Imaging of human pancreatic cancer xenografts by single-photon emission computed tomography with 99mTc-Hynic-PEG-AE105

Molecular imaging of the urokinase plasminogen activator receptor: opportunities beyond cancer

The urokinase plasminogen activator receptor (uPAR) plays a multifaceted role in almost any process where migration of cells and tissue-remodeling is involved such as inflammation, but also in diseases as arthritis and cancer. Normally, uPAR is absent in healthy tissues. By its carefully orchestrated interaction with the protease urokinase plasminogen activator and its inhibitor (plasminogen activator inhibitor-1), uPAR localizes a cascade of proteolytic activities, enabling (patho)physiologic cell migration. Moreover, via the interaction with a broad range of cell membrane proteins, like vitronectin and various integrins, uPAR plays a significant, but not yet completely understood, role in differentiation and proliferation of cells, affecting also disease progression. The implications of these processes, either for diagnostics or therapeutics, have received much attention in oncology, but only limited beyond. Nonetheless, the role of uPAR in different diseases provides ample opportunity to exploit new applications for targeting. Especially in the fields of oncology, cardiology, rheumatology, neurology, and infectious diseases, uPAR-targeted molecular imaging could offer insights for new directions in diagnosis, surveillance, or treatment options.

Improved positron emission tomography imaging of glioblastoma cancer using novel 68Ga-labeled peptides targeting the urokinase-type plasminogen activator receptor (uPAR)

The urokinase-type plasminogen activator receptor (uPAR) is overexpressed in several cancers including glioblastoma (GBM) and is an established biomarker for metastatic potential. The uPAR-targeting peptide AE105-NH₂ (Ac-Asp-Cha-Phe-(D)Ser-(D)Arg-Tyr-Leu-Trp-Ser-CONH₂) is a promising candidate for non-invasive positron emission tomography (PET) imaging of uPAR. Despite the optimal physical properties of ⁶⁸Ga for peptide-based PET imaging, low tumor uptakes have previously been reported using ⁶⁸Ga-labeled AE105-NH₂-based tracers. In an attempt to optimize the tumor uptake, we developed three novel tracers with alkane (AOC) and polyethylene glycol (PEG) spacers inserted between AE105-NH₂ and the radio metal chelator 2-(4,7-bis(carboxymethyl)-1,4,7-triazonan-1-yl)pentanedioic acid (NODAGA). The resulting tracers NODAGA-AOC-AE105-NH₂, NODAGA-PEG₃-AE105-NH₂ and NODAGA-PEG₈-AE105-NH₂ were compared to the non-spacer version, NODAGA-AE105-NH₂. Following radiolabeling with ⁶⁸Ga, we evaluated the in vitro and in vivo performance in mice bearing subcutaneous tumors derived from the uPAR-expressing human GBM cell line U87MG. In vivo PET/CT imaging showed that introduction of PEG spacers more than doubled the in vivo tumor uptake after 1 h compared with the non-spacer version: ⁶⁸Ga-NODAGA-PEG₃-AE105-NH₂ (2.08 ± 0.37%ID/g) and ⁶⁸Ga-NODAGA-PEG₈-AE105-NH₂ (2.01 ± 0.22%ID/g) vs. ⁶⁸Ga-NODAGA-AE105-NH₂ (0.70 ± 0.40%ID/g), p < 0.05. In addition, ⁶⁸Ga-NODAGA-PEG₈-AE105-NH₂ showed significantly higher (p < 0.05) tumor-to-background contrast (3.68 ± 0.23) than the other tracers. The specific tumor-targeting property of ⁶⁸Ga-NODAGA-PEG₈-AE105-NH₂ was established by effectively blocking the tumor uptake with co-injection of unlabeled AE105-NH₂ (1 h: unblocked 2.01 ± 0.22%ID/g vs. blocked 1.24 ± 0.09%ID/g, p < 0.05). Ex vivo biodistribution confirmed the improved tumor uptakes of the PEG-modified tracers. ⁶⁸Ga-NODAGA-PEG₈-AE105-NH₂ is thus a promising candidate for human translation for PET imaging of GBM.