局部复发和转移性进展的人三阴性乳腺癌模型中用 [In]In-DOTA-帕尼单抗进行辅助 Auger 电子发射放射免疫治疗。
Adjuvant Auger Electron-Emitting Radioimmunotherapy with [In]In-DOTA-Panitumumab in a Mouse Model of Local Recurrence and Metastatic Progression of Human Triple-Negative Breast Cancer.
机构信息
Department of Pharmaceutical Sciences, Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College St., Toronto, Ontario M5S 3M2, Canada.
Department of Medical Imaging, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario M5S 1A8, Canada.
出版信息
Mol Pharm. 2023 Dec 4;20(12):6407-6419. doi: 10.1021/acs.molpharmaceut.3c00780. Epub 2023 Nov 20.
Triple-negative breast cancer (TNBC) has a high risk for recurrence and metastasis. We studied the effectiveness of Auger electron (AE) radioimmunotherapy (RIT) with antiepidermal growth factor receptor (EGFR) panitumumab conjugated with DOTA complexed to In ([In]In-DOTA-panitumumab) for preventing metastatic progression after local treatment of 231/LM2-4 Luc+ human TNBC tumors in the mammary fat pad of NRG mice. Prior to RIT, the primary tumor was resected, and tumor margins were treated with X-irradiation (XRT; 5 days × 6 Gy/d). RIT was administered 1 day post-XRT by intravenous injection of 26 MBq (15 μg) or 2 × 10 MBq (15 μg each) separated by 7 d. These treatments were compared to tumor resection with or without XRT combined with DOTA-panitumumab (15 μg) or irrelevant [In]In-DOTA-IgG (24 MBq; 15 μg), and efficacy was evaluated by Kaplan-Meier survival curves. The effect of [In]In-DOTA-panitumumab (23 MBq; 15 μg) after tumor resection without local XRT was also studied. Tumor resection followed by XRT and RIT with 26 MBq [In]In-DOTA-panitumumab significantly increased the median survival to 35 d compared to tumor resection with or without XRT (23-24 d; < 0.0001). Local treatment with tumor resection and XRT followed by 2 × 10 MBq of [In]In-DOTA-panitumumab, DOTA-panitumumab, or [In]In-DOTA-IgG did not significantly improve median survival (26 days for all treatments). RIT alone with [In]In-DOTA-panitumumab postresection of the tumor without XRT increased median survival to 29 days, though this was not significant. Despite significantly improved survival in mice treated with tumor resection, XRT, and RIT with [In]In-DOTA-panitumumab, all mice eventually succumbed to advanced metastatic disease by 45 d post-tumor resection. SPECT/CT with [In]In-DOTA-panitumumab, PET/MRI with [Cu]Cu-DOTA-panitumumab F(ab'), and PET/CT with [F]FDG were used to detect recurrent and metastatic disease. Uptake of [In]In-DOTA-panitumumab at 4 d p.i. in the MFP tumor was 26.8 ± 9.7% ID/g and in metastatic lymph nodes (LN), lungs, and liver was 34.2 ± 26.9% ID/g, 17.5 ± 6.0% ID/g, and 9.4 ± 2.4%ID/g, respectively, while uptake in the lungs (6.0 ± 0.9% ID/g) and liver (5.2 ± 2.9% ID/g) of non-tumor-bearing NRG was significantly lower ( < 0.05). Radiation-absorbed doses in metastatic LN, lungs, and liver were 9.7 ± 6.1, 6.4 ± 2.1, and 10.9 ± 2.7 Gy, respectively. In conclusion, we demonstrated that RIT with [In]In-DOTA-panitumumab combined with tumor resection and XRT significantly improved the survival of mice with recurrent TNBC. However, the aggressive nature of 231/LM2-4 Luc+ tumors in NRG mice may have contributed to the tumor recurrence and progression observed.
三阴性乳腺癌(TNBC)具有较高的复发和转移风险。我们研究了使用与 DOTA 结合的抗表皮生长因子受体(EGFR)panitumumab([In]In-DOTA-panitumumab)进行放射性免疫治疗(RIT)对预防 NRG 小鼠乳腺脂肪垫中 231/LM2-4 Luc+人 TNBC 肿瘤局部治疗后转移进展的效果。在 RIT 之前,切除原发性肿瘤,并对肿瘤边缘进行 X 射线照射(XRT;5 天×6 Gy/d)。XRT 后 1 天通过静脉注射 26 MBq(15μg)或 2×10 MBq(15μg 各)进行 RIT,间隔 7d。将这些治疗方法与 XRT 联合或不联合 DOTA-panitumumab(15μg)或不相关的[In]In-DOTA-IgG(24 MBq;15μg)进行肿瘤切除术进行比较,并通过 Kaplan-Meier 生存曲线评估疗效。还研究了肿瘤切除后无局部 XRT 时[In]In-DOTA-panitumumab(23 MBq;15μg)的效果。与 XRT 联合或不联合 XRT 的肿瘤切除术相比,切除肿瘤后 XRT 和 26 MBq [In]In-DOTA-panitumumab 的 RIT 显著增加了中位生存时间至 35d(<0.0001)。肿瘤切除后局部治疗,XRT 后再使用 2×10 MBq [In]In-DOTA-panitumumab、DOTA-panitumumab 或[In]In-DOTA-IgG 并没有显著提高中位生存时间(所有治疗均为 26 天)。肿瘤切除后单独使用[In]In-DOTA-panitumumab 进行 RIT 可将中位生存时间延长至 29 天,但无统计学意义。尽管接受肿瘤切除术、XRT 和 [In]In-DOTA-panitumumab 联合 RIT 治疗的小鼠生存显著改善,但所有小鼠最终在肿瘤切除后 45 天都因晚期转移性疾病而死亡。使用[In]In-DOTA-panitumumab 进行 SPECT/CT、[Cu]Cu-DOTA-panitumumab F(ab') 进行 PET/MRI 和[F]FDG 进行 PET/CT 来检测复发性和转移性疾病。在 MFP 肿瘤中,在肿瘤切除后 4 天,[In]In-DOTA-panitumumab 的摄取量为 26.8±9.7%ID/g,在转移性淋巴结(LN)、肺部和肝脏中的摄取量分别为 34.2±26.9%ID/g、17.5±6.0%ID/g和 9.4±2.4%ID/g,而在非肿瘤携带 NRG 的肺部(6.0±0.9%ID/g)和肝脏(5.2±2.9%ID/g)中的摄取量明显较低(<0.05)。转移性 LN、肺部和肝脏的吸收剂量分别为 9.7±6.1、6.4±2.1 和 10.9±2.7 Gy。总之,我们证明了使用[In]In-DOTA-panitumumab 进行 RIT 联合肿瘤切除术和 XRT 可显著提高复发 TNBC 小鼠的生存率。然而,NRG 小鼠中 231/LM2-4 Luc+肿瘤的侵袭性可能导致观察到的肿瘤复发和进展。