Functionally Versatile and Highly Stable Chelator for 111In and 177Lu: Proof-of-Principle Prostate-Specific Membrane Antigen Targeting.

Here, we present the synthesis and characterization of a new potentially nonadentate chelator H4pypa and its bifunctional analogue tBu4pypa-C7-NHS conjugated to prostate-specific membrane antigen (PSMA)-targeting peptidomimetic (Glu-urea-Lys). H4pypa is very functionally versatile and biologically stable. Compared to the conventional chelators (e.g., DOTA, DTPA), H4pypa has outstanding affinities for both 111In (EC, t1/2 ≈ 2.8 days) and 177Lu (ß-,γ, t1/2 ≈ 6.64 days). Its radiolabeled complexes were achieved at >98% radiochemical yield, RT within 10 min, at a ligand concentration as low as 10-6 M, with excellent stability in human serum over at least 5-7 days (<1% transchelation). The thermodynamic stabilities of the [M(pypa)]- complexes (M3+ = In3+, Lu3+, La3+) were dependent on the ionic radii, where the smaller In3+ has the highest pM value (30.5), followed by Lu3+ (22.6) and La3+ (19.9). All pM values are remarkably higher than those with DOTA, DTPA, H4octapa, H4octox, and H4neunpa. Moreover, the facile and versatile bifunctionalization enabled by the p-OH group in the central pyridyl bridge of the pypa scaffold (compound 14) allows incorporation of a variety of linkers for bioconjugation through easy nucleophilic substitution. In this work, an alkyl linker was selected to couple H4pypa to a PSMA-targeting pharmacophore, proving that the bioconjugation sacrifices neither the tumor-targeting nor the chelation properties. The biodistribution profiles of 111In- and 177Lu-labeled tracers are different, but promising, with the 177Lu analogue particularly outstanding.

Technical note: Impact of dose voxel kernel (DVK) values on dosimetry estimates in 177 Lu and 90 Y radiopharmaceutical therapy (RPT) applications.

BACKGROUND: Radiopharmaceutical therapy (RPT) is an increasingly adopted modality for treating cancer. There is evidence that the optimization of the treatment based on dosimetry can improve outcomes. However, standardization of the clinical dosimetry workflow still represents a major effort. Among the many sources of variability, the impact of using different Dose Voxel Kernels (DVKs) to generate absorbed dose (AD) maps by convolution with the time-integrated activity (TIA) distribution has not been systematically investigated. PURPOSE: This study aims to compare DVKs and assess the differences in the ADs when convolving the same TIA map with different DVKs. METHODS: DVKs of 3 × 3 × 3 mm3 sampling-nine for 177 Lu, nine for 90 Y-were selected from those most used in commercial/free software or presented in prior publications. For each voxel within a 11 × 11 × 11 matrix, the coefficient of variation (CoV) and the percentage difference between maximum and minimum values (% maximum difference) were calculated. The total absorbed dose per decay (SUM), calculated as the sum of all the voxel values in each kernel, was also compared. Publicly available quantitative SPECT images for two patients treated with 177 Lu-DOTATATE and PET images for two patients treated with 90 Y-microspheres were used, including organs at risk (177 Lu: kidneys; 90 Y: liver and healthy liver) and tumors' segmentations. For each patient, the mean AD to the volumes of interest (VOIs) was calculated using the different DVKs, the same TIA map and the same software tool for dose convolution, thereby focusing on the DVK impact. For each VOI, the % maximum difference of the mean AD between maximum and minimum values was computed. RESULTS: The CoV (% maximum difference) in voxels of normalized coordinates [0,0,0], [0,1,0], and [0,1,1] were 5%(21%), 9%(35%), and 10%(46%) for the 177 Lu DVKs. For the case of 90 Y, these values were 2%(9%), 4%(14%), and 4%(16%). The CoV (% maximum difference) for SUM was 9%(33%) for 177 Lu, and 4%(15%) for 90 Y. The variability of the mean tumor and organ AD was up to 19% and 15% in 177 Lu-DOTATATE and 90 Y-microspheres patients, respectively. CONCLUSIONS: This study showed a considerable AD variability due exclusively to the use of different DVKs. A concerted effort by the scientific community would contribute to decrease these discrepancies, strengthening the consistency of AD calculation in RPT.