Safety, Dosimetry, and Tumor Detection Ability of 68Ga-NOTA-AE105: First-in-Human Study of a Novel Radioligand for uPAR PET Imaging

Dorthe Skovgaard Lund; Morten Persson; Malene Brandt-Larsen; Camilla Christensen; Jacob Madsen; Thomas Levin Klausen; Søren Holm; Flemming Littrup Andersen; Annika Loft; Anne Kiil Berthelsen; Helle Pappot; Klaus Brasso; Niels Kroman; Liselotte Højgaard; Andreas Kjaer

doi:10.2967/jnumed.116.178970

Safety, Dosimetry, and Tumor Detection Ability of⁶⁸Ga-NOTA-AE105: First-in-Human Study of a Novel Radioligand for uPAR PET Imaging

Dorthe Skovgaard Lund, Morten Persson, Malene Brandt-Larsen, Camilla Christensen, Jacob Madsen, Thomas Levin Klausen, Søren Holm, Flemming Littrup Andersen, Annika Loft, Anne Kiil Berthelsen, Helle Pappot, Klaus Brasso, Niels Kroman, Liselotte Højgaard, Andreas Kjaer

29 Citations (Scopus)

Abstract

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 a ⁶⁸Ga-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 of ⁶⁸Ga-NOTAAE105 (154 6 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 of ⁶⁸Ga-NOTA-AE105 was determined in collected blood and urine. PET images were visually analyzed for visible tumor uptake of ⁶⁸Ga-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 of ⁶⁸Ga- NOTA-AE105 as a new radioligand for uPAR PET imaging in cancer patients.

Original language	English
Journal	Journal of Nuclear Medicine
Volume	58
Issue number	3
Pages (from-to)	379-386
ISSN	0161-5505
DOIs	https://doi.org/10.2967/jnumed.116.178970
Publication status	Published - 1 Mar 2017

Keywords

Adult
Aged
Biomarkers, Tumor/metabolism
Female
Heterocyclic Compounds/pharmacokinetics
Humans
Male
Metabolic Clearance Rate
Middle Aged
Molecular Imaging/methods
Neoplasms/diagnostic imaging
Oligopeptides/pharmacokinetics
Organ Specificity
Pilot Projects
Positron-Emission Tomography/methods
Radiation Dosage
Radiation Exposure/analysis
Radiopharmaceuticals/pharmacokinetics
Receptors, Urokinase Plasminogen Activator/metabolism
Reproducibility of Results
Sensitivity and Specificity
Tissue Distribution
Whole-Body Counting

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Skovgaard Lund, D., Persson, M., Brandt-Larsen, M., Christensen, C., Madsen, J., Klausen, T. L., Holm, S., Andersen, F. L., Loft, A., Berthelsen, A. K., Pappot, H., Brasso, K., Kroman, N., Højgaard, L., & Kjaer, A. (2017). Safety, Dosimetry, and Tumor Detection Ability of⁶⁸Ga-NOTA-AE105: First-in-Human Study of a Novel Radioligand for uPAR PET Imaging. Journal of Nuclear Medicine, 58(3), 379-386. https://doi.org/10.2967/jnumed.116.178970

Skovgaard Lund, D, Persson, M, Brandt-Larsen, M, Christensen, C, Madsen, J, Klausen, TL, Holm, S, Andersen, FL, Loft, A, Berthelsen, AK, Pappot, H, Brasso, K , Kroman, N , Højgaard, L & Kjaer, A 2017, 'Safety, Dosimetry, and Tumor Detection Ability of⁶⁸Ga-NOTA-AE105: First-in-Human Study of a Novel Radioligand for uPAR PET Imaging', Journal of Nuclear Medicine, vol. 58, no. 3, pp. 379-386. https://doi.org/10.2967/jnumed.116.178970

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title = "Safety, Dosimetry, and Tumor Detection Ability of 68Ga-NOTA-AE105: First-in-Human Study of a Novel Radioligand for uPAR PET Imaging",

abstract = "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 a 68Ga-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 of 68Ga-NOTAAE105 (154 6 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 of 68Ga-NOTA-AE105 was determined in collected blood and urine. PET images were visually analyzed for visible tumor uptake of 68Ga-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 of 68Ga- NOTA-AE105 as a new radioligand for uPAR PET imaging in cancer patients.",

keywords = "Adult, Aged, Biomarkers, Tumor/metabolism, Female, Heterocyclic Compounds/pharmacokinetics, Humans, Male, Metabolic Clearance Rate, Middle Aged, Molecular Imaging/methods, Neoplasms/diagnostic imaging, Oligopeptides/pharmacokinetics, Organ Specificity, Pilot Projects, Positron-Emission Tomography/methods, Radiation Dosage, Radiation Exposure/analysis, Radiopharmaceuticals/pharmacokinetics, Receptors, Urokinase Plasminogen Activator/metabolism, Reproducibility of Results, Sensitivity and Specificity, Tissue Distribution, Whole-Body Counting",

author = "{Skovgaard Lund}, Dorthe and Morten Persson and Malene Brandt-Larsen and Camilla Christensen and Jacob Madsen and Klausen, {Thomas Levin} and S{\o}ren Holm and Andersen, {Flemming Littrup} and Annika Loft and Berthelsen, {Anne Kiil} and Helle Pappot and Klaus Brasso and Niels Kroman and Liselotte H{\o}jgaard and Andreas Kjaer",

note = "{\textcopyright} 2017 by the Society of Nuclear Medicine and Molecular Imaging.",

year = "2017",

month = mar,

day = "1",

doi = "10.2967/jnumed.116.178970",

language = "English",

volume = "58",

pages = "379--386",

journal = "The Journal of Nuclear Medicine",

issn = "0161-5505",

publisher = "Society of Nuclear Medicine",

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TY - JOUR

T1 - Safety, Dosimetry, and Tumor Detection Ability of 68Ga-NOTA-AE105

T2 - First-in-Human Study of a Novel Radioligand for uPAR PET Imaging

AU - Skovgaard Lund, Dorthe

AU - Persson, Morten

AU - Brandt-Larsen, Malene

AU - Christensen, Camilla

AU - Madsen, Jacob

AU - Klausen, Thomas Levin

AU - Holm, Søren

AU - Andersen, Flemming Littrup

AU - Loft, Annika

AU - Berthelsen, Anne Kiil

AU - Pappot, Helle

AU - Brasso, Klaus

AU - Kroman, Niels

AU - Højgaard, Liselotte

AU - Kjaer, Andreas

PY - 2017/3/1

Y1 - 2017/3/1

N2 - 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 a 68Ga-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 of 68Ga-NOTAAE105 (154 6 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 of 68Ga-NOTA-AE105 was determined in collected blood and urine. PET images were visually analyzed for visible tumor uptake of 68Ga-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 of 68Ga- NOTA-AE105 as a new radioligand for uPAR PET imaging in cancer patients.

AB - 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 a 68Ga-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 of 68Ga-NOTAAE105 (154 6 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 of 68Ga-NOTA-AE105 was determined in collected blood and urine. PET images were visually analyzed for visible tumor uptake of 68Ga-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 of 68Ga- NOTA-AE105 as a new radioligand for uPAR PET imaging in cancer patients.

KW - Adult

KW - Aged

KW - Biomarkers, Tumor/metabolism

KW - Female

KW - Heterocyclic Compounds/pharmacokinetics

KW - Humans

KW - Male

KW - Metabolic Clearance Rate

KW - Middle Aged

KW - Molecular Imaging/methods

KW - Neoplasms/diagnostic imaging

KW - Oligopeptides/pharmacokinetics

KW - Organ Specificity

KW - Pilot Projects

KW - Positron-Emission Tomography/methods

KW - Radiation Dosage

KW - Radiation Exposure/analysis

KW - Radiopharmaceuticals/pharmacokinetics

KW - Receptors, Urokinase Plasminogen Activator/metabolism

KW - Reproducibility of Results

KW - Sensitivity and Specificity

KW - Tissue Distribution

KW - Whole-Body Counting

U2 - 10.2967/jnumed.116.178970

DO - 10.2967/jnumed.116.178970

M3 - Journal article

C2 - 27609788

SN - 0161-5505

VL - 58

SP - 379

EP - 386

JO - The Journal of Nuclear Medicine

JF - The Journal of Nuclear Medicine

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ER -