Department of Radiology, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, 63110, USA.
Mol Imaging Biol. 2024 Aug;26(4):738-752. doi: 10.1007/s11307-024-01901-5. Epub 2024 Mar 13.
Multiple myeloma (MM) affects over 35,000 patients each year in the US. There remains a need for versatile Positron Emission Tomography (PET) tracers for the detection, accurate staging, and monitoring of treatment response of MM that have optimal specificity and translational attributes. CD38 is uniformly overexpressed in MM and thus represents an ideal target to develop CD38-targeted small molecule PET radiopharmaceuticals to address these challenges.
Using phage display peptide libraries and pioneering algorithms, we identified novel CD38 specific peptides. Imaging bioconjugates were synthesized using solid phase peptide chemistry, and systematically analyzed in vitro and in vivo in relevant MM systems.
The CD38-targeted bioconjugates were radiolabeled with copper-64 (Cu) with100% radiochemical purity and an average specific activity of 3.3 - 6.6 MBq/nmol. The analog NODAGA-PEG4-SL022-GGS (SL022: Thr-His-Tyr-Pro-Ile-Val-Ile) had a K of 7.55 ± 0.291 nM and was chosen as the lead candidate. Cu-NODAGA-PEG4-SL022-GGS demonstrated high binding affinity to CD38 expressing human myeloma MM.1S-CBR-GFP-WT cells, which was blocked by the non-radiolabeled version of the peptide analog and anti-CD38 clinical antibodies, daratumumab and isatuximab, by 58%, 73%, and 78%, respectively. The CD38 positive MM.1S-CBR-GFP-WT cells had > 68% enhanced cellular binding when compared to MM.1S-CBR-GFP-KO cells devoid of CD38. Furthermore, our new CD38-targeted radiopharmaceutical allowed visualization of tumors located in marrow rich bones, remaining there for up to 4 h. Clearance from non-target organs occurred within 60 min. Quantitative PET data from a murine disseminated tumor model showed significantly higher accumulation in the bones of tumor-bearing animals compared to tumor-naïve animals (SUV 2.06 ± 0.4 versus 1.24 ± 0.4, P = 0.02). Independently, tumor uptake of the target compound was significantly higher (P = 0.003) compared to the scrambled peptide, Cu-NODAGA-PEG4-SL041-GGS (SL041: Thr-Tyr-His-Ile-Pro-Ile-Val). The subcutaneous MM model demonstrated significantly higher accumulation in tumors compared to muscle at 1 and 4 h after tracer administration (SUV 0.8 ± 0.2 and 0.14 ± 0.04, P = 0.04 at 1 h; SUV 0.89 ± 0.01 and 0.09 ± 0.01, P = 0.0002 at 4 h).
The novel CD38-targeted, radiolabeled bioconjugates were specific and allowed visualization of MM, providing a starting point for the clinical translation of such tracers for the detection of MM.
在美国,每年有超过 35000 名患者患有多发性骨髓瘤(MM)。仍然需要用于检测、准确分期和监测 MM 的治疗反应的多功能正电子发射断层扫描(PET)示踪剂,这些示踪剂具有最佳的特异性和转化属性。CD38 在 MM 中普遍过表达,因此代表了开发针对 CD38 的小分子 PET 放射性药物以应对这些挑战的理想靶点。
使用噬菌体展示肽文库和开创性算法,我们鉴定了新的 CD38 特异性肽。使用固相肽化学合成成像生物缀合物,并在相关的 MM 系统中进行体外和体内系统分析。
CD38 靶向生物缀合物用铜-64(Cu)放射性标记,放射化学纯度为 100%,平均比活度为 3.3-6.6 MBq/nmol。类似物 NODAGA-PEG4-SL022-GGS(SL022: Thr-His-Tyr-Pro-Ile-Val-Ile)的 K 值为 7.55±0.291 nM,被选为先导候选物。Cu-NODAGA-PEG4-SL022-GGS 对表达 CD38 的人骨髓瘤 MM.1S-CBR-GFP-WT 细胞具有高结合亲和力,这种亲和力可被非放射性肽类似物和抗 CD38 临床抗体达雷妥尤单抗和伊沙妥昔单抗分别阻断 58%、73%和 78%。与缺乏 CD38 的 MM.1S-CBR-GFP-KO 细胞相比,CD38 阳性 MM.1S-CBR-GFP-WT 细胞的细胞结合增强了>68%。此外,我们的新型 CD38 靶向放射性药物允许可视化位于富含骨髓的骨骼中的肿瘤,在骨骼中可保留长达 4 小时。非靶器官中的清除在 60 分钟内发生。来自弥散性肿瘤模型的定量 PET 数据显示,与肿瘤未受累动物相比,荷瘤动物的骨骼中积累明显更高(SUV 2.06±0.4 与 1.24±0.4,P=0.02)。独立地,与 scrambled 肽 Cu-NODAGA-PEG4-SL041-GGS(SL041:Thr-Tyr-His-Ile-Pro-Ile-Val)相比,目标化合物的肿瘤摄取明显更高(P=0.003)。皮下 MM 模型显示,与肌肉相比,在示踪剂给药后 1 和 4 小时肿瘤的积累明显更高(SUV 0.8±0.2 和 0.14±0.04,P=0.04 在 1 小时;SUV 0.89±0.01 和 0.09±0.01,P=0.0002 在 4 小时)。
新型 CD38 靶向、放射性标记的生物缀合物具有特异性,并允许 MM 的可视化,为这些示踪剂用于 MM 检测的临床转化提供了起点。