Labeling Monoclonal Antibody with α-emitting 211At at High Activity Levels via a Tin Precursor.

Background: In a previous clinical study, the authors evaluated the potential of antitenascin C monoclonal antibody (mAb) 81C6 labeled with 211At via the prosthetic agent N-succinimidyl 3-[211At]astatobenzoate (SAB) for the treatment of primary brain tumors. Although encouraging results were obtained, labeling chemistry failed while attempting to escalate the dose to 370 MBq. The goal of the current study was to develop a revised procedure less susceptible to radiolysis-mediated effects on 211At labeling that would be suitable for use at higher activity levels of this α-emitter. Materials and Methods: Addition of N-chlorosuccinimide to the methanol used to remove the 211At from the cryotrap after bismuth target distillation was done to thwart radiolytic decomposition of reactive 211At and the tin precursor. A series of 11 reactions were performed to produce SAB at initial 211At activity levels of 0.31-2.74 GBq from 50 µg of N-succinimidyl 3-trimethylstannylbenzoate (Me-STB), which was then reacted with murine 81C6 mAb without purification of the SAB intermediate. Radiochemical purity, immunoreactive fraction, sterility, and apyrogenicity of the 211At-labeled 81C6 preparations were evaluated. Results: Murine 81C6 mAb was successfully labeled with 211At using these revised procedures with improved radiochemical yields and decreased overall synthesis time compared with the original clinical labeling procedure. Conclusions: With 2.74 GBq of 211At, it was possible to produce 1.0 GBq of 211At-labeled 81C6 with an immunoreactive fraction of 92%. These revised procedures permit production of 211At-labeled mAbs suitable for use at clinically relevant activity levels.

Radiopharmaceutical chemistry of targeted radiotherapeutics, part 4: Strategies for 211At labeling at high activities and radiation doses of 211At α-particles.

INTRODUCTION: Alpha particles are radiation of high energy and short range, properties that can lead to radiolysis-mediated complications in labeling chemistry at the high radioactivity levels required for clinical application. In previous papers in this series, we have shown that radiation dose has a profound effect on the astatine species that are present in the labeling reaction and their suitability for the synthesis of N-succinimidyl 3-[211At]astatobenzoate. The purpose of this study was to evaluate the effects of adding N-chlorosuccinimide (NCS) to the methanol solution used for initial isolation of 211At after distillation, a process referred to as 211At stabilization, on 211At chemistry after exposure to high radiation doses. METHODS: High performance liquid chromatography was used to evaluate the distribution of 211At species present in methanol in the 500-65,000Gy radiation dose range and the synthesis of SAB from N-succinimidyl 3-(tri-n-butylstannyl)benzoate in the 500-120,000Gy radiation dose range using different 211At timeactivity combinations under conditions with/without 211At stabilization. RESULTS: In the absence of NCS stabilization, a reduced form of astatine, At(2), increased with increasing radiation dose, accounting for about half the total activity by about 15,000Gy, while with stabilization, At(2) accounted for <10% of 211At activity even at doses >60,000Gy. SAB yields without stabilization rapidly declined with increasing dose, falling to ~20% at about 5000Gy while with stabilization, yields >80% were obtained with 211At solutions stored for more than 23h and receiving radiation doses >100,000Gy. CONCLUSIONS: Adding NCS to the methanol solution used for initial isolation of 211At is a promising strategy for countering the deleterious effects of radiolysis on 211At chemistry. ADVANCES IN KNOWLEDGE AND IMPLICATIONS FOR PATIENT CARE: This strategy could facilitate the ability to perform 211At labeling at sites remote from its production and at the high activity levels required for clinical applications.

Engineered modular recombinant transporters: application of new platform for targeted radiotherapeutic agents to alpha-particle emitting 211 At.

PURPOSE: To generate and evaluate a modular recombinant transporter (MRT) for targeting 211 At to cancer cells overexpressing the epidermal growth factor receptor (EGFR). METHODS AND MATERIALS: The MRT was produced with four functional modules: (1) human epidermal growth factor as the internalizable ligand, (2) the optimized nuclear localization sequence of simian vacuolating virus 40 (SV40) large T-antigen, (3) a translocation domain of diphtheria toxin as an endosomolytic module, and (4) the Escherichia coli hemoglobin-like protein (HMP) as a carrier module. MRT was labeled using N-succinimidyl 3-[211 At]astato-5-guanidinomethylbenzoate (SAGMB), its 125 I analogue SGMIB, or with 131 I using Iodogen. Binding, internalization, and clonogenic assays were performed with EGFR-expressing A431, D247 MG, and U87MG.wtEGFR human cancer cell lines. RESULTS: The affinity of SGMIB-MRT binding to A431 cells, determined by Scatchard analysis, was 22 nM, comparable to that measured before labeling. The binding of SGMIB-MRT and its internalization by A431 cancer cells was 96% and 99% EGFR specific, respectively. Paired label assays demonstrated that compared with Iodogen-labeled MRT, SGMIB-MRT and SAGMB-MRT exhibited more than threefold greater peak levels and durations of intracellular retention of activity. SAGMB-MRT was 10-20 times more cytotoxic than [211 At]astatide for all three cell lines. CONCLUSION: The results of this study have demonstrated the initial proof of principle for the MRT approach for designing targeted alpha-particle emitting radiotherapeutic agents. The high cytotoxicity of SAGMB-MRT for cancer cells overexpressing EGFR suggests that this 211 At-labeled conjugate has promise for the treatment of malignancies, such as glioma, which overexpress this receptor.

Targeted alpha-particle radiotherapy with 211At-labeled monoclonal antibodies.

An attractive feature of targeted radionuclide therapy is the ability to select radionuclides and targeting vehicles with characteristics that are best suited for a particular clinical application. One combination that has been receiving increasing attention is the use of monoclonal antibodies (mAbs) specifically reactive to receptors and antigens that are expressed in tumor cells to selectively deliver the alpha-particle-emitting radiohalogen astatine-211 (211At) to malignant cell populations. Promising results have been obtained in preclinical models with multiple 211At-labeled mAbs; however, translation of the concept to the clinic has been slow. Impediments to this process include limited radionuclide availability, the need for suitable radiochemistry methods operant at high activity levels and lack of data concerning the toxicity of alpha-particle emitters in humans. Nonetheless, two clinical trials have been initiated to date with 211At-labeled mAbs, and others are planned for the near future.

Radiopharmaceutical chemistry of targeted radiotherapeutics, Part 3: alpha-particle-induced radiolytic effects on the chemical behavior of (211)At.

UNLABELLED: Two characteristics of alpha-particles that enhance their potential for targeted radiotherapy are their high energy and approximately cellular range. Unfortunately, these properties also can have negative consequences, confounding the production of clinically relevant levels of radiopharmaceutical because of radiolytic effects. The purpose of this study was to evaluate the effect of radiation dose on the astatine species present before initiation of a labeling reaction and the potential role of these molecules in the efficiency of N-succinimidyl 3-(211)At-astatobenzoate (SAB) synthesis. The ranges of radiation dose evaluated were selected to reflect those that might be encountered in SAB synthesis for the preparation of clinical doses of (211)At-labeled radiopharmaceuticals. METHODS: The distribution of astatine species present in methanol, and the yields for the synthesis of SAB from N-succinimidyl 3-(tri-n-butylstannyl)benzoate as a function of radiation dose, were determined by high-performance liquid chromatography. Radiation doses in the range of 500-12,000 Gy were evaluated using different (211)At time-activity combinations, and the effect of acetic acid, a normal component of astatodestannylation reactions, also was studied. Finally, the effect of the reducing agent sodium sulfite also was evaluated to characterize the nature of the species produced by radiolysis. RESULTS: At radiation doses below 1,000 Gy, high-performance liquid chromatography analysis indicated that more than 90% of the (211)At was present in methanol as a single species, At(1), whereas at higher doses, a second peak, At(2), emerged. At(1) decreased and At(2) increased in a radiation dose-dependent fashion, with At(2) becoming the predominant species at about 3,000 Gy. At(2) was identified as a reduced form of astatine, presumably astatide, which could not be efficiently oxidized to a species suitable for electrophilic astatination. In methanol/acetic acid, more than 95% of the astatine was present as At(2) even at doses below 1,400 Gy. CONCLUSION: The emergence of a reduced form of astatine, At(2), at higher radiation doses is consistent with the decline in SAB yields observed under these conditions. Alteration of the chemical form of the astatine by radiolysis could account for the declining yields noted in the preparation of clinical-level (211)At-labeled radiopharmaceuticals and when the labeling chemistry is initiated hours after (211)At production.

Influence of prosthetic radioiodination on the chemical and biological behavior of chemotactic peptides labeled at high specific activity.

The influence of radioiodination made through prosthetic group N-succinimidyl-3-[131I]iodo-benzoate ([131I]SIB) on the behavior of small peptides was investigated using as model the chemotactic hexapeptide Nalpha-for-Nle-Leu-Phe-Nle-Tyr-Lys. No carrier added labeled peptide was isolated by reverse-phase HPLC (RP-HPLC) with coupling efficiencies up to 59-75%. Biodistribution in normal and infected C57 mice showed mainly a hepatobiliary clearance, a very low thyroid uptake and the highest uptake at the infection site was within 1h of injection. Superoxide production and competitive binding assays studies in human polymorphonuclear leukocytes showed a preserved biological activity and high-affinity specific binding. However, the results indicated that the changes observed in the receptor-binding properties with an IC50 almost twice than the unlabeled peptide and the increasing in the hepatobiliary excretion could be the consequence of the increased lipophicity observed due to the presence of the prosthetic group together with a strong influence of the radioisotope per se.

Iodide benzamides for the in-vivo detection of melanoma and metastases.

The aim of this work was to synthesize, label and evaluate in vivo [I]N-(2-diethylaminoethyl)-3-iodo-4-methoxybenzamide ([I]IMBA) as a radiotracer for B16-F0 melanoma cells, in C57 mice bearing a subcutaneous melanoma tumour and experimentally induced lung metastases. The average radio-iodination yield achieved, after labelling and Sep-Pak purification, was 65%, with a radiochemical purity of > or = 96%. Biodistribution studies using [I]IMBA (2.2 GBq/micromol) showed high specific tumour uptake, with low non-target tissue background, due to a rapid renal clearance from the animal body (corporal retention was 19.7 +/- 7.1% of the injected dose at 6 h and 4.00 +/- 2.4% of the injected dose at 24 h). The very high targeting efficiency of this radiopharmaceutical was also confirmed by images in which primary subcutaneous tumour and induced lung metastases were clearly visualized. In addition, a clear correlation was found between the uptake of radioactivity in the lungs (percentage of the injected dose per gram of tissue) and the number of metastases carried by them.

Radiopharmaceutical chemistry of targeted radiotherapeutics, Part 2: radiolytic effects of 211At alpha-particles influence N-succinimidyl 3-211AT-astatobenzoate synthesis.

UNLABELLED: A variety of promising targeted radiotherapeutics labeled with alpha-emitters have been developed. Clinical investigation of these radiopharmaceuticals requires the production of high activity levels, which can be hindered by alpha-particle-mediated radiolytic effects on labeling chemistry. The purpose of this study was to investigate the effects of radiation dose on the synthesis of N-succinimidyl 3-(211)At-astatobenzoate (SAB), a compound used in our clinical trials for labeling antibodies with alpha-particle-emitting (211)At. METHODS: Yields for the synthesis of SAB as a function of the radiation dose received by the reaction medium were determined. The variables studied included the radiohalogenation precursors N-succinimidyl 3-(tri-n-butylstannyl)benzoate (BuSTB) and N-succinimidyl 3-(trimethylstannyl)benzoate (MeSTB); the solvents chloroform, benzene, and methanol; and the addition of acetic acid and the oxidant N-chlorosuccinimide. The (211)At product spectra were determined from high-performance liquid chromatograms and then plotted against radiation dose. RESULTS: SAB production declined rapidly with increasing dose, consistent with the documented radiolytic decomposition of BuSTB and MeSTB in chloroform. Even though these tin precursors were not appreciably degraded in benzene, SAB could not be produced in this solvent; instead, highly lipophilic (211)At-labeled species were generated in nearly quantitative yields. Although a dose-dependent decline in SAB yield also was observed in methanol, both in the presence and in the absence of an oxidant, the results were better than those obtained with the other solvents. An unexpected observation was that SAB could be obtained at a yield of greater than 30% when the reaction was run in methanol without the addition of acetic acid or an oxidant; these 2 components previously were considered essential for astatodestannylation. CONCLUSION: Radiolytic factors can play an important role in the synthesis of clinical-level activities of (211)At-labeled radiopharmaceuticals, necessitating the development of reaction conditions different from those that are used successfully at lower activity levels.

Radiopharmaceutical chemistry of targeted radiotherapeutics, part 1: effects of solvent on the degradation of radiohalogenation precursors by 211At alpha-particles.

UNLABELLED: The high energy and short range of alpha-particles make them attractive for targeted radiotherapy. However, these properties can be problematic when the production of high activity levels of alpha-particle-emitting radiotherapeutics is required. For example, difficulties were encountered in the production of N-succinimidyl 3-[211At]-astatobenzoate (SAB), when 370-MBq doses of 211At-labeled antibody were required. The purpose of this study was to investigate a potential cause of this behavior--radiolytic degradation of the radiohalogenation precursor. METHODS: Both N-succinimidyl 3-(tri-n-butylstannyl)benzoate (BuSTB) and N-succinimidyl 3-trimethylstannylbenzoate (MeSTB) were incubated with various 211At time-activity combinations such that the radiation dose received by the reaction medium ranged from about 0 to 20,000 Gy. Studies were performed using chloroform, methanol, and benzene as the solvent, and both at neutral pH and at a pH of approximately 5.5, as used in SAB synthesis. The fraction of tin precursor remaining and the generation of unlabeled byproducts were determined from high-performance liquid chromatograms and then plotted against radiation dose. RESULTS: Extensive radiolytic decomposition of BuSTB and MeSTB was observed in chloroform, with 50% degradation taking place even at doses below 500 Gy. Formation of a byproduct, most likely N-succinimidyl 3-chlorobenzoate, increased with radiation dose. A greater degree of stability was seen in both methanol and benzene, with more than 85% of the precursor remaining at 3,500 Gy. No cold byproducts were observed with either solvent. CONCLUSION: The nature of the solvent profoundly influences the ability to synthesize high activity levels of SAB and possibly other 211At-labeled radiopharmaceuticals.

Sintesis, control y marcacion de d,I HM-PAO con tecnecio-99m y su aplicacion clinica en estudios neurologicos / Synthesis, control and bearing of d,I HM-PAO with technetium-99m and clinic aplication in neurology studies

Con el objeto de estimar los cambios funcionales en patologia del Sistema Nervioso Central, se estudio la perfusion encefalica con el isomero "d,I" del Hexametilpropilenaminooxima (HM-PAO), usando un tomografo por emision de foton unico (SPECT). La sintesis del radiofarmaco fue realizada mediante la tecnica de Schneider R.F. Se describe el metodo de preparacion y los controles correspondientes. La eficacia de la marcacion excedio el 85%en todos los casos. Cinco milimetros del complejo 99mTcHM-PAO (0.75 mg d.I HM-PAO, 25ug de Cl2Sn.2h2oy 25mCi de 99mTc) fueron inyectados en la vena antecubital. La adquisicion de datos se realiza antes de las 2 h de administrado el compuesto. La poblacion estudiada consiste en 28 controles normales y 140 pacientes con patologia neurologica (enfermedad cerebro-vascular isquemica o hemorragica 37, epilepsia 20, demencia vascular 22 y tipo Alzheimer 19, tumores 15 y miscelaneas 27), definidos por metodos clinicos, electrofisiologicos y radiologicos. Mediante el analisis semicuantitativo de los tomogramas transaxiales con 99mTc-HM-PAO, se descubrieron areas fotopenicas en el 90%de los pacientes con enfermedad cerebro-vascular, en el 65%de las demencias tipo Alzheimer, en el 80%de los epilepticos y en el 10%de los controles normales. El estudio de perfusion encefalica con 99mTc-HM-PAO y SPECT, permite diagnosticar la isquemia cerebral de diversa forma y etiologia, antes que la tomografia computada por Rxe, incluso, resulta mas util que la RMN para el diagnostico diferencial de las demencias

Sintesis, control y marcacion de d,I HM-PAO con tecnecio-99m y su aplicacion clinica en estudios neurologicos / Synthesis, control and bearing of d,I HM-PAO with technetium-99m and clinic aplication in neurology studies

Con el objeto de estimar los cambios funcionales en patologia del Sistema Nervioso Central, se estudio la perfusion encefalica con el isomero "d,I" del Hexametilpropilenaminooxima (HM-PAO), usando un tomografo por emision de foton unico (SPECT). La sintesis del radiofarmaco fue realizada mediante la tecnica de Schneider R.F. Se describe el metodo de preparacion y los controles correspondientes. La eficacia de la marcacion excedio el 85%en todos los casos. Cinco milimetros del complejo 99mTcHM-PAO (0.75 mg d.I HM-PAO, 25ug de Cl2Sn.2h2oy 25mCi de 99mTc) fueron inyectados en la vena antecubital. La adquisicion de datos se realiza antes de las 2 h de administrado el compuesto. La poblacion estudiada consiste en 28 controles normales y 140 pacientes con patologia neurologica (enfermedad cerebro-vascular isquemica o hemorragica 37, epilepsia 20, demencia vascular 22 y tipo Alzheimer 19, tumores 15 y miscelaneas 27), definidos por metodos clinicos, electrofisiologicos y radiologicos. Mediante el analisis semicuantitativo de los tomogramas transaxiales con 99mTc-HM-PAO, se descubrieron areas fotopenicas en el 90%de los pacientes con enfermedad cerebro-vascular, en el 65%de las demencias tipo Alzheimer, en el 80%de los epilepticos y en el 10%de los controles normales. El estudio de perfusion encefalica con 99mTc-HM-PAO y SPECT, permite diagnosticar la isquemia cerebral de diversa forma y etiologia, antes que la tomografia computada por Rxe, incluso, resulta mas util que la RMN para el diagnostico diferencial de las demencias