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Ziel/Aim: Der Einsatz von Actinium-225 mit dem DOTA-Konjugat PSMA-617 befindet sich in der klinischen Entwicklung. DOTA ist jedoch nicht ideal, da hohe Temperaturen für die Markierung benötigt werden und der Komplex in vivo nicht stabil genug ist. Ziel ist es, einen besseren, macropa-basierten Chelator zu finden und mit von PSMA-617 abgeleiteten Bindungsvektoren zu verknüpfen. Methodik/Methods: Es wurden 4 verschiedene Konjugate hergestellt, welche sich hinsichtlich der Anzahl der Bindungsmotive sowie ihrer Fähigkeit, an Albumin zu binden, unterscheiden. Die Stabilität der markierten Komplexe wurde über 10 Tage in Puffer und Serum untersucht. Weiterhin wurden Bindungsaffinitäten und Koloniebildungsassays an PSMA-positiven LNCaP-Zellen durchgeführt. Alle Konjugate wurden hinsichtlich ihrer Organverteilung in LNCaP-Tumor-tragenden SCID-Mäusen untersucht. Ergebnisse/Results: Alle 4 Konjugate wurden unter milden Bedingungen radiomarkiert und zeigen bei Zugabe von Gentisinsäure die höchste Stabilität über 10 Tagen. Die Bindungsaffinitäten der Konjugate wurden als KD-Werte bestimmt und liegen zwischen (10-40) nM. Die Untersuchungen zum Zellüberleben zeigen einen therapeutischen Vorteil der bivalenten gegenüber den monovalenten Konjugaten. Alle vier Konjugate erreichten in unterschiedlichen Zeitspannen (bis 5 d p.i.) Tumoranreicherungen von (12-85) %ID/g. Unerwünschte Anreicherungen traten v. a. bei dem dimeren, albuminbindenden Konjugat in Form von Akkumulationen (Leber, Milz, Nieren) auf. Schlussfolgerungen/Conclusions: Die Verwendung von macropa-basierten Konjugaten für die Therapie mit Actinium‑225 oder die zukünftige Bildgebung mit Lanthan‑133 ist vorteilhaft, da die gebildeten Komplexe stabiler sind und damit eine Anreicherung der Aktivität in off-Target-Regionen verringert werden kann. Weiterhin ergibt sich ein Vorteil im Handling, da die Reaktionen schnell und bei Raumtemperatur durchgeführt werden können, was die spätere Umsetzung in eine GMP-gerechte Herstellung erleichtert.

Das prostataspezifische Membranantigen (PSMA) ist ein hoch attraktives biologisches Target für die molekulare Bildgebung und für die zielgerichtete Radionuklidtherapie bei kastrationsresistentem Prostatakrebs (mCRPC), da es in allen Phasen der Erkrankung bei den Tumorzellen expremiert ist. Somit bieten hoch affine, PSMA-bindende Biomoleküle eine exzellente Basis zur Entwicklung von Radiokonjugaten für die Therapie mit Alphastrahlern. Aufgrund seiner hervorragenden kernphysikalischen Eigenschaften wird zunehmend Actinium-225 für diese Zwecke in der Nuklearmedizin verwendet. Das dreiwertige Kation Ac3+ muss dazu in einem Chelator hoch stabil komplexiert werden. Um das zu realisieren, wird der Chelator macropa verwendet, welcher eine sehr hohe In-vivo-Stabilität zeigt und Radiomarkierungen unter sehr milden Bedingungen zulässt. Dieser wird mit einer bzw. zwei PSMA-bindenden Einheiten modifiziert, um den 225Ac-Komplex zu den Tumorzellen zu bringen. Zunächst wurden zwei Actinium-225-Radiokonjugate entwickelt und deren pharmakologische Eigenschaften, z.B. die Bindung an Tumorzellen, Anreicherung im Tumor (ca. 10%ID/g für beide Konjugate) und in anderen Organen überprüft. Hier wurde ein ähnliches Verhalten festgestellt, vergleichbar mit dem Standardkonjugat 225Ac-PSMA-617. Die beiden 225Ac-Radiokonjugate wurden weiterentwickelt und mit einem Albumin-Binder (4-Iodphenylbutyrat) versehen. Dadurch wurde eine längere Blutverweilzeit, kombiniert mit einer höheren Aufnahme in den Tumor, erreicht (bis 50%ID/g Monomer, bis 120 %ID/g Dimer), um die Effektivität der Radiotherapie zu erhöhen.

The prostate-specific membrane antigen (PSMA) is expressed in approx. 80% of prostate cancer at considerably higher levels in tumor cells compared to healthy tissues. Its upregulation occurs in all stages of the disease. Therefore, PSMA has emerged as an attractive target for molecular imaging and especially targeted radionuclide therapy (endoradiotherapy) of metastatic castration-resistant prostate cancer (mCRPC). Due to its favorable nuclear physical properties, actinium-225 belongs to the clinically applied alpha emitters for therapeutic applications. More than ten clinical trials are displayed for actinium-225-DOTA-based conjugates. A trial using [225Ac]Ac-PSMA-617 as the IMP in men with PSMA-positive prostate cancer is projected to start. Actinium-225 can be chelated with the standard DOTA chelator, but requires rather harsh labeling conditions such as high temperatures (80–95°C) or microwave assistance. Alternatively, with the complexing agent macropa mild labeling conditions, low reaction temperature and high in vivo stability can be realized owing to its perfect characteristics for Ac3+ chelation. Moreover, to further improve the tumor uptake for future targeted alpha therapy, albumin binding units based on 4-iodophenylbutyrate were introduced to increase the tumor uptake. Two 225Ac-radioconjugates with albumin binders were prepared, either containing one or two PSMA-binding units (based on PSMA-617), the second one to raise the binding affinity to the PSMA receptor. The synthetic approach consisted of the functionalization of one or two picolinic side arms with a clickable reactive site for the connection of the vector molecules. The azide-functionalized PSMA derivative, which also contains the albumin binder, was prepared using standard peptide coupling conditions. Cell culture-based studies regarding radioligand affinity and clonogenicity were performed using PSMA-positive LNCaP cells and the biodistribution of the radioconjugates was evaluated using LNCaP tumor-bearing mice. Radiolabeling of both PSMA ligands with [225Ac]Ac3+ was performed at up to 5 MBq/nmol with >99% radiochemical purity. Cell binding and survival studies revealed a higher cell binding affinity and an improved cell killing efficiency for the radioconjugate with two PSMA-binding entities compared to the derivative with only one targeting motif. A considerable binding of both radioligands to mouse, rat and human serum proteins was confirmed. Biodistribution studies revealed enhanced blood circulation times of both albumin-binding PSMA ligands compared to their counterparts without the albumin binders. A substantially higher accumulation in LNCaP tumors up to 50 %ID/g (one PSMA-binding moiety) and 120 %ID/g (two PSMA-binding moieties) after 120 h p.i., respectively, was also observed. Additionally, a considerable DNA damage and a massive decrease in cell proliferation was observed by immunohistochemical examination of LNCaP tumors, whereas necrosis in the kidneys of the animals was not observed.

Objectives The prostate-specific membrane antigen (PSMA) is expressed in most cases of prostate cancer at considerably higher levels in tumor cells compared to healthy tissues [1-3] and its upregulation occurs in all stage of the disease [4, 5]. Therefore, PSMA has emerged as an attractive target for molecular imaging and especially targeted radionuclide therapy (endoradiotherapy) of metastatic castration-resistant prostate cancer (mCRPC), given the example of [177Lu]Lu-PSMA-617. We recently described the synthesis and in-depth characterization of PSMA radioligands for targeted alpha therapy with actinium-225 [6]. Our present study aimed at the design, synthesis and preclinical evaluation of albumin-binding PSMA ligands in order to optimize their tissue distribution profile and to improve their pharmacokinetic properties. Methods Two novel compounds were prepared by combining a macropa chelator with one or two lysine-ureido-glutamate–based PSMA-binding entities equipped with 4-(p-iodophenyl)butyrate residues. The albumin-binding properties of the 225Ac-labeled conjugates were investigated in vitro using mouse, rat and human serum. The specific interaction of both compounds with human serum albumin was confirmed by microscale thermophoresis. Cell culture-based studies regarding radioligand affinity and clonogenicity were performed on PSMA-positive LNCaP cells. The biodistribution of the radioconjugates was analyzed in LNCaP tumor-bearing mice with ensuing investigation of tissue toxicity by histological examinations. Results Radiolabeling of both PSMA ligands with 225Ac was achieved at up to 5 MBq/nmol with >99% radiochemical purity. In vitro assays confirmed considerable binding of the radioligands to mouse, rat and human serum proteins. Cell binding and survival studies revealed a higher cell binding affinity and an improved cell killing efficiency for the radioconjugate with two PSMA-binding entities compared to the derivative with only one targeting motif. Biodistribution studies revealed enhanced blood circulation times of the new albumin-binding PSMA ligands compared to their counterparts lacking the 4-(p-iodophenyl)butyrate residues as well as substantially higher accumulation in LNCaP tumors up to 50 %ID/g (one PSMA-binding moiety) and 150 %ID/g (two PSMA-binding moieties), respectively, after 120 h p.i. Considerable DNA damage and a massive decrease in cell proliferation was observed by histological examination of LNCaP tumors, whereas necrosis in the kidneys of the animals was not detected. Conclusions In this study, we demonstrate the development and evaluation of two new PSMA-targeting radioligands comprising 4-(p-iodophenyl)butyrate residues as albumin binder. The prolonged blood circulation of the novel radioligands resulted in greatly enhanced tumor uptake and retention over time. These radioconjugates have the potential to improve the efficacy of targeted alpha therapy and are promising candidates for the treatment of mCRPC.

Currently, targeted alpha therapy is one of the most investigated topics in radiopharmaceutical cancer management. Especially, the alpha emitter 225 Ac provides excellent nuclear properties and is gaining increasing popularity for the treatment of various tumor entities. We herein report on the synthesis of two universal 225Ac-chelators for mild condition radiolabeling and binding sites to conjugate biomolecules via the copper-mediated click chemistry. A convenient radiolabeling procedure was investigated as well as the complex stability proved for both chelators and two PSMA-targeting model radioconjugates. Studies regarding affinity and cell survival were per-formed on LNCaP cells followed by biodistribution studies, which were performed using LNCaP tumor-bearing mice. High efficiency radiolabeling for all conjugates was demonstrated. Cell binding studies revealed a fourfold lower cell affinity for the PSMA conjugate with one targeting vector compared to the conjugate owing two targeting vectors. Additionally, these differences were verified by in vitro cell survival evaluation and biodistribution studies, both showing a higher therapeutic efficiency for the same dose on a cellular leve, a higher tumor up-take (15%ID/g) and a rapid whole body clearance after 24 hours. The synthesized chelators will overcome obstacles of lacking stability and worse labeling needs regarding 225Ac complexation using the DOTA chelator. Moreover, the universal functionalization expands the coverage of these chelators in combination with any sensitive bio(macro)molecule, thus improving treat-ment of any addressable tumor target.

Targeted alpha therapy is currently one of the most intensively investigated topics in radiopharmaceutical sciences and cancer management in nuclear medicine. Especially, the alpha emitter 225Ac provides excellent physical and chemical properties (t1/2 = 10 d, 4 α and 2 β decays). Thus, it is consistently gaining an increasing interest for the radioligand therapy (RLT) of various tumor entities. The aim of this study was to synthesize macropa-based chelators that allow room temperature labeling and offer the modular functionalization properties for a straightforward coupling of temperature-sensitive biomolecules by e.g. click chemistry approaches. As a proof of concept study, the chelators were coupled to known PSMA-targeting vector molecules and then evaluated in vitro as well as in vivo.

Aim of the study. The goal of the present study was to analyse the exclusive use of absorbable suture material (Vicryl) in the fixation of transposed bone segments in cranial vault reshaping without modification of the osteotomy design. Clinical rationale for the study. In the surgical correction of craniosynostosis, bone fixation using osteosynthesis is a key step. Absorbable osteosynthesis is a widespread tool in cranial vault remodelling, but only a limited number of studies have described the use of absorbable sutures in the treatment of patients with craniosynostosis. Materials and methods. In 72 children with various types of craniosynostosis, up to 24 months of age, osteosynthesis was conducted exclusively with Vicryl sutures. All patients were evaluated for the stability of postoperative results, and foreign body reactions were examined as part of the routine clinical and radiological follow-up ranging from 1 to 36 months. Results. All examined children exhibited stable postoperative conditions with immediate stability of all remodelled cranial vaults. 2D and 3D radiological examinations demonstrated good bony union in all cases. Significant foreign body reactions were not observed and bone healing was noted at all sites. Conclusion and clinical implications. The exclusive application of absorbable suture material enables stable and cost-effective osteosynthesis in craniofacial surgery without altering the osteotomy design. © 2019 Polish Neurological Society.

Contains fulltext : 153523.pdf (Publisher’s version ) (Open Access) Within the last years 89Zr has attracted considerable attention as long-lived radionuclide for positron emission tomography (PET) applications. So far desferrioxamine B (DFO) has been mainly used as bifunctional chelating system. Fusarinine C (FSC), having complexing properties comparable to DFO, was expected to be an alternative with potentially higher stability due to its cyclic structure. In this study, as proof of principle, various FSC-RGD conjugates targeting αvß3 integrins were synthesized using different conjugation strategies and labeled with 89Zr. In vitro stability, biodistribution and microPET/CT imaging were evaluated using [89Zr]FSC-RGD conjugates or [89Zr]triacetylfusarinine C (TAFC). Quantitative 89Zr labeling was achieved within 90 min at room temperature. The distribution coefficients of the different radioligands indicate hydrophilic character. Compared to [89Zr]DFO, [89Zr]FSC derivatives showed excellent in vitro stability and resistance against transchelation in phosphate buffered saline (PBS), ethylenediaminetetraacetic acid solution (EDTA) and human serum for up to seven days. Cell binding studies and biodistribution as well as microPET/CT imaging experiments showed efficient receptor-specific targeting of [89Zr]FSC-RGD conjugates. No bone uptake was observed analyzing PET images indicating high in vivo stability. These findings indicate that FSC is a highly promising chelator for the development of 89Zr-based PET imaging agents.