Radioimmune & Inorganic Chemistry Section, Radiation Oncology Branch, NCI, NIH, Bethesda, MD 20892-1002, USA.
Nucl Med Biol. 2013 Jul;40(5):592-9. doi: 10.1016/j.nucmedbio.2013.01.010. Epub 2013 Apr 17.
Alpha particles possess an exquisite degree of cytotoxicity when employed for targeted α-particle therapy (TAT) or radioimmunotherapy (RIT). (212)Pb, which acts as an in vivo generator of the α-emitting nuclide (212)Bi has shown great promise in pre-clinical studies when used to label the HER2 binding antibody, trastuzumab. Currently, the first RIT clinical trial employing (212)Pb radiolabeled trastuzumab is in progress. This report provides detailed current protocol operations and steps that were generated for use in the clinical trial as well as the relevant pre-clinical experimentation, and describes in detail the labeling of proteins or peptides with (212)Pb as provided via a (224)Ra based generator system.
(212)Pb was eluted from the (224)Ra/(212)Pb generator using hydrochloric acid (2M). The generator eluate was evaporated and digested with nitric acid (8M) followed by extraction of the (212)Pb with dilute nitric acid (0.1M). The dilute nitric acid solution of (212)Pb was used to label the immunoconjugate Trastuzumab-TCMC (2-(4-isothiocyanatobenzyl-1,4,7,10-tetraaza-1,4,7,10,tetra-(2-carbamonylmethyl)-cyclododecane) at pH5.5.
Elution of (212)Pb from the generator was efficient yielding>90% of available (212)Pb. Trastuzumab-TCMC was efficiently labeled with a radiochemical yield of 94% ± 4% (n=7) by ITLC and an isolated yield of 73% ± 3% (n=7).
The results show the feasibility of generating radioimmunoconjugates and peptide conjugates for use as in vivo α generator systems in the clinic. The technology holds promise in applications involving the treatment of minimal disease such as micrometastases and residual tumor after surgical debulking, hematological cancers, infections, and compartmental cancers, such as ovarian cancer.
当用于靶向 α 粒子治疗 (TAT) 或放射性免疫治疗 (RIT) 时,α 粒子具有极高的细胞毒性。(212)Pb 作为体内生成发射 α 粒子的核素 (212)Bi 的物质,在用于标记 HER2 结合抗体曲妥珠单抗的临床前研究中显示出巨大的潜力。目前,第一个使用 (212)Pb 放射性标记曲妥珠单抗的 RIT 临床试验正在进行中。本报告提供了详细的当前方案操作步骤,这些步骤是为临床试验以及相关的临床前实验生成的,并详细描述了使用基于 (224)Ra 的发生器系统标记蛋白质或肽的方法。
使用盐酸 (2M) 从 (224)Ra/(212)Pb 发生器中洗脱 (212)Pb。发生器洗脱液蒸发并与硝酸 (8M) 消化,然后用稀硝酸 (0.1M) 萃取 (212)Pb。将稀硝酸溶液中的 (212)Pb 用于在 pH5.5 下标记免疫偶联物曲妥珠单抗-TCMC(2-(4-异硫氰酸基苄基-1,4,7,10-四氮杂-1,4,7,10-四-(2-氨甲酰基甲基)-环十二烷)。
从发生器中洗脱 (212)Pb 的效率很高,超过 90%的可用 (212)Pb 被洗脱出来。曲妥珠单抗-TCMC 的放射性化学产率为 94%±4%(n=7),通过 ITLC 分离得到的产率为 73%±3%(n=7)。
结果表明,在临床中生成放射性免疫偶联物和肽偶联物作为体内α发生器系统是可行的。该技术在治疗微小疾病(如微转移灶和手术减瘤后残留肿瘤、血液系统癌症、感染和局部癌症,如卵巢癌)方面具有广阔的应用前景。