Optimal timing of bisphosphonate administration in combination with samarium-153 oxabifore in the treatment of painful metastatic bone disease

Quasi-dendritic sulfonate-based organic small molecule for high-quality NIR-II bone-targeted imaging

The visualization of bone imaging in vivo is of great significance for the understanding of some bone-related diseases or physiological processes. Herein, a bone-targeted NIR-II small molecule (TTQF-SO₃), which was modified with multiple sulfonate groups, was successfully fabricated for the second near-infrared (NIR-II) bone imaging. In vitro studies revealed that TTQF-SO₃ showed high affinity for hydroxyapatite and excellent macrophage accumulation ability. In in vivo assays, TTQF-SO₃ displayed high bone uptake ability and high NIR-II bone imaging quality, demonstrating the specific bone-targeting ability of the sulfonate-containing probe. In addition, the noninvasive NIR-II imaging detection in bone calcium loss was successfully verified in osteoporosis mice models. Moreover, the negative charge characteristic of TTQF-SO₃ showed efficient lymphoid enrichment in living mice by intravenous injection. Overall, these warrant that our TTQF-SO₃ is an optimal bone-targeted diagnostic agent for high-quality NIR-II imaging, highlighting its potential promise for clinical translation.

Synthesis, Complexation Properties, and Evaluation of New Aminodiphosphonic Acids as Vector Molecules for 68Ga Radiopharmaceuticals

Two new aminodiphosphonic acids derived from salicylic acid and its phosphonic analogue were prepared through a simple and efficient synthesis. 2-[(2-Amino-2,2-diphosphono)ethyloxy]-benzoic acid 8 and 2-[(2-amino-2,2-diphosphono)ethyloxy]-5-ethyl-phenylphosphonic acid 9 were evaluated for their applicability as ⁶⁸Ga binding bone-seeking agents. Protonation constants of 8 and 9 and stability constants of the Ga³⁺ complexes with 8 and 9 in water were determined. The stability constant of Ga³⁺ complex with fully phosphorylated acid 9 (logK_GaL = 31.92 ± 0.32) significantly exceeds stability constant of Ga³⁺ complex with 8 (logK_GaL = 26.63 ± 0.24). Ligands 8 and 9 are as effective for Ga³⁺ cation binding as ethylenediamine-N,N’-diacetic-N,N’-bis(methy1enephosphonic) acid and ethylenediamine-N,N,N’,N’-tetrakis(methylenephosphonic) acid, respectively. The labelling process and stability of [⁶⁸Ga]Ga-8 and [⁶⁸Ga]Ga-9 were studied. Both 8 and 9 readily form ⁶⁸Ga-complexes stable to ten-fold dilution with saline. However, in fetal bovine serum, only [⁶⁸Ga]Ga-9 was stable enough to be subject to biological evaluation. It was injected into rats with bone pathology and aseptic inflammation of soft tissues. For [⁶⁸Ga]Ga-9 in animals with a bone pathology model in 60 and 120 min after injection, a slight accumulation in the pathology site, stable blood percentage level, and moderate accumulation in the liver were observed. For animals with an aseptic inflammation, the accumulation of [⁶⁸Ga]Ga-9 in the pathology site was higher than that in animals with bone pathology. Moreover, the accumulation of [⁶⁸Ga]Ga-9 in inflammation sites was more stable than that for [⁶⁸Ga]Ga-citrate. The percentage of [⁶⁸Ga]Ga-9 in the blood decreased from 3.1% ID/g (60 min) to 1.5% ID/g (120 min). Accumulation in the liver was comparable to that obtained for [⁶⁸Ga]Ga-citrate.

Systemic Radiotherapy of Bone Metastases With Radionuclides

Treatments of bone metastases using radionuclides are now well established in oncology. It is also a field that continues to develop. This article reviews the evidence base that led to the approval of strontium-89 and samarium-153 ethylenediaminetetramethylene phophanate (EDTMP) for the palliation of pain from bone metastases, as well as the evidence for the use of radium-223 in metastatic castrate-resistant prostate cancer. Efforts to optimise treatments and improve response rates, either by safely increasing the radiation dose to bone metastases or by combining treatment with non-radiation-based therapies, are discussed. In addition, the development of both alpha- and beta-particle-emitting radiopharmaceuticals designed to target prostate-specific membrane antigen are reviewed.

Targeted Palliative Radionuclide Therapy for Metastatic Bone Pain

Bone metastasis develops in multiple malignancies with a wide range of incidence. The presence of multiple bone metastases, leading to a multitude of complications and poorer prognosis. The corresponding refractory bone pain is still a challenging issue managed through multidisciplinary approaches to enhance the quality of life. Radiopharmaceuticals are mainly used in the latest courses of the disease. Bone-pain palliation with easy-to-administer radionuclides offers advantages, including simultaneous treatment of multiple metastatic foci, the repeatability and also the combination with other therapies. Several β¯- and α-emitters as well as pharmaceuticals, from the very first [⁸⁹Sr]strontium-dichloride to recently introduced [²²³Ra]radium-dichloride, are investigated to identify an optimum agent. In addition, the combination of bone-seeking radiopharmaceuticals with chemotherapy or radiotherapy has been employed to enhance the outcome. Radiopharmaceuticals demonstrate an acceptable response rate in pain relief. Nevertheless, survival benefits have been documented in only a limited number of studies. In this review, we provide an overview of bone-seeking radiopharmaceuticals used for bone-pain palliation, their effectiveness and toxicity, as well as the results of the combination with other therapies. Bone-pain palliation with radiopharmaceuticals has been employed for eight decades. However, there are still new aspects yet to be established.

EANM guidelines for radionuclide therapy of bone metastases with beta-emitting radionuclides

The skeleton is the most common metastatic site in patients with advanced cancer. Pain is a major healthcare problem in patients with bone metastases. Bone-seeking radionuclides that selectively accumulate in the bone are used to treat cancer-induced bone pain and to prolong survival in selected groups of cancer patients. The goals of these guidelines are to assist nuclear medicine practitioners in: (a) evaluating patients who might be candidates for radionuclide treatment of bone metastases using beta-emitting radionuclides such as strontium-89 (89Sr), samarium-153 (153Sm) lexidronam (153Sm-EDTMP), and phosphorus-32 (32P) sodium phosphate; (b) performing the treatments; and

Charge and hydrophobicity effects of NIR fluorophores on bone-specific imaging

Recent advances in near-infrared (NIR) fluorescence imaging enabled real-time intraoperative detection of bone metastases, bone growth, and tissue microcalcification. Pamidronate (PAM) has been widely used for this purpose because of its high binding affinity toward bone and remarkable therapeutic effects. Herein we describe the development of a series of PAM-conjugated NIR fluorophores that varied in net charges and hydrophobicity, and compared their bone targeting efficiency, biodistribution, and blood clearance. Since the targeting moiety, PAM, is highly negatively charged but small, the overall in vivo bone targeting and biodistribution were mediated by the physicochemical properties of conjugated fluorophores.