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1.
J Nanobiotechnology ; 22(1): 306, 2024 Jun 02.
Article in English | MEDLINE | ID: mdl-38825717

ABSTRACT

Targeted alpha therapy (TAT) relies on chemical affinity or active targeting using radioimmunoconjugates as strategies to deliver α-emitting radionuclides to cancerous tissue. These strategies can be affected by transmetalation of the parent radionuclide by competing ions in vivo and the bond-breaking recoil energy of decay daughters. The retention of α-emitting radionuclides and the dose delivered to cancer cells are influenced by these processes. Encapsulating α-emitting radionuclides within nanoparticles can help overcome many of these challenges. Poly(lactic-co-glycolic acid) (PLGA) nanoparticles are a biodegradable and biocompatible delivery platform that has been used for drug delivery. In this study, PLGA nanoparticles are utilized for encapsulation and retention of actinium-225 ([225Ac]Ac3+). Encapsulation of [225Ac]Ac3+ within PLGA nanoparticles (Zave = 155.3 nm) was achieved by adapting a double-emulsion solvent evaporation method. The encapsulation efficiency was affected by both the solvent conditions and the chelation of [225Ac]Ac3+. Chelation of [225Ac]Ac3+ to a lipophilic 2,9-bis-lactam-1,10-phenanthroline ligand ([225Ac]AcBLPhen) significantly decreased its release (< 2%) and that of its decay daughters (< 50%) from PLGA nanoparticles. PLGA nanoparticles encapsulating [225Ac]AcBLPhen significantly increased the delivery of [225Ac]Ac3+ to murine (E0771) and human (MCF-7 and MDA-MB-231) breast cancer cells with a concomitant increase in cell death over free [225Ac]Ac3+ in solution. These results demonstrate that PLGA nanoparticles have potential as radionuclide delivery platforms for TAT to advance precision radiotherapy for cancer. In addition, this technology offers an alternative use for ligands with poor aqueous solubility, low stability, or low affinity, allowing them to be repurposed for TAT by encapsulation within PLGA nanoparticles.


Subject(s)
Actinium , Nanoparticles , Polylactic Acid-Polyglycolic Acid Copolymer , Nanoparticles/chemistry , Polylactic Acid-Polyglycolic Acid Copolymer/chemistry , Actinium/chemistry , Humans , Cell Line, Tumor , Animals , Alpha Particles/therapeutic use , Mice , Female , Biocompatible Materials/chemistry , Breast Neoplasms/drug therapy , Radioimmunotherapy/methods
2.
Int J Mol Sci ; 25(11)2024 May 23.
Article in English | MEDLINE | ID: mdl-38891856

ABSTRACT

Astatine (211At) is a cyclotron-produced alpha emitter with a physical half-life of 7.2 h. In our previous study, the 211At-labeled prostate-specific membrane antigen (PSMA) compound ([211At]PSMA-5) exhibited excellent tumor growth suppression in a xenograft model. We conducted preclinical biodistribution and toxicity studies for the first-in-human clinical trial. [211At]PSMA-5 was administered to both normal male ICR mice (n = 85) and cynomolgus monkeys (n = 2). The mice were divided into four groups for the toxicity study: 5 MBq/kg, 12 MBq/kg, 35 MBq/kg, and vehicle control, with follow-ups at 1 day (n = 10 per group) and 14 days (n = 5 per group). Monkeys were observed 24 h post-administration of [211At]PSMA-5 (9 MBq/kg). Blood tests and histopathological examinations were performed at the end of the observation period. Blood tests in mice indicated no significant myelosuppression or renal dysfunction. However, the monkeys displayed mild leukopenia 24 h post-administration. Despite the high accumulation in the kidneys and thyroid, histological analysis revealed no abnormalities. On day 1, dose-dependent single-cell necrosis/apoptosis was observed in the salivary glands of mice and intestinal tracts of both mice and monkeys. Additionally, tingible body macrophages in the spleen and lymph nodes indicated phagocytosis of apoptotic B lymphocytes. Cortical lymphopenia (2/10) in the thymus and a decrease in the bone marrow cells (9/10) were observed in the 35 MBq/kg group in mice. These changes were transient, with no irreversible toxicity observed in mice 14 days post-administration. This study identified no severe toxicities associated with [211At]PSMA-5, highlighting its potential as a next-generation targeted alpha therapy for prostate cancer. The sustainable production of 211At using a cyclotron supports its applicability for clinical use.


Subject(s)
Mice, Inbred ICR , Prostatic Neoplasms , Animals , Male , Prostatic Neoplasms/pathology , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/metabolism , Mice , Tissue Distribution , Astatine/pharmacokinetics , Astatine/chemistry , Alpha Particles/therapeutic use , Humans , Macaca fascicularis , Glutamate Carboxypeptidase II/metabolism , Radiopharmaceuticals/pharmacokinetics , Radiopharmaceuticals/chemistry
3.
Zhongguo Yi Liao Qi Xie Za Zhi ; 48(3): 271-276, 2024 May 30.
Article in Chinese | MEDLINE | ID: mdl-38863092

ABSTRACT

In order to improve the biological effect of proton therapy, the authors first propose a new method of boron-based proton-enhanced radiotherapy in a " ternary " radiotherapy mode, based on the existing sensitizing effect of proton radiotherapy: i.e, Boron-based mediators (11B and 10B) induce the proton-hydrogen-boron fusion reaction of the low-energy protons arriving at the Bragg peak region of the tumor target area (p+11B→3α) and thermal neutron capture (10B+n→7Li3+(0.84 MeV)+4He2+(1.47 MeV)+γ(0.477 MeV)), which release low-energy α-particles with high LETs to enhance the biological effect of proton dose in the target area, thus improve the clinical effect of proton therapy. Then, the advantages and disadvantages of the "ternary" model were analyzed from the theoretical basis and current research status, and finally, the "ternary" model is summarized and prospected.


Subject(s)
Proton Therapy , Protons , Boron , Neoplasms/radiotherapy , Radiotherapy Dosage , Alpha Particles/therapeutic use , Models, Theoretical
4.
Cell Death Dis ; 15(6): 426, 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38890278

ABSTRACT

Radiation therapy (RT) remains a common treatment for cancer patients worldwide, despite the development of targeted biological compounds and immunotherapeutic drugs. The challenge in RT lies in delivering a lethal dose to the cancerous site while sparing the surrounding healthy tissues. Low linear energy transfer (low-LET) and high linear energy transfer (high-LET) radiations have distinct effects on cells. High-LET radiation, such as alpha particles, induces clustered DNA double-strand breaks (DSBs), potentially inducing cell death more effectively. However, due to limited range, alpha-particle therapies have been restricted. In human cancer, mutations in TP53 (encoding for the p53 tumor suppressor) are the most common genetic alteration. It was previously reported that cells carrying wild-type (WT) p53 exhibit accelerated senescence and significant rates of apoptosis in response to RT, whereas cells harboring mutant p53 (mutp53) do not. This study investigated the combination of the alpha-emitting atoms RT based on internal Radium-224 (224Ra) sources and systemic APR-246 (a p53 reactivating compound) to treat tumors with mutant p53. Cellular models of colorectal cancer (CRC) or pancreatic ductal adenocarcinoma (PDAC) harboring mutant p53, were exposed to alpha particles, and tumor xenografts with mutant p53 were treated using 224Ra source and APR-246. Effects on cell survival and tumor growth, were assessed. The spread of alpha emitters in tumors was also evaluated as well as the spatial distribution of apoptosis within the treated tumors. We show that mutant p53 cancer cells exhibit radio-sensitivity to alpha particles in vitro and to alpha-particles-based RT in vivo. APR-246 treatment enhanced sensitivity to alpha radiation, leading to reduced tumor growth and increased rates of tumor eradication. Combining alpha-particles-based RT with p53 restoration via APR-246 triggered cell death, resulting in improved therapeutic outcomes. Further preclinical and clinical studies are needed to provide a promising approach for improving treatment outcomes in patients with mutant p53 tumors.


Subject(s)
Alpha Particles , Radiation-Sensitizing Agents , Tumor Suppressor Protein p53 , Alpha Particles/therapeutic use , Humans , Tumor Suppressor Protein p53/metabolism , Tumor Suppressor Protein p53/genetics , Animals , Mice , Radiation-Sensitizing Agents/pharmacology , Mutation , Quinuclidines/pharmacology , Cell Line, Tumor , Mice, Nude , Xenograft Model Antitumor Assays , Apoptosis/drug effects , Apoptosis/radiation effects , Neoplasms/radiotherapy , Neoplasms/genetics , Neoplasms/pathology
5.
Theranostics ; 14(7): 2969-2992, 2024.
Article in English | MEDLINE | ID: mdl-38773983

ABSTRACT

Targeted alpha particle therapy (TAT) has emerged as a promising strategy for the treatment of prostate cancer (PCa). Actinium-225 (225Ac), a potent alpha-emitting radionuclide, may be incorporated into targeting vectors, causing robust and in some cases sustained antitumor responses. The development of radiolabeling techniques involving EDTA, DOTA, DOTPA, and Macropa chelators has laid the groundwork for advancements in this field. At the forefront of clinical trials with 225Ac in PCa are PSMA-targeted TAT agents, notably [225Ac]Ac-PSMA-617, [225Ac]Ac-PSMA-I&T and [225Ac]Ac-J591. Ongoing investigations spotlight [225Ac]Ac-hu11B6, [225Ac]Ac-YS5, and [225Ac]Ac-SibuDAB, targeting hK2, CD46, and PSMA, respectively. Despite these efforts, hurdles in 225Ac production, daughter redistribution, and a lack of suitable imaging techniques hinder the development of TAT. To address these challenges and additional advantages, researchers are exploring alpha-emitting isotopes including 227Th, 223Ra, 211At, 213Bi, 212Pb or 149Tb, providing viable alternatives for TAT.


Subject(s)
Actinium , Alpha Particles , Prostatic Neoplasms , Humans , Male , Actinium/therapeutic use , Actinium/chemistry , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/therapy , Alpha Particles/therapeutic use , Radiopharmaceuticals/therapeutic use , Animals
6.
Appl Radiat Isot ; 210: 111360, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38781612

ABSTRACT

Human activities usually have some contamination as effluents from chemical industries and radionuclides from nuclear reactors. For assessing the probable radioactive contamination in vicinity of Tehran Research Reactor, The gross alpha and beta radioactivity concentrations in soil, pine and cedar leaves and some selected fruits (fig, apple, berry and pomegranate) were investigated using an alpha/beta spectrometer during 2021-2022. Also, the concentrations of artificial and natural radionuclides in samples were investigated by the method of gamma spectroscopy. The gross alpha activity concentrations in soil, pine and cedar leaves and some selected fruits samples are from 0.05 to 0.35 Bq/gr and 0.07-0.31 Bq/gr and 0.04-0.18 Bq/gr, respectively. The gross beta activity concentrations in soil, pine and cedar leaves and some selected fruit samples are from 0.73 to 4.25 Bq/gr and 0.21-3.97 Bq/gr and 1.01-2.71 Bq/gr, respectively. Average activities concentration of natural radionuclide 232Th, 238U and 40K in soil, pine and cedar leaves and some selected fruits are 31.89-16.23-582.73 Bq/kg and 1.84-0.99-84.60 Bq/kg and 1.98-1.09-72.08 Bq/kg respectively. From artificial radionuclides, just 137Cs is recognized in soil sample and the range of 137Cs concentration in surface soils was observed to vary in the range 0.85-2.21 (Bq/kg). The result showed that the Tehran Research Reactor activities not have increased the environmental radioactivity and radiation level in the area.


Subject(s)
Beta Particles , Fruit , Radiation Monitoring , Soil Pollutants, Radioactive , Iran , Soil Pollutants, Radioactive/analysis , Fruit/chemistry , Radiation Monitoring/methods , Alpha Particles , Nuclear Reactors , Uranium/analysis , Food Contamination, Radioactive/analysis , Radioisotopes/analysis , Humans , Plant Leaves/chemistry , Thorium
7.
Appl Radiat Isot ; 210: 111355, 2024 Aug.
Article in English | MEDLINE | ID: mdl-38761509

ABSTRACT

This study calculates dose rate in Gy y-1 for individual dust, soil, and sediment particles that contain significant amounts of alpha-emitting uranium or thorium. When inhaled or ingested, these particles deliver radiation dose to organs where they embed. The presented method uses X-ray microscopy to measure alpha emitting elements in environmental microparticles, followed by calculation of dose rates delivered to the targeted volume of tissues that surround embedded microparticles. The example calculations use a real-world, 89% uranium house dust particle.


Subject(s)
Alpha Particles , Radiation Dosage , Thorium , Uranium , Uranium/analysis , Thorium/analysis , Humans , Dust/analysis , Soil Pollutants, Radioactive/analysis
8.
Cancer J ; 30(3): 218-223, 2024.
Article in English | MEDLINE | ID: mdl-38753757

ABSTRACT

ABSTRACT: Radiopharmaceutical therapy has emerged as a promising approach for the treatment of various cancers. The exploration of novel targets such as tumor-specific antigens, overexpressed receptors, and intracellular biomolecules using antibodies, peptides, or small molecules has expanded the scope of radiopharmaceutical therapy, enabling precise and effective cancer treatment for an increasing number of tumor types. Alpha emitters, characterized by their high linear energy transfer and short path length, offer unique advantages in targeted therapy due to their potent cytotoxicity against cancer cells while sparing healthy tissues. This article reviews recent advancements in identifying novel targets for radiopharmaceutical therapy and applications in utilizing α-emitters for targeted treatment.


Subject(s)
Neoplasms , Radiopharmaceuticals , Humans , Radiopharmaceuticals/therapeutic use , Neoplasms/therapy , Neoplasms/diagnosis , Neoplasms/drug therapy , Alpha Particles/therapeutic use , Molecular Targeted Therapy/methods , Animals
9.
J Inorg Biochem ; 256: 112569, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38701687

ABSTRACT

The clinical success of [223Ra]RaCl2 (Xofigo®) for the palliative treatment of bone metastases in patients with prostate cancer has highlighted the therapeutic potential of α-particle emission. Expanding the applicability of radium-223 in Targeted Alpha Therapy of non-osseous tumors is followed up with significant interest, as it holds the potential to unveil novel treatment options in the comprehensive management of cancer. Moreover, the use of barium radionuclides, like barium-131 and -135m, is still unfamiliar in nuclear medicine applications, although they can be considered as radium-223 surrogates for imaging purposes. Enabling these applications requires the establishment of chelators able to form stable complexes with radium and barium radionuclides. Until now, only a limited number of ligands have been suggested and these molecules have been primarily inspired by existing structures known for their ability to complex large metal cations. However, a systematic inspection of chelators specifically tailored to Ra2+ and Ba2+ has yet to be conducted. This work delves into a comprehensive investigation of a series of small organic ligands, aiming to unveil the coordination preferences of both radium-223 and barium-131/135m. Electronic binding energies of both metal cations to each ligand were theoretically computed via Density Functional Theory calculations (COSMO-ZORA-PBE-D3/TZ2P), while thermodynamic stability constants were experimentally determined for Ba2+-ligand complexes by potentiometry, NMR and UV-Vis spectroscopies. The outcomes revealed malonate, 2-hydroxypyridine 1-oxide and picolinate as the most favorable building blocks to design multidentate chelators. These findings serve as foundation guidelines, propelling the development of cutting-edge radium-223- and barium-131/135m-based radiopharmaceuticals for Targeted Alpha Therapy and theranostics of cancer.


Subject(s)
Radium , Radium/chemistry , Radium/therapeutic use , Humans , Radioisotopes/chemistry , Coordination Complexes/chemistry , Coordination Complexes/therapeutic use , Barium/chemistry , Alpha Particles/therapeutic use , Chelating Agents/chemistry , Chelating Agents/therapeutic use , Neoplasms/drug therapy , Theranostic Nanomedicine/methods , Metals, Alkaline Earth/chemistry , Radiopharmaceuticals/chemistry , Radiopharmaceuticals/therapeutic use
10.
Phys Med ; 121: 103367, 2024 May.
Article in English | MEDLINE | ID: mdl-38701625

ABSTRACT

PURPOSE: Diffusing alpha-emitters radiation therapy (DaRT) is a brachytherapy technique using α-particles to treat solid tumours. The high linear energy transfer (LET) and short range of α-particles make them good candidates for the targeted treatment of cancer. Treatment planning of DaRT requires a good understanding of the dose from α-particles and the other particles released in the 224Ra decay chain. METHODS: The Geant4 Monte Carlo toolkit has been used to simulate a DaRT seed to better understand the dose contribution from all particles and simulate the DNA damage due to this treatment. RESULTS: Close to the seed α-particles deliver the majority of dose, however at radial distances greater than 4 mm, the contribution of ß-particles is greater. The RBE has been estimated as a function of number of double strand breaks (DSBs) and complex DSBs. A maximum seed spacing of 5.5 mm and 6.5 mm was found to deliver at least 20 Gy RBE weighted dose between the seeds for RBEDSB and RBEcDSB respectively. CONCLUSIONS: The DNA damage changes with radial distance from the seed and has been found to become less complex with distance, which is potentially easier for the cell to repair. Close to the seed α-particles contribute the majority of dose, however the contribution from other particles cannot be neglected and may influence the choice of seed spacing.


Subject(s)
Alpha Particles , DNA Damage , Monte Carlo Method , Alpha Particles/therapeutic use , Radiotherapy Dosage , Radiation Dosage , Relative Biological Effectiveness , Diffusion , Brachytherapy/methods , Humans , Linear Energy Transfer , Radiotherapy Planning, Computer-Assisted/methods , DNA Breaks, Double-Stranded/radiation effects
11.
Sci Rep ; 14(1): 11468, 2024 05 20.
Article in English | MEDLINE | ID: mdl-38769339

ABSTRACT

Diffusing alpha-emitters radiation therapy (Alpha-DaRT) is a unique method, in which interstitial sources carrying 224Ra release a chain of short-lived daughter atoms from their surface. Although DNA damage response (DDR) is crucial to inducing cell death after irradiation, how the DDR occurs during Alpha-DaRT treatment has not yet been explored. In this study, we temporo-spatially characterized DDR such as kinetics of DNA double-strand breaks (DSBs) and cell cycle, in two-dimensional (2D) culture conditions qualitatively mimicking Alpha-DaRT treatments, by employing HeLa cells expressing the Fucci cell cycle-visualizing system. The distribution of the alpha-particle pits detected by a plastic nuclear track detector, CR-39, strongly correlated with γH2AX staining, a marker of DSBs, around the 224Ra source, but the area of G2 arrested cells was more widely spread 24 h from the start of the exposure. Thereafter, close time-lapse observation revealed varying cell cycle kinetics, depending on the distance from the source. A medium containing daughter nuclides prepared from 224Ra sources allowed us to estimate the radiation dose after 24 h of exposure, and determine surviving fractions. The present experimental model revealed for the first time temporo-spatial information of DDR occurring around the source in its early stages.


Subject(s)
Alpha Particles , DNA Breaks, Double-Stranded , Humans , HeLa Cells , DNA Breaks, Double-Stranded/radiation effects , DNA Damage/radiation effects , Cell Cycle/radiation effects , Histones/metabolism , Cell Culture Techniques/methods
12.
Sci Rep ; 14(1): 11502, 2024 05 20.
Article in English | MEDLINE | ID: mdl-38769353

ABSTRACT

Astronauts travelling in space will be exposed to mixed beams of particle radiation and photons. Exposure limits that correspond to defined cancer risk are calculated by multiplying absorbed doses by a radiation-type specific quality factor that reflects the biological effectiveness of the particle without considering possible interaction with photons. We have shown previously that alpha radiation and X-rays may interact resulting in synergistic DNA damage responses in human peripheral blood lymphocytes but the level of intra-individual variability was high. In order to assess the variability and validate the synergism, blood from two male donors was drawn at 9 time points during 3 seasons of the year and exposed to 0-2 Gy of X-rays, alpha particles or 1:1 mixture of both (half the dose each). DNA damage response was quantified by chromosomal aberrations and by mRNA levels of 3 radiation-responsive genes FDXR, CDKN1A and MDM2 measured 24 h post exposure. The quality of response in terms of differential expression of alternative transcripts was assessed by using two primer pairs per gene. A consistently higher than expected effect of mixed beams was found in both donors for chromosomal aberrations and gene expression with some seasonal variability for the latter. No synergy was detected for alternative transcription.


Subject(s)
Chromosome Aberrations , Lymphocytes , Radiation, Ionizing , Humans , Lymphocytes/radiation effects , Lymphocytes/metabolism , Male , Chromosome Aberrations/radiation effects , X-Rays/adverse effects , DNA Damage , Space Flight , Alpha Particles/adverse effects , Transcription, Genetic/radiation effects , Adult , Gene Expression Regulation/radiation effects , Dose-Response Relationship, Radiation
13.
Eur J Nucl Med Mol Imaging ; 51(9): 2649-2662, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38641714

ABSTRACT

Alpha-particle radionuclide-antibody conjugates are being clinically evaluated against solid tumors even when they moderately express the targeted markers. At this limit of lower tumor-absorbed doses, to maintain efficacy, the few(er) intratumorally delivered alpha-particles need to traverse/hit as many different cancer cells as possible. We complement antibody-radioconjugate therapies with a separate nanocarrier delivering a fraction of the same total injected radioactivity to tumor regions geographically different than those affected by targeting antibodies; these carrier-cocktails collectively distribute the alpha-particle emitters better. METHODS: The efficacy of actinium-225 delivered by our carrier-cocktails was assessed in vitro and on mice with orthotopic MDA-MB-436 and/or MDA-MB-231 triple-negative breast cancers and/or an ectopic BxPC3 pancreatic cancer. Cells/tumors were chosen to express low-to-moderate levels of HER1, as model antibody-targeted marker. RESULTS: Independent of cell line, antibody-radioconjugates were most lethal on cell monolayers. On spheroids, with radii greater than alpha-particles' range, carrier-cocktails improved killing efficacy (p < 0.0500). Treatment with carrier-cocktails decreased the MDA-MB-436 and MDA-MB-231 orthotopic tumor volumes by 73.7% and 72.1%, respectively, relative to treatment with antibody-radioconjugates alone, at same total injected radioactivity; these carrier-cocktails completely eliminated formation of spontaneous metastases vs. 50% and 25% elimination in mice treated with antibody-radioconjugates alone. In BxPC3 tumor-bearing mice, carrier-cocktails increased the median survival to 25-26 days (in male-female animals) vs. 20-21 days of mice treated with antibody-radioconjugates alone (vs. 17 days for non-treated animals). Survival with carrier-cocktail radiotherapy was further prolonged by pre-injecting low-dose, standard-of-care, gemcitabine (p = 0.0390). CONCLUSION: Tumor-agnostic carrier-cocktails significantly enhance the therapeutic efficacy of existing alpha-particle radionuclide-antibody treatments.


Subject(s)
Actinium , Alpha Particles , Animals , Actinium/chemistry , Actinium/therapeutic use , Mice , Cell Line, Tumor , Humans , Alpha Particles/therapeutic use , Female , Immunoconjugates/chemistry , Immunoconjugates/therapeutic use , Biomarkers, Tumor/metabolism , Drug Carriers/chemistry
14.
Eur J Nucl Med Mol Imaging ; 51(7): 1965-1980, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38676735

ABSTRACT

Preclinical studies are essential for effectively evaluating TAT radiopharmaceuticals. Given the current suboptimal supply chain of these radionuclides, animal studies must be refined to produce the most translatable TAT agents with the greatest clinical potential. Vector design is pivotal, emphasizing harmonious physical and biological characteristics among the vector, target, and radionuclide. The scarcity of alpha-emitting radionuclides remains a significant consideration. Actinium-225 and lead-212 appear as the most readily available radionuclides at this stage. Available animal models for researchers encompass xenografts, allografts, and PDX (patient-derived xenograft) models. Emerging strategies for imaging alpha-emitters are also briefly explored. Ultimately, preclinical research must address two critical aspects: (1) offering valuable insights into balancing safety and efficacy, and (2) providing guidance on the optimal dosing of the TAT agent.


Subject(s)
Alpha Particles , Radiopharmaceuticals , Animals , Humans , Alpha Particles/therapeutic use , Drug Evaluation, Preclinical , Radiopharmaceuticals/therapeutic use , Disease Models, Animal
15.
PET Clin ; 19(3): 341-349, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38658229

ABSTRACT

Peptide receptor radionuclide therapy (PRRT) has become mainstream therapy of metastatic neuroendocrine tumors not controlled by somatostatin analog therapy. Currently, beta particle-emitting radiopharmaceuticals are the mainstay of PRRT. Alpha particle-emitting radiopharmaceuticals have a theoretic advantage over beta emitters in terms of improved therapeutic efficacy due to higher cancer cell death and lower nontarget tissue radiation-induced adverse events due to shorter path length of alpha particles. We discuss the available evidence for and the role of alpha particle PRRT.


Subject(s)
Alpha Particles , Neuroendocrine Tumors , Radiopharmaceuticals , Receptors, Peptide , Humans , Neuroendocrine Tumors/radiotherapy , Neuroendocrine Tumors/diagnostic imaging , Radiopharmaceuticals/therapeutic use , Alpha Particles/therapeutic use , Octreotide/analogs & derivatives , Octreotide/therapeutic use , Radioisotopes/therapeutic use
16.
Clin Cancer Res ; 30(11): 2531-2544, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38593212

ABSTRACT

PURPOSE: Initially, prostate cancer responds to hormone therapy, but eventually resistance develops. Beta emitter-based prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy is approved for the treatment of metastatic castration-resistant prostate cancer. Here we introduce a targeted alpha therapy (TAT) consisting of the PSMA antibody pelgifatamab covalently linked to a macropa chelator and labeled with actinium-225 and compare its efficacy and tolerability with other TATs. EXPERIMENTAL DESIGN: The in vitro characteristics and in vivo biodistribution, antitumor efficacy, and tolerability of 225Ac-macropa-pelgifatamab (225Ac-pelgi) and other TATs were investigated in cell line- and patient-derived prostate cancer xenograft models. The antitumor efficacy of 225Ac-pelgi was also investigated in combination with the androgen receptor inhibitor darolutamide. RESULTS: Actinium-225-labeling of 225Ac-pelgi was efficient already at room temperature. Potent in vitro cytotoxicity was seen in PSMA-expressing (LNCaP, MDA-PCa-2b, and C4-2) but not in PSMA-negative (PC-3 and DU-145) cell lines. High tumor accumulation was seen for both 225Ac-pelgi and 225Ac-DOTA-pelgi in the MDA-PCa-2b xenograft model. In the C4-2 xenograft model, 225Ac-pelgi showed enhanced antitumor efficacy with a T/Cvolume (treatment/control) ratio of 0.10 compared with 225Ac-DOTA-pelgi, 225Ac-DOTA-J591, and 227Th-HOPO-pelgifatamab (227Th-pelgi; all at 300 kBq/kg) with T/Cvolume ratios of 0.37, 0.39, and 0.33, respectively. 225Ac-pelgi was less myelosuppressive than 227Th-pelgi. 225Ac-pelgi showed dose-dependent treatment efficacy in the patient-derived KuCaP-1 model and strong combination potential with darolutamide in both cell line- (22Rv1) and patient-derived (ST1273) xenograft models. CONCLUSIONS: These results provide a strong rationale to investigate 225Ac-pelgi in patients with prostate cancer. A clinical phase I study has been initiated (NCT06052306).


Subject(s)
Actinium , Alpha Particles , Antigens, Surface , Glutamate Carboxypeptidase II , Xenograft Model Antitumor Assays , Male , Humans , Animals , Mice , Cell Line, Tumor , Glutamate Carboxypeptidase II/antagonists & inhibitors , Glutamate Carboxypeptidase II/metabolism , Antigens, Surface/metabolism , Alpha Particles/therapeutic use , Tissue Distribution , Prostatic Neoplasms/drug therapy , Prostatic Neoplasms/pathology , Prostatic Neoplasms/metabolism , Immunoconjugates/pharmacology , Immunoconjugates/therapeutic use , Prostatic Neoplasms, Castration-Resistant/drug therapy , Prostatic Neoplasms, Castration-Resistant/pathology , Radiopharmaceuticals/administration & dosage
17.
PET Clin ; 19(3): 307-323, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38688775

ABSTRACT

Targeted radionuclide therapy (TRT) has significantly evolved from its beginnings with iodine-131 to employing carrier molecules with beta emitting isotopes like lutetium-177. With the success of Lu-177-DOTATATE for neuroendocrine tumors and Lu-177-PSMA-617 for prostate cancer, several other beta emitting radioisotopes, such as Cu-67 and Tb-161, are being explored for TRT. The field has also expanded into targeted alpha therapy (TAT) with agents like radium-223 for bone metastases in prostate cancer, and several other alpha emitter radioisotopes with carrier molecules, such as Ac-225, and Pb-212 under clinical trials. Despite these advancements, the scope of TRT in treating diverse solid tumors and integration with other therapies like immunotherapy remains under investigation. The success of antibody-drug conjugates further complements treatments with TRT, though challenges in treatment optimization continue.


Subject(s)
Alpha Particles , Beta Particles , Radioisotopes , Radiopharmaceuticals , Humans , Beta Particles/therapeutic use , Alpha Particles/therapeutic use , Radioisotopes/therapeutic use , Radiopharmaceuticals/therapeutic use , Neoplasms/radiotherapy , Prostatic Neoplasms/radiotherapy , Prostatic Neoplasms/diagnostic imaging , Male , Lutetium/therapeutic use , Radium/therapeutic use , Bone Neoplasms/radiotherapy , Bone Neoplasms/secondary
18.
PET Clin ; 19(3): 371-388, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38658230

ABSTRACT

Novel prostate-specific membrane antigen (PSMA) ligands labeled with α-emitting radionuclides are sparking a growing interest in prostate cancer treatment. These targeted alpha therapies (TATs) have attractive physical properties that deem them effective in progressive metastatic castrate-resistant prostate cancer (mCRPC). Among the PSMA TAT radiopharmaceuticals, [225Ac]Ac-PSMA has been used extensively on a compassionate basis and is currently undergoing phase I trials. Notably, TAT has the potential to improve quality of life and has favorable antitumor activity and outcomes in multiple scenarios other than in mCRPC. In addition, resistance mechanisms to TAT may be amenable to combination therapies.


Subject(s)
Antigens, Surface , Glutamate Carboxypeptidase II , Radiopharmaceuticals , Humans , Radiopharmaceuticals/therapeutic use , Male , Prostatic Neoplasms, Castration-Resistant/radiotherapy , Prostatic Neoplasms, Castration-Resistant/diagnostic imaging , Prostatic Neoplasms/diagnostic imaging , Prostatic Neoplasms/radiotherapy , Alpha Particles/therapeutic use , Actinium/therapeutic use
19.
Nucl Med Biol ; 132-133: 108909, 2024.
Article in English | MEDLINE | ID: mdl-38599144

ABSTRACT

BACKGROUND: Radioligand therapy using alpha emitters has gained more and more prominence in the last decade. Despite continued efforts to identify new appropriate radionuclides, the combination of 225Ac/213Bi remains among the most promising. Bismuth-213 has been employed in clinical trials in combination with appropriate vectors to treat patients with various forms of cancer, such as leukaemia, bladder cancer, neuroendocrine tumours, melanomas, gliomas, or lymphomas. However, the half-life of 213Bi (T½ = 46 min) implies that its availability for clinical use is limited to hospitals possessing a 225Ac/213Bi radionuclide generator, which is still predominantly scarce. We investigated a new Ac/Bi generator system based on using the composite sorbent α-ZrP-PAN (zirconium(IV) phosphate as active component and polyacrylonitrile as matrix). The developed 225Ac/213Bi generator was subjected to long-term testing after its development. The elution profile was determined and the elution yield, the contamination of the eluate with the parent 225Ac and the contamination of the eluate with the column material were monitored over time. RESULTS: The high activity (75 MBq of parent 225Ac) generator with a length of 75 mm and a diameter of 4 mm containing the composite sorbent α-ZrP-PAN with a particle size of 0.8 to 1.0 mm as the stationary phase, eluted with a mixture of 10 mM DTPA in 5 mM nitric acid, provided 213Bi with yields ranging from 77 % to 96 % in 2.8 mL of eluate, with parent 225Ac contamination in the order of 10-3 %, up to twenty days of use. CONCLUSION: All the results of the monitored parameters indicate that the composite sorbent α-ZrP-PAN based separation system for the elution of 213Bi is a very promising and functional solution.


Subject(s)
Actinium , Alpha Particles , Bismuth , Radioisotopes , Bismuth/chemistry , Alpha Particles/therapeutic use , Radioisotopes/chemistry , Actinium/chemistry , Zirconium/chemistry , Radionuclide Generators , Radiochemistry/methods , Radiochemistry/instrumentation
20.
Clin Nucl Med ; 49(6): 546-548, 2024 Jun 01.
Article in English | MEDLINE | ID: mdl-38537249

ABSTRACT

ABSTRACT: 212 Pb emerges as a compelling in vivo α-particle generator for targeted α therapy due to its favorable half-life ( t1/2 = 10.6 hours) aligning with the biological half-lives of small peptides and its potent α-particle emissions within the decay series. However, one of the challenges with 212 Pb is to perform appropriate image-guided dosimetry. To date, all the data have been extrapolated from its imaging analog, 203 Pb. We present the first-in-human posttherapy image-guided dosimetric estimates of a single cycle of 212 Pb VMT-α-peptide, administered in a 41-year-old woman with an advanced grade 2 NET. The patient also demonstrated partial response on treatment.


Subject(s)
Alpha Particles , Neuroendocrine Tumors , Humans , Female , Adult , Neuroendocrine Tumors/diagnostic imaging , Neuroendocrine Tumors/radiotherapy , Neuroendocrine Tumors/drug therapy , Neuroendocrine Tumors/pathology , Alpha Particles/therapeutic use , Radiometry , Neoplasm Metastasis , Lead Radioisotopes , Radiotherapy, Image-Guided , Treatment Outcome
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