Synthesis and preclinical characterization of the PSMA-targeted hybrid tracer PSMA-I&F for nuclear and fluorescence imaging of prostate cancer

Schottelius M, Wurzer A, Wissmiller K, Beck R, Koch M, Gorpas D, Notni J, Buckle T, Van Oosterom MN, Steiger K, Ntziachristos V, Schwaiger M, Van Leeuwen FWB, Wester HJ (2019)


Publication Type: Journal article

Publication year: 2019

Journal

Book Volume: 60

Pages Range: 71-78

Journal Issue: 1

DOI: 10.2967/jnumed.118.212720

Abstract

The prostate-specific membrane antigen (PSMA)-targeted radiotracers 68 Ga/ 177 Lu-PSMA-I&T and 99m Tc-PSMA-I&S (for imaging and surgery) are currently successfully used for clinical PET imaging, radionuclide therapy, and radioguided surgery of metastatic prostate cancer. To additionally exploit the high sensitivity and spatial resolution of fluorescence imaging for improved surgical guidance, a PSMA-I&T-based hybrid tracer, PSMA-I&F (DOTAGA-k(Sulfo-Cy5)-y-nal-k-Sub-KuE), has been developed and evaluated. Methods: The in vitro PSMA-targeting efficiency of PSMA-I&F, the reference PSMA-I&T, and their corresponding nat Ga-/ 68 Ga- and nat Lu/ 177 Lu counterparts was determined in LNCaP cells via competitive binding assays (IC 50 ) and dual-tracer radioligand and fluorescence internalization studies. Biodistribution and small-animal PET imaging studies were performed in CB17 SCID and LNCaP xenograft-bearing SHO mice, respectively, and complemented by intraoperative far-red fluorescence imaging using a clinical laparoscope. Additionally, fully automated serial cryosectioning and fluorescence imaging of 1 tumor-bearing animal as well as PSMA immunohistochemistry and fluorescence microscopy of organ cryosections (tumor, kidney, spleen) were also performed. Results: Compared with the parent PSMA-I&T analogs, the PSMA affinities of PSMA-I&F and its nat Ga-/ nat Lu-complexes remained high and unaffected by dye conjugation (7.9, IC 50 , 10.5 nM for all ligands). The same was observed for the internalization of 68 Ga- and 177 Lu-PSMA-I&F. In vivo, blood clearance of 68 Ga- and 177 Lu-PSMA-I&F was only slightly delayed by high plasma protein binding (94%-95%), and very low accumulation in nontarget organs was observed already at 1 h after injection. Dynamic PET imaging confirmed PSMA-specific (as demonstrated by coinjection of 2-PMPA) uptake into the LNCaP xenograft (4.5% ± 1.8 percentage injected dose per gram) and the kidneys (106% ± 23 percentage injected dose per gram). Tumor-to-background ratios of 2.1, 5.2, 9.6, and 9.6 for blood, liver, intestines, and muscle, respectively, at 1 h after injection led to excellent imaging contrast in 68 Ga-PSMA-I&F PET and in intraoperative fluorescence imaging. Furthermore, fluorescence imaging of tissue cryosections allowed high-resolution visualization of intraorgan PSMA-I&F distribution in vivo and its correlation with PSMA expression as determined by immunohistochemistry. Conclusion: Thus, with its high PSMA-targeting efficiency and favorable pharmacokinetic profile, 68 Ga/ 177 Lu-PSMA-I&F serves as an excellent proof-of-concept compound for the general feasibility of PSMA-I&T-based hybrid imaging. The PSMA-I&T scaffold represents a versatile PSMA-targeted lead structure, allowing relatively straightforward adaptation to the different structural requirements of dedicated nuclear or hybrid imaging agents.

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How to cite

APA:

Schottelius, M., Wurzer, A., Wissmiller, K., Beck, R., Koch, M., Gorpas, D.,... Wester, H.-J. (2019). Synthesis and preclinical characterization of the PSMA-targeted hybrid tracer PSMA-I&F for nuclear and fluorescence imaging of prostate cancer. Journal of Nuclear Medicine, 60(1), 71-78. https://doi.org/10.2967/jnumed.118.212720

MLA:

Schottelius, Margret, et al. "Synthesis and preclinical characterization of the PSMA-targeted hybrid tracer PSMA-I&F for nuclear and fluorescence imaging of prostate cancer." Journal of Nuclear Medicine 60.1 (2019): 71-78.

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