Safety, Dosimetry, and Tumor Detection Ability of68Ga-NOTA-AE105: First-in-Human Study of a Novel Radioligand for uPAR PET Imaging.
The overexpression of urokinase-type plasminogen activator receptors (uPARs) represents an established biomarker for aggressiveness in most common malignant diseases, including breast cancer (BC), prostate cancer (PC), and urinary bladder cancer (UBC), and is therefore an important target for new cancer therapeutic and diagnostic strategies. In this study, uPAR PET imaging using a68Ga-labeled version of the uPAR-targeting peptide (AE105) was investigated in a group of patients with BC, PC, and UBC. The aim of this first-in-human, phase I clinical trial was to investigate the safety and biodistribution in normal tissues and uptake in tumor lesions.Methods:Ten patients (6 PC, 2 BC, and 2 UBC) received a single intravenous dose of68Ga-NOTA-AE105 (154 ± 59 MBq; range, 48-208 MBq). The biodistribution and radiation dosimetry were assessed by serial whole-body PET/CT scans (10 min, 1 h, and 2 h after injection). Safety assessment included measurements of vital signs with regular intervals during the imaging sessions and laboratory blood screening tests performed before and after injection. In a subgroup of patients, the in vivo stability of68Ga-NOTA-AE105 was determined in collected blood and urine. PET images were visually analyzed for visible tumor uptake of68Ga-NOTA-AE105, and SUVs were obtained from tumor lesions by manually drawing volumes of interest in the malignant tissue.Results:No adverse events or clinically detectable pharmacologic effects were found. The radioligand exhibited good in vivo stability and fast clearance from tissue compartments primarily by renal excretion. The effective dose was 0.015 mSv/MBq, leading to a radiation burden of 3 mSv when the clinical target dose of 200 MBq was used. In addition, radioligand accumulation was seen in primary tumor lesions as well as in metastases.Conclusion:This first-in-human, phase I clinical trial demonstrates the safe use and clinical potential of68Ga-NOTA-AE105 as a new radioligand for uPAR PET imaging in cancer patients.
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Dorthe
D
Skovgaard
Curasight, Copenhagen, Denmark.
Morten
M
Persson
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Malene
M
Brandt-Larsen
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Camilla
C
Christensen
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Jacob
J
Madsen
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Thomas Levin
TL
Klausen
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Søren
S
Holm
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Flemming Littrup
FL
Andersen
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Annika
A
Loft
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Anne Kiil
AK
Berthelsen
Department of Oncology, Rigshospitalet, Copenhagen, Denmark.
Helle
H
Pappot
Department of Urology, Copenhagen Prostate Cancer Center, Rigshospitalet, Copenhagen, Denmark; and.
Klaus
K
Brasso
Department of Plastic Surgery, Breast Surgery and Burns Treatment, Rigshospitalet, Copenhagen, Denmark.
Niels
N
Kroman
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark.
Liselotte
L
Højgaard
Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark akjaer@sund.ku.dk.
Andreas
A
Kjaer
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D005260:Female; D006571:Heterocyclic Compounds / Q000493:pharmacokinetics; D006573:Heterocyclic Compounds, 1-Ring; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*; D009842:Oligopeptides / Q000493:pharmacokinetics*; D009928:Organ Specificity; D010865:Pilot Projects; D049268:Positron-Emission Tomography / Q000379:methods*; D011829:Radiation Dosage; D000069079:Radiation Exposure / Q000032:analysis* / Q000517:prevention & control; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D055293:Receptors, Urokinase Plasminogen Activator / Q000378:metabolism*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014018:Tissue Distribution; D014915:Whole-Body Counting
D014408:Biomarkers, Tumor; D006571:Heterocyclic Compounds; D006573:Heterocyclic Compounds, 1-Ring; D009842:Oligopeptides; D019275:Radiopharmaceuticals; D055293:Receptors, Urokinase Plasminogen Activator; C000609091:beta-cyclohexylalanyl-phenylalanyl-seryl-arginyl-tyrosyl-leucyl-tryptophyl-serine; C048993:1,4,7-triazacyclononane-N,N',N''-triacetic acid
68Ga-NOTA-AE105; PET/CT; first in humans; general; molecular imaging; oncology; phase I; uPAR PET