Crump Institute for Molecular Imaging, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
Department of Molecular Imaging and Therapy, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA, 91010, USA.
Eur J Nucl Med Mol Imaging. 2019 Feb;46(2):489-500. doi: 10.1007/s00259-018-4214-x. Epub 2018 Nov 19.
Metabolic imaging using [F]FDG is the current standard for clinical PET; however, some malignancies (e.g., indolent lymphomas) show low avidity for FDG. The majority of B cell lymphomas express CD20, making it a valuable target both for antibody-based therapy and imaging. We previously developed PET tracers based on the humanised anti-CD20 antibody obinutuzumab (GA101). Preclinical studies showed that the smallest bivalent fragment, the cys-diabody (GAcDb, 54.5 kDa) with a peak uptake at 1-2 h post-injection and a biological half-life of 2-5 h, is compatible with short-lived positron emitters such as fluorine-18 (F, t 110 min), enabling same-day imaging.
GAcDb was radiolabeled using amine-reactive N-succinimidyl 4-[F]-fluorobenzoate ([F]SFB), or thiol-reactive N-[2-(4-[F]-fluorobenzamido)ethyl]maleimide ([F]FBEM) for site-specific conjugation to C-terminal cysteine residues. Both tracers were used for immunoPET imaging of the B cell compartment in human CD20 transgenic mice (hCD20TM). [F]FB-GAcDb immunoPET was further evaluated in a disseminated lymphoma (A20-hCD20) syngeneic for hCD20TM and compared to [F]FDG PET. Tracer uptake was confirmed by ex vivo biodistribution.
The GAcDb was successfully F-radiolabeled using two different conjugation methods resulting in similar specific activities and without impairing immunoreactivity. Both tracers ([F]FB-GAcDb and [F]FBEM-GAcDb) specifically target human CD20-expressing B cells in transgenic mice. Fast blood clearance results in high contrast PET images as early as 1 h post injection enabling same-day imaging. [F]FB-GAcDb immunoPET detects disseminated lymphoma disease in the context of normal tissue expression of hCD20, with comparable sensitivity as [F]FDG PET but with added specificity for the therapeutic target.
[F]FB-GAcDb and [F]FBEM-GAcDb could monitor normal B cells and B cell malignancies non-invasively and quantitatively in vivo. In contrast to [F]FDG PET, immunoPET provides not only information about the extent of disease but also about presence and localisation of the therapeutic target.
使用 [F]FDG 的代谢成像目前是临床 PET 的标准;然而,一些恶性肿瘤(例如惰性淋巴瘤)对 FDG 的亲和力较低。大多数 B 细胞淋巴瘤表达 CD20,这使其成为抗体为基础的治疗和成像的有价值的靶点。我们之前基于人源化抗 CD20 抗体奥滨尤妥珠单抗(GA101)开发了 PET 示踪剂。临床前研究表明,最小的二价片段,半胱氨酸二抗体(GAcDb,54.5 kDa)在注射后 1-2 小时达到峰值摄取,生物半衰期为 2-5 小时,与氟-18(F,t 110 min)等短寿命正电子发射体兼容,能够实现当天成像。
使用胺反应性 N-琥珀酰亚胺基 4-[F]-氟代苯甲酸酯 ([F]SFB)或硫醇反应性 N-[2-(4-[F]-氟苯甲酰胺基)乙基]马来酰亚胺 ([F]FBEM)将 GAcDb 进行放射性标记,用于 C 末端半胱氨酸残基的位点特异性连接。两种示踪剂均用于人 CD20 转基因小鼠(hCD20TM)的 B 细胞区免疫 PET 成像。[F]FB-GAcDb 免疫 PET 进一步在同种异体 A20-hCD20 弥漫性淋巴瘤中进行评估,并与 [F]FDG PET 进行比较。通过离体生物分布确证示踪剂摄取。
使用两种不同的缀合方法成功地对 GAcDb 进行了 F 放射性标记,结果示踪剂具有相似的比活度且不影响免疫反应性。两种示踪剂([F]FB-GAcDb 和 [F]FBEM-GAcDb)均特异性靶向转基因小鼠中表达人类 CD20 的 B 细胞。快速的血液清除导致在注射后 1 小时即可获得高对比度的 PET 图像,从而能够实现当天成像。[F]FB-GAcDb 免疫 PET 在 hCD20 正常组织表达的情况下检测到弥散性淋巴瘤疾病,其灵敏度与 [F]FDG PET 相当,但对治疗靶点具有更高的特异性。
[F]FB-GAcDb 和 [F]FBEM-GAcDb 可以在体内非侵入性和定量地监测正常 B 细胞和 B 细胞恶性肿瘤。与 [F]FDG PET 相比,免疫 PET 不仅提供了关于疾病程度的信息,还提供了关于治疗靶点的存在和定位的信息。