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使用靶向胃泌素释放肽受体的放射性药物对前列腺癌进行核成像。

Nuclear imaging of prostate cancer with gastrin-releasing-peptide-receptor targeted radiopharmaceuticals.

作者信息

Ananias H J K, de Jong I J, Dierckx R A, van de Wiele C, Helfrich W, Elsinga P H

机构信息

Department of Urology, University Medical Center Groningen, Groningen, The Netherlands.

出版信息

Curr Pharm Des. 2008;14(28):3033-47. doi: 10.2174/138161208786404335.

Abstract

Prostate cancer is one of the most common causes of cancer in men. Evaluating the different stages of prostate cancer with conventional imaging techniques still proves difficult. Nuclear imaging might provide a technique that is able to evaluate prostate cancer, but clinical application has been limited due to lack of accuracy of current radiopharmaceuticals. The development of radiopharmaceuticals that can be targeted to specific antigens, overexpressed in prostate cancer, but sparse in normal tissue, is crucial. Peptides are of particular interest because of their favourable characteristics, leading to increased attention for nuclear imaging of the gastrin-releasing-peptide-receptor (GRPR) with radiolabelled bombesin-like peptides. Several derivatives of bombesin and its truncated form have been prepared for imaging with single photon emission computed tomography (SPECT) or positron emission tomography (PET), thereby delivering potent candidates for further clinical evaluation. This article provides an overview of the development and preclinical evaluation of radiolabelled bombesin analogues for in vivo targeting of GRPR in prostate cancer. The effect of the radionuclide, chelator, spacer and unnatural amino acids on affinity, metabolic stability and image quality are discussed, as well as agonistic or antagonistic properties. Potent candidates are proposed based on these selection criteria: (I) high affinity for GRPR, with rapid and specific tumour uptake (II) high hydrophilicity resulting in the preferred renal-urinary mode of excretion and low hepatobiliary excretion, (III) high stability, but relatively rapid clearance from blood. Also, a summary is made of clinical studies that report on the detection of prostate cancer with GRPR targeted radiopharmaceuticals.

摘要

前列腺癌是男性最常见的癌症病因之一。用传统成像技术评估前列腺癌的不同阶段仍然很困难。核成像可能提供一种能够评估前列腺癌的技术,但由于目前放射性药物缺乏准确性,其临床应用受到限制。开发能够靶向前列腺癌中过表达但在正常组织中稀少的特定抗原的放射性药物至关重要。肽因其有利的特性而特别受关注,这导致用放射性标记的蛙皮素样肽对胃泌素释放肽受体(GRPR)进行核成像的关注度增加。已经制备了几种蛙皮素及其截短形式的衍生物用于单光子发射计算机断层扫描(SPECT)或正电子发射断层扫描(PET)成像,从而为进一步的临床评估提供了有力的候选物。本文概述了用于体内靶向前列腺癌中GRPR的放射性标记蛙皮素类似物的开发和临床前评估。讨论了放射性核素、螯合剂、间隔基和非天然氨基酸对亲和力、代谢稳定性和图像质量的影响,以及激动或拮抗特性。基于这些选择标准提出了有力的候选物:(I)对GRPR具有高亲和力,肿瘤摄取迅速且特异性;(II)高亲水性导致首选的肾-尿排泄模式和低肝胆排泄;(III)高稳定性,但从血液中清除相对较快。此外,还总结了关于用GRPR靶向放射性药物检测前列腺癌的临床研究。

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