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In recent years, the targeting of G protein-coupled membrane receptors (GPCRs) with radiolabeled ligands has become very important in nuclear imaging, particularly with the progressive replacement of somatostatin analogues labelled with 111In for SPECT by others labelled with 68Ga for PET imaging, which improves diagnostic efficacy. High-affinity bombesin receptors (GRPR) or neurotensin receptors (NTR1) are also GPCRs overexpressed in many cancers as compared with normal tissue. GRPR is overexpressed in 83% of estrogen-dependent ductal carcinomas. In the first part of this work, we demonstrated that 68Ga-AMBA, an agonist ligand of GRPR, allowed the PET detection of a mouse model of estrogen-dependent breast cancer and could be more sensitive than 18F-FDG to predict and monitor tumour response to hormone therapy.Dr. Gruaz-Guyon's team has developed new neurotensin radioanalogues for targeting NTR1-positive tumours. They studied the properties of these 111In-labeled peptides in a model of colon adenocarcinoma overexpressing NTR1. Obtaining high-contrast images allowing the detection of cancer within a short time after injection, this team subsequently developed this peptide radiotracer for PET imaging. In the second part of this work, we carried out the 68Ga radiolabeling of the best-performing of these derivatives and evaluated its potential for PET imaging of colon adenocarcinoma in a tumor model. Overexpression of NTR1 has been demonstrated in several human cancers such as PDAC (75-88%). We characterized the expression of NTR1 using specimens of human pancreatic cancer and then demonstrated the potential of this PET radiotracer to image two mouse models of human PDAC. We characterized its biodistribution, assessed its specificity in vivo in comparison with 18F-FDG, in particular its ability to discriminate in vivo pancreatitis from pancreatic adenocarcinoma., Ces dernières années, le ciblage des RCPG avec des ligands radiomarqués est devenu très important en imagerie nucléaire, notamment avec le remplacement progressif d’analogues peptidiques de la somatostatine marqués à l’111In pour la TEMP par d’autres marqués au 68Ga pour l'imagerie TEP qui présente une meilleure efficacité diagnostique. Les récepteurs de haute affinité de la bombésine (GRPR) ou de la neurotensine (NTR1) sont eux aussi des RCPG surexprimés par les cellules tumorales par rapport au tissu sain. Le GRPR est surexprimé dans 83% des carcinomes mammaires canalaires estrogènes dépendants. Dans la première partie de ce travail, nous avons démontré qu’un agoniste du GRPR, l’AMBA marqué au 68Ga, permettait la détection en TEP d’un modèle murin de cancer du sein humain estrogène-dépendant et qu’il permettait de prédire la réponse tumorale à une hormonothérapie de manière plus sensible que le 18F-FDG.L’équipe du Dr. Gruaz-Guyon a développé de nouveaux radioligands analogues de la neurotensine pour le ciblage des tumeurs exprimant le NTR1 et a étudié les propriétés de ces peptides marqués à l'111In dans un modèle de tumeurs d’adénocarcinome colique surexprimant le NTR1. L’obtention d’images TEMP de contraste élevé, permettant une détection des greffes tumorales dans des temps courts après injection, a conduit cette équipe à envisager ce traceur peptidique pour l’imagerie TEP. Dans la seconde partie de ce travail, nous avons réalisé le radiomarquage au 68Ga du meilleur de ces dérivés (DOTA NT20.3) et évalué son potentiel pour l'imagerie TEP et la détection de tumeurs d’adénocarcinome colique. La surexpression de NTR1 a été démontrée dans plusieurs autres cancers comme l’adénocarcinome pancréatique (PDAC) (75-88%). Nous avons donc voulu étudier l'expression du NTR1 dans une tumorothèque locale de PDAC. Nous avons ensuite démontré le potentiel du 68Ga-DOTA-NT20.3 pour l’imagerie TEP dans deux modèles murins de PDAC humains. Nous avons caractérisé sa biodistribution, évalué sa spécificité in vivo et l’avons comparé au 18F-FDG, notamment pour valider sa capacité à discriminer in vivo la pancréatite de l’adénocarcinome pancréatique.

Overexpression of the high affinity neurotensin receptor 1 (NTSR1), demonstrated in several human cancers, has been proposed as a new marker for human ductal pancreatic carcinoma and as an independent factor for poor prognosis for ductal breast cancer, head and neck squamous cell carcinoma, and non-small cell lung cancer. The aim of the present study was to develop new DOTA-neurotensin analogues for positron emission tomography (PET) imaging with Ga-68 and for targeted radiotherapy with Y-90 or Lu-177. We synthesized a DOTA-neurotensin analogue series. Two of these peptides bear two sequence modifications for metabolic stability: DOTA-NT-20.3 shares the same peptide sequence as the previously described DTPA-NT-20.3. In the sequence of DOTA-NT-20.4, the Arg(8)-Arg(9) bond was N-methylated instead of the Pro(7)-Arg(8) bond in DOTA-NT-20.3. An additional sequence modification was introduced in DOTA-LB119 to increase stability. A spacer was added between DOTA and the peptide sequence to increase affinity. Binding to HT29 cells, which express NTSR1, in vivo stability, and biodistribution of the various analogues were compared, and the best candidate was used to image tumors of various sizes with the microPET in mice. In-111-DOTA-NT-20.3, in spite of a relatively high uptake in kidneys, showed specific tumor uptake and elevated tumor to other organ uptake ratios. High contrast images were obtained at early time points after injection that allowed tumor detection at a time interval postinjection appropriate for imaging with the short-lived radionuclide Ga-68. In-111-DOTA-NT-20.4 displayed inferior binding to HT29 cells and reduced tumor uptake. In-111-DOTA-LB119 displayed at early time points a significantly lower renal uptake but also a lower tumor uptake than In-111-DOTA-NT-20.3, although binding to HT29 cells was similar. Ga-68-DOTA-NT-20.3 displayed higher tumor uptake than Ga-68-DOTA-LB119 and allowed the detection of very small tumors by PET. In conclusion, DOTA-NT-20.3 is a promising candidate for Ga-68-PET imaging of neurotensin receptor-positive tumors. DOTA-NT-20.3 may also be considered for therapy, as the yttrium-labeled peptide has higher affinity than that of the indium-labeled one. A prerequisite for therapeutic application of this neurotensin analogue would be to lower kidney uptake, for example, by infusion of basic amino acids, gelofusin, or albumin fragments, to prevent nephrotoxicity, as with radiolabeled somatostatin analogues.