Physics in Biology and Medicine Interdepartmental Graduate Program, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Molecular & Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Crump Institute for Molecular Imaging, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA; Department of Molecular & Medical Pharmacology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Nucl Med Biol. 2018 Jun;61:36-44. doi: 10.1016/j.nucmedbio.2018.04.001. Epub 2018 Apr 20.
Peptides labeled with positron-emitting isotopes are emerging as a versatile class of compounds for the development of highly specific, targeted imaging agents for diagnostic imaging via positron-emission tomography (PET) and for precision medicine via theranostic applications. Despite the success of peptides labeled with gallium-68 (for imaging) or lutetium-177 (for therapy) in the clinical management of patients with neuroendocrine tumors or prostate cancer, there are significant advantages of using fluorine-18 for imaging. Recent developments have greatly simplified such labeling: in particular, labeling of organotrifluoroborates via isotopic exchange can readily be performed in a single-step under aqueous conditions and without the need for HPLC purification. Though an automated synthesis has not yet been explored, microfluidic approaches have emerged for F-labeling with high speed, minimal reagents, and high molar activity compared to conventional approaches. As a proof-of-concept, we performed microfluidic labeling of an octreotate analog ([F]AMBF-TATE), a promising F-labeled analog that could compete with [Ga]Ga-DOTATATE with the advantage of providing a greater number of patient doses per batch produced.
Both [F]AMBF-TATE and [Ga]Ga-DOTATATE were labeled, the former by microscale methods adapted from manual labeling, and were imaged in mice bearing human SSTR2-overexpressing, rat SSTR2 wildtype, and SSTR2-negative xenografts. Furthermore, a dosimetry analysis was performed for [F]AMBF-TATE.
The micro-synthesis exhibited highly-repeatable performance with radiochemical conversion of 50 ± 6% (n = 15), overall decay-corrected radiochemical yield of 16 ± 1% (n = 5) in ~40 min, radiochemical purity >99%, and high molar activity. Preclinical imaging with [F]AMBF-TATE in SSTR2 tumor models correlated well with [Ga]Ga-DOTATATE. The favorable biodistribution, with the highest tracer accumulation in the bladder followed distantly by gastrointestinal tissues, resulted in 1.26 × 10 mSv/MBq maximal estimated effective dose in human, a value lower than that reported for current clinical F- and Ga-labeled compounds.
The combination of novel chemical approaches to F-labeling and microdroplet radiochemistry have the potential to serve as a platform for greatly simplified development and production of F-labeled peptide tracers. Favorable preclinical imaging and dosimetry of [F]AMBF-TATE, combined with a convenient synthesis, validate this assertion and suggest strong potential for clinical translation.
正电子发射同位素标记的肽作为一类多功能化合物,在通过正电子发射断层扫描(PET)进行高特异性、靶向成像剂的开发,以及通过治疗诊断应用进行精准医学方面具有广阔的应用前景。尽管使用镓-68(用于成像)或镥-177(用于治疗)标记的肽在神经内分泌肿瘤或前列腺癌患者的临床管理中取得了成功,但使用氟-18 进行成像具有显著优势。最近的发展极大地简化了这种标记方法:特别是,通过同位素交换在水相条件下一步即可方便地进行有机三氟硼酸盐的标记,而无需高效液相色谱纯化。虽然尚未探索自动化合成,但与传统方法相比,微流控方法已经出现,用于 F 标记,具有更高的速度、更少的试剂和更高的摩尔活性。作为概念验证,我们对一种奥曲肽类似物([F]AMBF-TATE)进行了微流控标记,这是一种很有前途的 F 标记类似物,与[Ga]Ga-DOTATATE 相比,它具有提供更多批次患者剂量的优势。
对[F]AMBF-TATE 和[Ga]Ga-DOTATATE 进行了标记,前者通过从小规模手动标记方法改编而来的方法进行标记,并在表达人 SSTR2 的、大鼠野生型 SSTR2 和 SSTR2 阴性异种移植瘤的小鼠中进行了成像。此外,还对[F]AMBF-TATE 进行了剂量分析。
微合成表现出高度可重复性,放射化学转化率为 50±6%(n=15),总放射性化学产率为 16±1%(n=5),在 40 分钟左右,放射化学纯度>99%,摩尔活性高。在 SSTR2 肿瘤模型中的[F]AMBF-TATE 进行的临床前成像与[Ga]Ga-DOTATATE 很好地相关。有利的生物分布,膀胱中最高的示踪剂积累,随后是胃肠道组织,导致人体最大估计有效剂量为 1.26×10 mSv/MBq,低于目前临床 F 和 Ga 标记化合物报告的值。
新型 F 标记化学方法与微滴射流放射化学的结合,有可能成为简化 F 标记肽示踪剂开发和生产的平台。[F]AMBF-TATE 的有利临床前成像和剂量学,结合方便的合成,验证了这一观点,并表明具有很强的临床转化潜力。