Development of fibroblast activation protein-targeted radiotracers with improved tumor retention

Cancer-associated fibroblasts constitute a vital subpopulation of the tumor stroma and are present in more than 90% of epithelial carcinomas. The overexpression of the serine protease fibroblast activation protein (FAP) allows a selective targeting of a variety of tumors by inhibitor-based radiophar...

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Hauptverfasser: Loktev, Anastasia (VerfasserIn) , Lindner, Thomas (VerfasserIn) , Altmann, Annette (VerfasserIn) , Giesel, Frederik L. (VerfasserIn) , Kratochwil, Clemens (VerfasserIn) , Debus, Jürgen (VerfasserIn) , Marmé, Frederik (VerfasserIn) , Jäger, Dirk (VerfasserIn) , Mier, Walter (VerfasserIn) , Haberkorn, Uwe (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: March 8, 2019
In: Journal of nuclear medicine
Year: 2019, Jahrgang: 60, Heft: 10, Pages: 1421-1429
ISSN:2159-662X
DOI:10.2967/jnumed.118.224469
Online-Zugang:Verlag, Volltext: https://doi.org/10.2967/jnumed.118.224469
Verlag: http://jnm.snmjournals.org/content/60/10/1421
Volltext
Verfasserangaben:Anastasia Loktev, Thomas Lindner, Eva-Maria Burger, Annette Altmann, Frederik Giesel, Clemens Kratochwil, Jürgen Debus, Frederik Marmé, Dirk Jäger, Walter Mier, and Uwe Haberkorn

MARC

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520 |a Cancer-associated fibroblasts constitute a vital subpopulation of the tumor stroma and are present in more than 90% of epithelial carcinomas. The overexpression of the serine protease fibroblast activation protein (FAP) allows a selective targeting of a variety of tumors by inhibitor-based radiopharmaceuticals (FAPIs). Of these compounds, FAPI-04 has been recently introduced as a theranostic radiotracer and demonstrated high uptake into different FAP-positive tumors in cancer patients. To enable the delivery of higher doses, thereby improving the outcome of a therapeutic application, several FAPI variants were designed to further increase tumor uptake and retention of these tracers. Methods: Novel quinoline-based radiotracers were synthesized by organic chemistry and evaluated in radioligand binding assays using FAP-expressing HT-1080 cells. Depending on their in vitro performance, small-animal PET imaging and biodistribution studies were performed on HT-1080-FAP tumor-bearing mice. The most promising compounds were used for clinical PET imaging in 8 cancer patients. Results: Compared with FAPI-04, 11 of 15 FAPI derivatives showed improved FAP binding in vitro. Of these, 7 compounds demonstrated increased tumor uptake in tumor-bearing mice. Moreover, tumor-to-normal-organ ratios were improved for most of the compounds, resulting in images with higher contrast. Notably two of the radiotracers, FAPI-21 and -46, displayed substantially improved ratios of tumor to blood, liver, muscle, and intestinal uptake. A first diagnostic application in cancer patients revealed high intratumoral uptake of both radiotracers already 10 min after administration but a higher uptake in oral mucosa, salivary glands, and thyroid for FAPI-21. Conclusion: Chemical modification of the FAPI framework enabled enhanced FAP binding and improved pharmacokinetics in most of the derivatives, resulting in high-contrast images. Moreover, higher doses of radioactivity can be delivered while minimizing damage to healthy tissue, which may improve therapeutic outcome. 
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