Preclinical Combination Studies of an FGFR2 Targeted Thorium-227 Conjugate and the ATR Inhibitor BAY 1895344.

PURPOSE: Fibroblast growth factor receptor 2 (FGFR2) has been previously reported to be overexpressed in several types of cancer, whereas the expression in normal tissue is considered to be moderate to low. Thus, FGFR2 is regarded as an attractive tumor antigen for targeted alpha therapy. This study reports the evaluation of an FGFR2-targeted thorium-227 conjugate (FGFR2-TTC, BAY 2304058) comprising an anti-FGFR2 antibody, a chelator moiety covalently conjugated to the antibody, and the alpha particle-emitting radionuclide thorium-227. FGFR2-TTC was assessed as a monotherapy and in combination with the DNA damage response inhibitor ATRi BAY 1895344. METHODS AND MATERIALS: The in vitro cytotoxicity and mechanism of action were evaluated by determining cell viability, the DNA damage response marker γH2A.X, and cell cycle analyses. The in vivo efficacy was determined using human tumor xenograft models in nude mice. RESULTS: In vitro mechanistic assays demonstrated upregulation of γH2A.X and induction of cell cycle arrest in several FGFR2-expressing cancer cell lines after treatment with FGFR2-TTC. In vivo, FGFR2-TTC significantly inhibited tumor growth at a dose of 500 kBq/kg in the xenograft models NCI-H716, SNU-16, and MFM-223. By combining FGFR2-TTC with the ATR inhibitor BAY 1895344, an increased potency was observed in vitro, as were elevated levels of γH2A.X and inhibition of FGFR2-TTC-mediated cell cycle arrest. In the MFM-223 tumor xenograft model, combination of the ATRi BAY 1895344 with FGFR2-TTC resulted in significant tumor growth inhibition at doses at which the single agents had no effect. CONCLUSIONS: The data provide a mechanism-based rationale for combining the FGFR2-TTC with the ATRi BAY 1895344 as a new therapeutic approach for treatment of FGFR2-positive tumors from different cancer indications.

Mesothelin-Targeted Thorium-227 Conjugate (MSLN-TTC): Preclinical Evaluation of a New Targeted Alpha Therapy for Mesothelin-Positive Cancers.

PURPOSE: Targeted thorium-227 conjugates (TTC) represent a new class of molecules for targeted alpha therapy (TAT). Covalent attachment of a 3,2-HOPO chelator to an antibody enables specific complexation and delivery of the alpha particle emitter thorium-227 to tumor cells. Because of the high energy and short penetration range, TAT efficiently induces double-strand DNA breaks (DSB) preferentially in the tumor cell with limited damage to the surrounding tissue. We present herein the preclinical evaluation of a mesothelin (MSLN)-targeted thorium-227 conjugate, BAY 2287411. MSLN is a GPI-anchored membrane glycoprotein overexpressed in mesothelioma, ovarian, pancreatic, lung, and breast cancers with limited expression in healthy tissue. EXPERIMENTAL DESIGN: The binding activity and radiostability of BAY 2287411 were confirmed bioanalytically. The mode-of-action and antitumor potency of BAY 2287411 were investigated in vitro and in vivo in cell line and patient-derived xenograft models of breast, colorectal, lung, ovarian, and pancreatic cancer. RESULTS: BAY 2287411 induced DSBs, apoptotic markers, and oxidative stress, leading to reduced cellular viability. Furthermore, upregulation of immunogenic cell death markers was observed. BAY 2287411 was well-tolerated and demonstrated significant antitumor efficacy when administered via single or multiple dosing regimens in vivo. In addition, significant survival benefit was observed in a disseminated lung cancer model. Biodistribution studies showed specific uptake and retention of BAY 2287411 in tumors and enabled the development of a mechanistic pharmacokinetic/pharmacodynamic model to describe the preclinical data. CONCLUSIONS: These promising preclinical results supported the transition of BAY 2287411 into a clinical phase I program in mesothelioma and ovarian cancer patients (NCT03507452).

Bioaccumulation of Uranium and Thorium by Lemna minor and Lemna gibba in Pb-Zn-Ag Tailing Water.

This study focused on the ability of Lemna minor and Lemna gibba to remove U and Th in the tailing water of Keban, Turkey. These plants were placed in tailing water and individually fed to the reactors designed for these plants. Water and plant samples were collected daily from the mining area. The plants were ashed at 300°C for 1 day and analyzed by ICP-MS for U and Th. U was accumulated as a function of time by these plants, and performances between 110 % and 483 % for L. gibba, and between 218 % and 1194 % for L. minor, were shown. The highest Th accumulations in L. minor and L. gibba were observed at 300 % and 600 % performances, respectively, on the second day of the experiment. This study indicated that both L. gibba and L. minor demonstrated a high ability to remove U and Th from tailing water polluted by trace elements.

Non-destructive determination of uranium, thorium and 40K in tobacco and their implication on radiation dose levels to the human body.

The naturally occurring radionuclides of (235)U, (238)U and (232)Th and their daughter products are a potential major source of anthropogenic radiation to tobacco smokers. Often overlooked is the presence of (40)K in tobacco and its implication to radiation dose accumulation in the human body. In this study, these three radiation sources have been determined in four typical US cigarettes using neutron activation analysis (NAA). The NAA reactions of (238)U(n,γ)(239)U, (232)Th(n,γ)(233)Th and (41)K(n,γ)(42)K were used to determine (235)U, (238)U and (232)Th and (40)K, respectively. The activity of (238)U can easily be determined by epithermal NAA of the (238)U(n,γ)(239)U reaction, and the activity of (235, 234)U can easily be deduced. Using isotopic ratios, the activity due to (40)K was found by the determined concentrations of (41)K (also by epithermal neutrons) in the bulk material. Each gram of total potassium yields 30 Bq of (40)K. The annual effective dose for smokers using 20 cigarettes per day was calculate to be 14.6, 137 and 9 µSv y(-1) for (238,235,) (234)U, (232)Th and (40)K, respectively. These values are significantly lower that the dose received from (210)Po except for (232)Th.

Ingestion dose from 238U, 232Th, 226Ra, 40K and 137Cs in cereals, pulses and drinking water to adult population in a high background radiation area, Odisha, India.

A natural high background radiation area is located in Chhatrapur, Odisha in the eastern part of India. The inhabitants of this area are exposed to external radiation levels higher than the global average background values, due to the presence of uranium, thorium and its decay products in the monazite sands bearing placer deposits in its beaches. The concentrations of (232)Th, (238)U, (226)Ra, (40)K and (137)Cs were determined in cereals (rice and wheat), pulses and drinking water consumed by the population residing around this region and the corresponding annual ingestion dose was calculated. The annual ingestion doses from cereals, pulses and drinking water varied in the range of 109.4-936.8, 10.2-307.5 and 0.5-2.8 µSv y(-1), respectively. The estimated total annual average effective dose due to the ingestion of these radionuclides in cereals, pulses and drinking water was 530 µSv y(-1). The ingestion dose from cereals was the highest mainly due to a high consumption rate. The highest contribution of dose was found to be from (226)Ra for cereals and drinking water and (40)K was the major dose contributor from the intake of pulses. The contribution of man-made radionuclide (137)Cs to the total dose was found to be minimum. (226)Ra was found to be the largest contributor to ingestion dose from all sources.

Ecological transfer of radionuclides and metals to free-living earthworm species in natural habitats rich in NORM.

Transfer of radionuclides ((232)Th and (238)U) and associated metals (As, Cd, Pb and Cr) from soil to free-living earthworm species was investigated in a thorium ((232)Th) rich area in Norway. Sampling took place within former mining sites representing the technologically enhanced naturally occurring radioactive materials (TENORM), at undisturbed site with unique bedrock geology representing the naturally occurring radioactive materials (NORM) and at site outside the (232)Th rich area taken as reference Background site. Soil analysis revealed the elevated levels of investigated elements at NORM and TENORM sites. Based on sequential extraction, uranium ((238)U) and cadmium (Cd) were quite mobile, while the other elements were strongly associated with mineral components of soil. Four investigated earthworm species (Aporrectodea caliginosa, Aporrectodea rosea, Dendrodrilus rubidus and Lumbricus rubellus) showed large individual variability in the accumulation of radionuclides and metals. Differences in uptake by epigeic and endogeic species, as well as differences within same species from the NORM, TENORM and Background sites were also seen. Based on total concentrations in soil, the transfer factors (TF) were in ranges 0.03-0.08 and 0.09-0.25, for (232)Th and (238)U, respectively. TFs for lead (Pb), chromium (Cr) and arsenic (As) were low (less than 0.5), while TFs for Cd were higher (about 10). Using the ERICA tool, the estimated radiation exposure dose rate of the earthworms ranged from 2.2 to 3.9 µGy/h. The radiological risk for investigated earthworms was low (0.28). The obtained results demonstrated that free-living earthworm species can survive in soil containing elevated (232)Th and (238)U, as well As, Cd, Pb and Cr levels, although certain amount of radionuclides was accumulated within their bodies. The present investigation contributes to general better understanding of complex soil-to-biota transfer processes of radionuclides and metals and to assessment of risk for non-human species in the ecosystem with multiple contaminants.

[The dynamics of tundra vole populations and accumulation of natural radionuclides in the territories with increased level of radioactive pollution].

The analysis of natural radionuclide (226Ra) contamination and tundra vole (Microtus oeconomus Pall.) relative number (from the sixties of 20-th century to 2007) reveals the impotent role of murine rodents in radionuclide migration. As a result of their pawing and of radionuclides carry-over by plants on the soil surface since the beginning of 1990 to present time the increase of 226Ra content in animals from control and radioactive plots have been ascertain. In the plots under study tundra vole number was half as much from 1993 to 2007. Simultaneous rotation of population cycle stages noticed in the control plot and in the plot with radium contamination, and long periods of low number was recorded in the plot with radium and thorium contamination, which are typical for border and impact populations.

Risk assessment after internal exposure to black sand from Camargue: uptake and prospective dose calculation.

Some beaches in the south of France present high levels of natural radioactivity mainly due to thorium (Th) and uranium (U) present in the sand. Risk assessment after internal exposure of members of the public by either inhalation or ingestion of black sand of Camargue was performed. This evaluation required some information on the human bioavailability of U and Th from this sand. In vitro assays to determine the solubility of U, Th and their progeny were performed either in simulated lung fluid, with the inhalable fraction of sand, or in both simulated gastric and intestinal fluids with a sample of the whole sand. The experimental data show that the bioavailability of these radionuclides from Camargue sand is low in the conditions of the study. Prospective dose assessment for both routes of intake show low risk after internal exposure to this sand.

Observation of changes in urinary excretion of thorium in humans following ingestion of a therapeutic soil.

The study investigated the changes in urinary thorium excretion by humans following ingestion of a therapeutic soil, which contains about 10 ppm of thorium. This well-known healing earth in Germany has been considered as an alternative medicine for diarrhoea and gastric hyper-acidity. Six adult volunteers ingested this therapeutic soil in varying quantities for 1-15 days at levels approximating those described in the package insert of the medicine (10-60 g of soil per day). The subjects ingested about 0.1-0.6 mg of thorium daily, which is 100-600 times higher than the normal daily intake of about 1 microg thorium in Germany. All 24-h urine samples collected from the subjects during pre-ingestion, ingestion and post-ingestion periods of the soil were analyzed for (232)Th using inductively coupled plasma mass spectrometry (ICP-MS). The measured excretion values varied in a wide range. Apparently, the high thorium amounts administered did not increase the (232)Th excretion in urine as expected, suggesting that this soil ingestion will not result in a considerably higher and harmful uptake of thorium into the human body.

Influence of the soil bioavailability of radionuclides on the transfer of uranium and thorium to mushrooms.

The soil-mushroom transfer of thorium and uranium was analyzed in two ecologically similar but geographically separated Spanish ecosystems by means of the transfer factor, TF. Uranium TF values were in the range 0.043-0.49, and thorium TF values in the range 0.030-0.62. These values were similar to those of (90)Sr, (239+240)Pu, and (241)Am found previously in the same ecosystems. Given the low availability of uranium and thorium, the available transfer factors, ATF, were also determined. These were higher than the TF values by one order of magnitude for (234, 238)U, and by 2-3 orders of magnitude for (228, 230, 232)Th. The ATF value of thorium was similar to that of (137)Cs, and that of uranium similar to that of (40)K. Hebeloma cylindrosporum presented the highest uranium and thorium transfer factors, confirming this species as a good bioindicator of a soil's radioactive content.

Uptake and distribution of natural radioactivity in wheat plants from soil.

The uptake of naturally occurring uranium, thorium, radium and potassium by wheat plant from two morphologically different soils of India was studied under natural field conditions. The soil to wheat grain transfer factors (TF) were calculated and observed to be in the range of 4.0 x 10(-4) to 2.1 x 10(-3) for 238U, 6.0 x 10(-3) to 2.4 x 10(-2) for 232Th, 9.0 x 10(-3) to 1.6 x 10(-2) for 226Ra and 0.14-3.1 for 40K. Observed ratios (OR) of radionuclides with respect to calcium have been calculated to explain nearly comparable TF values in spite of differences in soil concentration of the different fields. They also give an idea about the discrimination exhibited by the plant in uptake of essential and nonessential elements. The availability of calcium and potassium in soil for uptake affects the uranium, thorium and radium content of the plant. The other soil factors such as illite clays of alluvial soil which trap potassium in its crystal lattice and phosphates which form insoluble compounds with thorium are seen to reduce their availability to plants. A major percentage (54-75%) of total 238U, 232Th and 226Ra activity in the plant is concentrated in the roots and only about 1-2% was distributed in the grains, whereas about 57% of 40K activity accumulated in the shoots and 16% in the grains. The intake of radionuclides by consumption of wheat grains from the fields studied contributes a small fraction to the total annual ingestion dose received by man due to naturally existing radioactivity in the environment.

Contents of cesium, iodine, strontium, thorium, and uranium in selected human organs of adult asian population.

Contents of cesium, iodine, strontium, thorium, and uranium in some selected human organs were estimated for adult Asian population using data obtained in four Asian countries: China, India, Philippines, and Republic of Korea, as part of a Coordinated Research Program of the International Atomic Energy Agency on "Ingestion and Organ contents of elements of importance in radiation protection." These countries together represent more than 40% of the world population. Highly sensitive analytical techniques were employed to measure cesium in skeletal muscle, iodine in thyroid, strontium in skeleton, thorium and uranium in skeleton, liver, kidneys, and lungs where, in comparison to other organs, these elements are present in higher concentrations. The organ contents for adult Asian population, when compared with the corresponding data proposed for Reference Man by International Commission on Radiological Protection (ICRP), showed about 40 times lower kidneys content and about 10 times lower skeleton content of uranium. The content of thorium in skeleton for Asian population was also half of the ICRP Reference Man value. Interestingly, organ contents for the other elements such as iodine in thyroid, cesium in skeletal muscle, and strontium in skeleton were comparable for Asian and the Caucasian population (represented by ICRP Reference Man). Organ contents for these elements were also calculated by applying the new ICRP models of these elements to their daily intakes. The comparison of the calculated and measured organ contents showed that despite uncertainties in the organ content values arising due to the inter-country variations in daily dietary intakes, the contents were within a factor of two to three. This observation is significant since human data both on organ contents and ingestion were obtained at environmental level of intakes. The study suggests that currently available ICRP models for these elements are quite realistic.

NORM workers: a challenge for internal dosimetry programmes.

The mining, milling and processing of uranium and thorium bearing minerals may result in radiation doses to workers. The control of occupational exposures from these natural sources of radiation imposes a challenge to regulators and radiation protection advisers. A survey pilot programme, which included six mines in Brazil and a monazite plant, was established, consisting of the collection and analysis of concentrations of uranium, thorium and polonium in urine, faeces and air samples. Results from workers were compared to background data from their families living in the same area and from residents from the population of Rio de Janeiro. Positive exposure results were identified among the coal miners, the niobium miners and the monazite sand workers. Difficulties in the application of internal dosimetry programmes are discussed in relation to the control of NORM workers.

Improved chelation therapy of intramuscularly deposited thorium by CaDTPA in the rat.

Comparative studies on the translocation and retention of intramuscularly (i.m.) injected thorium nitrate (234Th 46 ng + 232Th 5 microg per rat) in solutions of citrate, CaDTPA or citrate + CaDTPA in rats have been conducted. Results showed that only thorium in mixed-ligand solution was entirely translocated from the muscle, with the greatest part being excreted from the body. In this case, the whole-body retention of thorium decreased to 16% of the injected radioactivity within 2 d, 13% being retained in the skeleton. Studies on the decorporation of 234Th + 232Th nitrates from a rat wound simulated with i.m. injection have also been carried out. The greatest translocation of thorium and its excretion was achieved with a single local injection of the mixed-ligand (citrate + CaDTPA) solution when compared with those of citrate or CaDTPA alone. The efficiency of mixed-ligand treatment decreased with its delay. On day 2 post-therapy, the whole-body content of thorium decreased to 30, 37 and 55% of injected radioactivity when the local treatment started immediately, postponed to 1 h or 24 h, after i.m. injection of thorium, respectively. In control rats without treatment, there was only a slight decrease in the content of thorium in the whole body.

Soil-to-plant transfer factors for natural radionuclides and stable elements in a Mediterranean area.

The transfer factors (TF) for natural uranium isotopes (238U and 234U), thorium isotopes (232Th, 230Th and 228Th), and 226Ra were obtained in plant samples (grass-pasture) growing in granitic and alluvial soils around a disused uranium mine located in the Extremadura region in the south-west of Spain. Affected and non-affected areas of the mine presented large differences in the activity concentrations of radionuclides of the uranium series. We also determined transfer factors for several stable elements (essential and non-essential). A set of statistical tests were applied to validate the data. The results showed that the transfer factors for both the natural radionuclides and the stable elements are independent of the two substrate types involved and also of the two areas considered in the study.

Deaths from neoplasms and detection of radionuclides in excised human lungs in the Eordea Basin, Greece.

Lignite contains various trace-metal natural radioactive contaminants. In the Eordea Basin, the most important lignite field in Greece, the authors conducted a proportional mortality ratio (PMR) study that compared the mortality rates of individuals who lived in the basin vs. a control group who resided in the city of Kilkis, over a 30-yr period. The following information was used in the study: (a) municipal registrations of deaths from neoplasms during the period from 1971 to 2000, and (b) detection of radioactive substances in samples obtained from excised lungs of individuals living in Eordea Basin who suffered from neoplasm. The corresponding registrations of deaths from neoplasm of the inhabitants of Kilkis, a city located outside the Eordea Basin, formed the control group. A diachronic increase of the PMR was detected as a result of neoplasms and, particularly, as a result of lung cancer in Eordea Basin. However, the above ratio did not exceed the corresponding PMR recorded in Kilkis. In 20 lung samples obtained from patients who had lived in Eordea Basin, and in 19 lung samples from patients in Kilkis, the activity of the radionuclides of uranium and thorium radioactive decay series, potassium-40, and cesium-137 was not higher than expected. No statistically significant difference was found between the inhabitants of the 2 regions, thus it was concluded that the increase in respiratory-system neoplasms was likely associated with the high prevalence of smoking among the regions' inhabitants. In future studies, a longer observation period and examination of more cases will be necessary to further investigate a possible association between radionuclides and lung neoplasms in the Eordea Basin.

Natural uranium and thorium distributions in podzolized soils and native blueberry.

Plant uptake of radionuclides is one of many vectors for introduction of contaminants into the human food chain. Thus, it is critical to understand soil-plant relationships that control nuclide bioavailability. Our objectives in this study were to (i) determine the extent of U and Th uptake and cycling by blueberry (Vaccinium pallidum Aiton) in native habitat and (ii) identify the soil properties and processes that contribute most to U and Th bioavailability in this system. We collected composite samples of plant leaves and stems, and samples from surface (AE) horizons and from the upper part of the Bs horizon at two sites. Concentration ratios (CRs) for U and Th were calculated for all plant tissues, using both the AE and Bs horizons as the base. Soil concentrations of U ranged from 16 to 25 microg g(-1), with a mean of 21.1 microg g(-1). Soil concentrations of Th ranged from 14 to 97 microg g(-1), with a mean of 41.8 microg g(-1). Mean U concentrations were 8.65 x 10(-3) microg g(-1) in leaf tissue, and 7.95 x 10(-3) microg g(-1) in stem tissue. Mean Th concentrations were 1.59 x 10(-1) microg g(-1) in leaf tissue, and 9.10 x 10(-2) microg g(-1) in stem tissue. Blueberry plants are cycling both U and Th in this system, with Th cycling occurring to a greater extent than U. In addition, Th was translocated preferentially to plant leaves while U concentrations showed little preferential translocation. Uranium uptake, however, seemed more sensitive than Th uptake to soil properties.

Distribution and mobilization of U, Th and 226Ra in the plant-soil compartments of a mineralized uranium area in south-west Spain.

The activity concentrations of natural uranium isotopes (238U and 234U), thorium isotopes (232Th, 230Th and 225Th) and 226Ra were studied in soil and vegetation samples from a disused uranium mine located in the Extremadura region in the south-west of Spain. The results allowed us to characterize radiologically the area close to the installation and one affected zone was clearly manifest as being dependent on the direction of the surface water flow from the mine. The activity concentration mean values (Bq/kg) in this zone were: 10,924, 10,900, 10,075 and 5,289 for 238U, 234U, 230Th and 226Ra, respectively, in soil samples and 1,050, 1,060, 768 and 1,141 for the same radionuclides in plant samples. In an unaffected zone, the activity concentration mean values (Bq/kg) were: 184, 190, 234 and 7251 for 235U, 234U, 230Th and 226Ra, respectively, in soil samples and 28. 29, 31 and 80 in plant samples. The activity concentrations obtained for 232Th and 228Th showed that the influence of the mine was only important for the uranium series radionuclides. The relative radionuclide mobilities were determined from the activity ratios. Correlations between radionuclide activity concentrations and stable element concentrations in the soil samples helped to understand the possible distribution paths for the natural radionuclides.

About the assumption of linearity in soil-to-plant transfer factors for uranium and thorium isotopes and 226Ra.

The linearity assumption for soil and plant concentrations of radionuclides is usually a good approximation for use in food-chain models. To verify this assumption, different samples of plant and substrate were collected from a granitic zone located near a disused uranium mine in order to cover a large range of concentrations. In all of the samples, the activity concentration of 226Ra and of different isotopes of uranium (238U and 234U) and thorium (232Th, 230Th and 228Th) were determined. The results indicate that the linearity assumption can be considered valid when the range of concentrations taken into account is large (approx. two orders of magnitude). Otherwise, there is a clear deviation from linearity. Also, the influence of different stable elements on the soil-plant transfer factors was studied by using multivariate regression methods. The uptake of uranium, thorium and radium was found to be mainly associated with the concentration of iron in the plant and the phosphorus and alkaline earths in the substrate.

Uranium and uranium decay series radionuclide dynamics in bone of rats following chronic uranium ore dust inhalation.

The accumulation and release of uranium and some uranium decay chain radionuclides were measured in the bones of rats that had been chronically exposed to inhaled uranium ore dust during the first half (approximately) of their natural adult lifespan. Endochondral bone (femur, tibia, humerus, radius, and ulna), membrane bone (skull roofing bones) and muscle of Sprague-Dawley rats (n = 55) that died at various times up to 65 weeks after the end of chronic inhalation of uranium ore dust aerosol (4.2 h d(-1) for 65 wk) and from age matched controls (n = 10), were analyzed for uranium, 230Th, 226Ra, 210Pb, and 210Po. Overall, during the period of dust inhalation, the nuclides accumulated in the above order of decreasing concentration in dry bone. However, the results demonstrate that there was some differential accumulation of uranium and uranium decay series radionuclides in muscle and two bone types of rats during the chronic inhalation period. The data also show that the bone levels of some, but not all, radionuclides decreased significantly with time after inhalation ceased. Lung uranium concentration at the time of death was a highly significant covariant for temporal changes in the levels of some radionuclides in both endochondral bone and membrane bone, indicating that lung remained a major source of these isotopes for accumulation in these bone types after ore dust inhalation had ceased. For some isotopes, the two bone types behaved differently during the dust inhalation period, and differently again after the dust inhalation ceased. The relative behavior of one bone type compared to the other for a particular isotope during the dust inhalation period did not predict the relative behavior after dust inhalation ceased. However, a faster accumulation of one bone type compared to the other for a particular isotope during the dust inhalation period predicted a faster decrease after dust inhalation ended.