC and TLC provides a reliable tool for quality control of [177Lu]Lu-PSMA I&T.
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Affiliation(s)
- Martin Kraihammer
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
- Department of Nuclear Medicine and Endocrinology, Kepler University Hospital, Linz, Austria
| | - Piotr Garnuszek
- Radioisotope Centre POLATOM, National Centre for Nuclear Research, Otwock, Poland
| | - Andreas Bauman
- Division of Radiopharmaceutical Chemistry, University Hospital Basel, Basel, Switzerland
| | - Michael Maurin
- Radioisotope Centre POLATOM, National Centre for Nuclear Research, Otwock, Poland
| | | | - Roland Haubner
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Elisabeth von Guggenberg
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Michael Gabriel
- Department of Nuclear Medicine and Endocrinology, Kepler University Hospital, Linz, Austria
| | - Clemens Decristoforo
- Department of Nuclear Medicine, Medical University Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
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Hooijman EL, Ntihabose CM, Reuvers TGA, Nonnekens J, Aalbersberg EA, van de Merbel JRJP, Huijmans JE, Koolen SLW, Hendrikx JJMA, de Blois E. Radiolabeling and quality control of therapeutic radiopharmaceuticals: optimization, clinical implementation and comparison of radio-TLC/HPLC analysis, demonstrated by [ 177Lu]Lu-PSMA. EJNMMI Radiopharm Chem 2022; 7:29. [PMID: 36333648 PMCID: PMC9636342 DOI: 10.1186/s41181-022-00181-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/13/2022] [Indexed: 11/06/2022] Open
Abstract
Background Radiopharmaceuticals are considered as regular medicinal products and therefore the same regulations as for non-radioactive medicinal products apply. However, specific aspects should be considered due to the radiochemical properties. Radiopharmaceutical dedicated monographs are developed in the European Pharmacopoeia to address this. Currently, different quality control methods for non-registered radiopharmaceuticals are utilized, often focusing on radio-TLC only, which has its limitations. When the radiochemical yield (RCY) is measured by radio-TLC analysis, degradation products caused by radiolysis are frequently not detected. In contrast, HPLC analysis defines the radiochemical purity (RCP), allowing for detection of peak formation related to radiolysis. During the introduction and optimization phase of therapeutic radiopharmaceuticals, significant percentages of impurities, like radiolysed construct formation, may have consequential impact on patient treatment. Since more hospitals and institutes are offering radiopharmaceutical therapies, such as [177Lu]Lu-PSMA with an in-house production, the demand for adequate quality control is increasing. Here we show the optimization and implementation of a therapeutic radiopharmaceutical, including the comparison of ITLC and HPLC quality control. Results Downscaled conditions (74 MBq/μg) were in concordance to clinical conditions (18 GBq/250 µg, 5 mL syringe/100 mL flacon); all results were consistent with an > 98% RCY (radio-TLC) and stability of > 95% RCP (HPLC). Radio-TLC did not identify radiolysis peaks, while clear identification was performed by HPLC analysis. Decreasing the RCP with 50%, reduced the cell-binding capacity with 27%. Conclusion This research underlines the importance of the radiolabeling and optimization including clinical implementation and clarifies the need for cross-validation of the RCY and RCP for quality control measurements. Only HPLC analysis is suitable for identification of radiolysis. Here we have proven that radiolysed [177Lu]Lu-PSMA has less binding affinity and thus likely will influence treatment efficacy. HPLC analysis is therefore essential to include in at least the validation phase of radiopharmaceutical implementation to ensure clinical treatment quality.
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Affiliation(s)
- Eline L. Hooijman
- grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus MC, 3015 CN Rotterdam, The Netherlands
| | - Carolline M. Ntihabose
- grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus MC, 3015 CN Rotterdam, The Netherlands
| | - Thom G. A. Reuvers
- grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Molecular Genetics, Erasmus MC, 3015 CN Rotterdam, The Netherlands
| | - Julie Nonnekens
- grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Molecular Genetics, Erasmus MC, 3015 CN Rotterdam, The Netherlands
| | - Else A. Aalbersberg
- grid.430814.a0000 0001 0674 1393Department of Nuclear Medicine, The Netherlands Cancer Institute (NKI-AVL), Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Jordy R. J. P. van de Merbel
- grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands
| | | | - Stijn L. W. Koolen
- grid.5645.2000000040459992XDepartment of Hospital Pharmacy, Erasmus MC, 3015 CN Rotterdam, The Netherlands ,grid.508717.c0000 0004 0637 3764Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Jeroen J. M. A. Hendrikx
- grid.430814.a0000 0001 0674 1393Department of Nuclear Medicine, The Netherlands Cancer Institute (NKI-AVL), Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands ,grid.430814.a0000 0001 0674 1393Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute (NKI-AVL), Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands
| | - Erik de Blois
- grid.5645.2000000040459992XDepartment of Radiology and Nuclear Medicine, Erasmus MC, 3015 CN Rotterdam, The Netherlands
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