DOI QR코드

DOI QR Code

Targeted alpha therapy (TAT) for cancer using metallic radioisotopes

  • Kang, Chi Soo (Division of Applied RI, Korea Institute of Radiological and Medical Sciences) ;
  • Lee, Kyo Chul (Division of Applied RI, Korea Institute of Radiological and Medical Sciences) ;
  • Lee, Yong Jin (Division of Applied RI, Korea Institute of Radiological and Medical Sciences)
  • Received : 2019.12.12
  • Accepted : 2019.12.28
  • Published : 2019.12.30

Abstract

Targeted alpha therapy (TAT) based on metallic radionuclides has attracted a lot of attention lately due to its impressive therapeutic efficacy displayed in couple of clinical studies for cancer. Representative metallic radionuclides emitting alpha-particle include 225Ac, 213Bi, and 227Th, and there have been variety of TAT formulations based on different targeting moiety and chelating agents. In this review, we introduce strategies to label metallic radioisotopes with biomolecules and look at some of recent preclinical and clinical results of TAT for cancer.

Keywords

References

  1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394-424. https://doi.org/10.3322/caac.21492
  2. Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Pineros M, Znaor A, Bray F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer 2019;144:1941-1953. https://doi.org/10.1002/ijc.31937
  3. Maule M, Merletti F. Cancer transition and priorities for cancer control. Lancet Oncol 2012;13:745-746. https://doi.org/10.1016/S1470-2045(12)70268-1
  4. Harding MC, Sloan CD, Merrill RM, Harding TM, Thacker BJ, Thacker EL. Transitions from heart disease to cancer as the leading cause of death in US States, 1999-2016. Prev Chronic Dis 2018;15:E158. https://doi.org/10.5888/pcd15.180151
  5. Oun R, Moussa YE, Wheate NJ. The side effects of platinum-based chemotherapy drugs: a review for chemists. Dalton Trans 2018;47:6645-6653. https://doi.org/10.1039/C8DT00838H
  6. Langendijk JA, Doornaert P, Verdonck-de Leeuw IM, Leemans CR, Aaronson NK, Slotman BJ. Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J Clin Oncol 2008;26:3770-3776. https://doi.org/10.1200/JCO.2007.14.6647
  7. Carvalho S, Levi-Schaffer F, Sela M, Yarden Y. Immunotherapy of cancer: from monoclonal to oligoclonal cocktails of anti-cancer antibodies: IUPHAR review 18. Br J Pharmacol 2016;173:1407-1424. https://doi.org/10.1111/bph.13450
  8. Lambert JM, Chari RV. Ado-trastuzumab emtasine (TDM1): an antibody-drug conjugate (ADC) for HER2-positive breast cancer. J Med Chem 2014;57:6949-6964. https://doi.org/10.1021/jm500766w
  9. Barok M, Joensuu H, Isola J. Trastuzumab emtansine: mechanisms of action and drug resistance. Breast cancer Res 2014;16:209. https://doi.org/10.1186/bcr3621
  10. Li G, Guo J, Shen B-Q, Yadav DB, Sliwkowski MX, Crocker LM, Lacap JA, Phillips GDL. Mechanisms of acquired resistance to trastuzumab emtansine in breast cancer cells. Mol Cancer Ther 2018;17:1441-1453. https://doi.org/10.1158/1535-7163.MCT-17-0296
  11. Sgouros G. Alpha-particles for targeted therapy. Adv Drug Deliv Rev 2008;60:1402-1406. https://doi.org/10.1016/j.addr.2008.04.007
  12. Scheinberg DA, McDevit MR. Actinium-225 in targeted alpha-particle therapeutic applications. Curr Radiopharm 2011;4:306-320. https://doi.org/10.2174/1874471011104040306
  13. Deal KA, Davis IA, Mirzadeh S, Kennel SJ, Brechbiel MW. Improved in vivo stability of actinium-225 macrocyclic complexes. J Med Chem 1999;42:2988-2992. https://doi.org/10.1021/jm990141f
  14. McDevitt MR, Ma D, Simon J, Frank RK, Scheinberg DA. Design and synthesis of $^{225}Ac$ radioimmunopharmaceuticals. Appl Radiat Isot 2002;57:841-847. https://doi.org/10.1016/S0969-8043(02)00167-7
  15. Chappell LL, Deal KA, Dadachova E, Brechbiel MW. Synthesis, conjugation, and radiolabeling of a novel bifunctional chelating agent for $^{225}Ac$ radioimmunotherapy applications. Bioconjug Chem 2000;11:510-519. https://doi.org/10.1021/bc990153f
  16. Thiele NA, Wilson JJ. Actinium-225 for Targeted ${\alpha}$ Therapy: Coordination Chemistry and Current Chelation Approaches. Cancer Biother Radiopharm 2018;33:336-348. https://doi.org/10.1089/cbr.2018.2494
  17. Comba P, Jermilova U, Orvig C, Patrick BO, Ramogida CF, Ruck K, Schneider C, Starke M. Octadentate Picolinic Acid-Based Bispidine Ligand for Radiometal Ions. Chemistry 2017;23: 15945-15956. https://doi.org/10.1002/chem.201702284
  18. Thiele NA, Brown V, Kelly JM, Amor-Coarasa A, Jermilova U, MacMillan SN, Nikolopoulou A, Ponnala S, Ramogida CF, Robertson AKH, Rodriguez-Rodriguez C, Schaffer P, Williams C Jr, Babich JW, Radchenko V, Wilson JJ. An Eighteen-Membered Macrocyclic Ligand for Actinium-225 Targeted Alpha Therapy. Angew Chem Int Ed Engl 2017;56:14712-14717. https://doi.org/10.1002/anie.201709532
  19. Kelly JM, Amor-Coarasa A, Nikolopoulou A, Kim D, Williams C Jr, Vallabhajosula S, Babich JW. Assessment of PSMA targeting ligands bearing novel chelates with application to theranostics: Stability and complexation kinetics of $^{68}Ga^{3+}$, $^{111}In^{3+}$, $^{177}Lu^{3+}$ and $^{225}Ac^{3+}$. Nucl Med Biol 2017;55:38-46. https://doi.org/10.1016/j.nucmedbio.2017.10.001
  20. Essler M, Gartner FC, Neff F, Blechert B, Senekowitsch-Schmidtke R, Bruchertseifer F, Morgenstern A, Seidl C. Therapeutic efficacy and toxicity of $^{225}Ac$-labelled vs. $^{213}Bi$-labelled tumour-homing peptides in a preclinical mouse model of peritoneal carcinomatosis. Eur J Nucl Med Mol Imaging 2012;39:602-612. https://doi.org/10.1007/s00259-011-2023-6
  21. Graf F, Fahrer J, Maus S, Morgenstern A, Bruchertseifer F, Venkatachalam S, Fottner C, Weber MM, Huelsenbeck J, Schreckenberger M, Kaina B, Miederer M. DNA double strand breaks as predictor of efficacy of the alphaparticle emitter $^{225}Ac$ and the electron emitter $^{177}Lu$ for somatostatin receptor targeted radiotherapy. PLoS One 2014;9:e88239. https://doi.org/10.1371/journal.pone.0088239
  22. Sattiraju A, Solingapuram Sai KK, Xuan A, Pandya DN, Almaguel FG, Wadas TJ, Herpai DM, Debinski W, Mintz A. IL13RA2 targeted alpha particle therapy against glioblastomas. Oncotarget 2017;8:42997-43007. https://doi.org/10.18632/oncotarget.17792
  23. Wang G, de Kruijff RM, Rol A, Thijssen L, Mendes E, Morgenstern A, Bruchertseifer F, Stuart MC, Wolterbeek HT, Denkova AG Retention studies of recoiling daughter nuclides of $^{225}Ac$ in polymer vesicles. Appl Radiat Isot 2014;85:45-53. https://doi.org/10.1016/j.apradiso.2013.12.008
  24. Afshar-Oromieh A, Babich JW, Kratochwil C, Giesel FL, Eisenhut M, Kopka K, Haberkorn U. The Rise of PSMA Ligands for Diagnosis and Therapy of Prostate Cancer. J Nucl Med 2016;57(Suppl 3):79S-89S. https://doi.org/10.2967/jnumed.115.170720
  25. Benesova M, Schafer M, Bauder-Wust U, Afshar-Oromieh A, Kratochwil C, Mier W, Haberkorn U, Kopka K, Eder M. Preclinical Evaluation of a Tailor-Made DOTA-Conjugated PSMA Inhibitor with Optimized Linker Moiety for Imaging and Endoradiotherapy of Prostate Cancer. J Nucl Med 2015;56:914-920. https://doi.org/10.2967/jnumed.114.147413
  26. Kratochwil C, Bruchertseifer F, Giesel FL, Weis M, Verburg FA, Mottaghy F, Kopka K, Apostolidis C, Haberkorn U, Morgenstern A. $^{225}Ac$-PSMA-617 for PSMA-Targeted ${\alpha}$-Radiation Therapy of Metastatic Castration-Resistant Prostate Cancer. J Nucl Med 2016;57:1941-1944. https://doi.org/10.2967/jnumed.116.178673
  27. Wilson JJ, Ferrier M, Radchenko V, Maassen JR, Engle JW, Batista ER, Martin RL, Nortier FM, Fassbender ME, John KD, Birnbaum ER. Evaluation of nitrogenrich macrocyclic ligands for the chelation of therapeutic bismuth radioisotopes. Nucl Med Biol 2015;42:428-438. https://doi.org/10.1016/j.nucmedbio.2014.12.007
  28. Teiluf K, Seidl C, Blechert B, Gaertner FC, Gilbertz KP, Fernandez V, BassermannF, EndellJ, BoxhammerR, Leclair S, Vallon M, Aichler M, Feuchtinger A, Bruchertseifer F, Morgenstern A, Essler M. ${\alpha}$-Radioimmunotherapy with $^{213}Bi$-anti-CD38 immunoconjugates is effective in a mouse model of human multiple myeloma. Oncotarget 2015;6:4692-4703. https://doi.org/10.18632/oncotarget.2986
  29. Bryan RA, Jiang Z, Jandl T, Strauss J, Koba W, Onyedika C, Morgenstern A, Bruchertseifer F, Epstein AL, Dadachova E. Treatment of experimental pancreatic cancer with 213-Bismuth-labeled chimeric antibody to single-strand DNA. Expert Rev Anticancer Ther 2014;14:1243-1249. https://doi.org/10.1586/14737140.2014.952285
  30. Gustafsson-Lutz A, Back T, Aneheim E, Hultborn R, Palm S, Jacobsson L, Morgenstern A, Bruchertseifer F, Albertsson P, Lindegren S. Therapeutic efficacy of ${\alpha}$-radioimmunotherapy with different activity levels of the 213Bi-labeled monoclonal antibody MX35 in an ovarian cancer model. EJNMMI Res 2017;7:38. https://doi.org/10.1186/s13550-017-0283-2
  31. Kratochwil C, Giesel FL, Bruchertseifer F, Mier W, Apostolidis C, Boll R, Murphy K, Haberkorn U, Morgenstern A. $^{213}Bi$-DOTATOC receptor-targeted alpharadionuclide therapy induces remission in neuroendocrine tumours refractory to beta radiation: a first-in-human experience. Eur J Nucl Med Mol Imaging 2014;41:2106-2119. https://doi.org/10.1007/s00259-014-2857-9
  32. Krolicki L, Bruchertseifer F, Kunikowska J, Koziara H, Krolicki B, Jakucinski M, Pawlak D, Apostolidis C, Mirzadeh S, Rola R, Merlo A, Morgenstern A. Prolonged survival in secondary glioblastoma following local injection of targeted alpha therapy with $^{213}Bi$-substance P analogue. Eur J Nucl Med Mol Imaging 2018;45:1636-1644. https://doi.org/10.1007/s00259-018-4015-2
  33. Autenrieth ME, Seidl C, Bruchertseifer F, Horn T, Kurtz F, Feuerecker B, D'Alessandria C, Pfob C, Nekolla S, Apostolidis C, Mirzadeh S, Gschwend JE, Schwaiger M, Scheidhauer K, Morgenstern A. Treatment of carcinoma in situ of the urinary bladder with an alpha-emitter immunoconjugate targeting the epidermal growth factor receptor: a pilot study. Eur J Nucl Med Mol Imaging 2018;45:1364-1371. https://doi.org/10.1007/s00259-018-4003-6
  34. Beyer GJ, Miederer M, Vranjes-Duric S, Comor JJ, Kunzi G, Hartley O, Senekowitsch-Schmidtke R, Soloviev D, Buchegger F. Targeted alpha therapy in vivo: direct evidence for single cancer cell kill using 149Tb-rituximab. Eur J Nucl Med Mol Imaging 2004;31:547-554. https://doi.org/10.1007/s00259-003-1413-9
  35. Muller C, Reber J, Haller S, Dorrer H, Koster U, Johnston K, Zhernosekov K, Turler A, Schibli R. Folate receptor targeted alpha-therapy using terbium-149. Pharmaceuticals (Basel) 2014;7:353-365. https://doi.org/10.3390/ph7030353
  36. Liepe K, Shinto A. From palliative therapy to prolongation of survival: $^{223}RaCl2$ in the treatment of bone metastases. Ther Adv Med Oncol 2016;8:294-304. https://doi.org/10.1177/1758834016640494
  37. Nilsson S, Parker C, Haugen I, Lokna A, Aksnes A, Bolstad B, O’Bryan-Tear G, Bruland OS. Radium-223 chloride, a first-in-class alpha-pharmaceutical with a benign safety profile for patients with castration resistant prostate cancer (CRPC) and bone metastases: combined analysis of phase I and II clinical trials. J Clin Oncol 2010;28:4678. https://doi.org/10.1200/jco.2010.28.15_suppl.4678
  38. Nilsson S, Balteskard L, Fossa S. Phase I study of alpharadin2 ($^{223}Ra$), and a-emitting bone-seeking agent in cancer patients with skeletal metastases. Eur J Nucl Med 2004;31:370.
  39. Nilsson S, Franzen L, Parker C, Tyrrell C, Blom R, Tennvall J, Lennemas B, Petersson U, Johannessen DC, Sokal M, Pigott K, Yachnin J, Garkavij M, Strang P, Harmenberg J, Bolstad B, Bruland OS. Bone-targeted radium-223 in symptomatic, hormone-refractory prostate cancer: a randomised, multicentre, placebo controlled phase II study. Lancet Oncol 2007;8:587-594. https://doi.org/10.1016/S1470-2045(07)70147-X
  40. Parker C, Nilsson S, Heinrich D, Helle SI, O'Sullivan JM, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013;369:231-223. https://doi.org/10.1056/NEJMoa1213755
  41. Zalutsky MR, Zhao XG, Alston KL, Bigner D. Highlevel production of alpha-particle-emitting $^{211}At$ and preparation of $^{211}At$-labeled antibodies for clinical use. J Nucl Med 2001;42:1508-1515.
  42. Melhus KB, Larsen RH, Stokke T, Kaalhus O, Selbo PK, Dahle J. Evaluation of the binding of radiolabeled rituximab to CD20-positive lymphoma cells: an in vitro feasibility study concerning low-dose-rate radioimmunotherapy with the ${\alpha}$-emitter $^{227}Th$. Cancer Biother Radiopharm 2007;22:469-479. https://doi.org/10.1089/cbr.2007.371
  43. Larsen RH, Borrebaek J, Dahle J, Melhus KB, Krogh C, Valan MH, Bruland OS. Preparation of 227Th-labeled radioimmunoconjugates, assessment of serum stability and antigen binding ability. Cancer Biother Radiopharm 2007;22:431-437. https://doi.org/10.1089/cbr.2006.321
  44. Dahle J, Borrebaek J, Jonasdottir TJ, Hjelmerud AK, Melhus KB, Bruland OS, Press OW, Larsen RH. Targeted cancer therapy with a novel low-dose rate ${\alpha}$-emitting radioimmunoconjugate. Blood 2007;110:2049-2056.
  45. Heyerdahl H, Abbas N, Sponheim K, Mollatt C, Bruland O, Dahle J. Targeted alpha therapy with 227Th-trastuzumab of intraperitoneal ovarian cancer in nude mice. Curr Radiopharm 2013;6:106-116. https://doi.org/10.2174/18744710113069990018
  46. Hagemann UB, Mihaylova D, Uran SR, Borrebaek J, Grant D, Bjerke RM, Karlsson J, Cuthbertson AS. Targeted alpha therapy using a novel CD70 targeted thorium-227 conjugate in in vitro and in vivo models of renal cell carcinoma. Oncotarget 2017;8:56311-56326. https://doi.org/10.18632/oncotarget.16910
  47. Hagemann UB, Ellingsen C, Schuhmacher J, Kristian A, Mobergslien A, Cruciani V, Wickstroem K, Schatz CA, Kneip C, Golfier S, Smeets R, Uran S, Hennekes H, Karlsson J, Bjerke RM, Ryan OB, Mumberg D, Ziegelbauer K, Cuthbertson AS. Mesothelin-Targeted Thorium-227 Conjugate (MSLN-TTC): Preclinical Evaluation of a New Targeted Alpha Therapy for Mesothelin-Positive Cancers. Clin Cancer Res 2019;25:4723-4734. https://doi.org/10.1158/1078-0432.CCR-18-3476