Stability of 47Sc-complexes with acyclic polyamino-polycarboxylate ligands

Improved titanium-44 purification process for establishing a high apparent molar activity titanium-44/scandium-44 generator

44Sc-radiopharmaceuticals are gaining more interest but still lack availability. The proof of principle of a44Ti/44Sc generator, which can produce 44Sc daily, has been established but with some limitations and drawbacks. Despite recent advances, separation of 44Ti from massive quantities of scandium target material is still cumbersome. In this work, the improved radiochemical separation of 44Ti from residual scandium target material was carried out by precipitation of Sc with fluoride ions. Furthermore, two approaches were used to set up a high apparent molar activity small-scale generator. The first method relied on extraction chromatography for fine purification using a DGA resin, followed by loading of the purified 44Ti onto a ZR resin column. In the second method, 44Ti was loaded on the ZR resin directly after the precipitation step. This second method was used to set up a generator of 370 kBq and evaluate by radiolabeling. An apparent molar activity of 2 MBq/nmol was obtained for the radiolabeling with DOTA, the most common and suitable chelate for scandium. This result is comparable with previously published data on 44 m/44Sc.

Towards Clinical Development of Scandium Radioisotope Complexes for Use in Nuclear Medicine: Encouraging Prospects with the Chelator 1,4,7,10-Tetraazacyclododecane-1,4,7,10-tetraacetic Acid (DOTA) and Its Analogues

Scandium (Sc) isotopes have recently attracted significant attention in the search for new radionuclides with potential uses in personalized medicine, especially in the treatment of specific cancer patient categories. In particular, Sc-43 and Sc-44, as positron emitters with a satisfactory half-life (3.9 and 4.0 h, respectively), are ideal for cancer diagnosis via Positron Emission Tomography (PET). On the other hand, Sc-47, as an emitter of beta particles and low gamma radiation, may be used as a therapeutic radionuclide, which also allows Single-Photon Emission Computed Tomography (SPECT) imaging. As these scandium isotopes follow the same biological pathway and chemical reactivity, they appear to fit perfectly into the "theranostic pair" concept. A step-by-step description, initiating from the moment of scandium isotope production and leading up to their preclinical and clinical trial applications, is presented. Recent developments related to the nuclear reactions selected and employed to produce the radionuclides Sc-43, Sc-44, and Sc-47, the chemical processing of these isotopes and the main target recovery methods are also included. Furthermore, the radiolabeling of the leading chelator, 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid (DOTA), and its structural analogues with scandium is also discussed and the advantages and disadvantages of scandium complexation are evaluated. Finally, a review of the preclinical studies and clinical trials involving scandium, as well as future challenges for its clinical uses and applications, are presented.

Evaluation of a novel hexadentate 1,2-hydroxypyridinone-based acyclic chelate, HOPO-O6-C4, for 43Sc/47Sc, 68Ga, and 45Ti radiopharmaceuticals

INTRODUCTION

Chelators play a crucial role in the development of metal-based radiopharmaceuticals, and with the continued interest in 68Ga and increasing availability of new radiometals such as 43Sc/47Sc and 45Ti, there is a growing demand for tailored chelators that can form stable complexes with these metals. This work reports the synthesis and characterization of a hexadentate tris-1,2-hydroxypyridonone chelator HOPO-O6-C4 and its in vitro and in vivo evaluation with the above mentioned radiometals.

METHODS

To investigate the affinity of HOPO-O6-C4, macroscopic studies were performed with Sc3+, and Ga3+ followed by DFT structural optimization of the Sc3+, Ga3+ and Ti4+ complexes. Further tracer studies with 43Sc (and 47Sc), 45Ti, and 68Ga were performed to determine the potential for positron emission tomography (PET) imaging with these complexes. In vitro stability studies followed by in vivo imaging and biodistribution studies were performed to understand the kinetic stability of the resultant radiometal-complexes of HOPO-O6-C4.

RESULTS

Promising radiolabeling results with HOPO-O6-C4 were obtained with 43Sc, 47Sc, 45Ti, and 68Ga radionuclides; rapid radiolabeling was observed at 37 °C and pH 7 in under 30-min. Apparent molar activity measurements were performed for radiolabeling of HOPO-O6-C4 with 43Sc (4.9 ± 0.26 GBq/μmol), 47Sc (1.58 ± 0.01 GBq/μmol), 45Ti (11.5 ± 1.6 GBq/μmol) and 68Ga (5.74 ± 0.7 GBq/μmol), respectively. Preclinical in vivo imaging studies resulted in promising results with [68Ga]Ga-HOPO-O6-C4 indicating a rapid clearance through hepatic excretion route and no decomplexation whereas [43Sc]Sc-HOPO-O6-C4, [47Sc]Sc-HOPO-O6-C4 and [45Ti]Ti-HOPO-O6-C4 showed modest and significant evidence of decomplexation, respectively.

CONCLUSIONS

The tris-1,2-HOPO chelator HOPO-O6-C4 is a promising scaffold for elaboration into a 68Ga- based radiopharmaceutical.

Sc-HOPO: A Potential Construct for Use in Radioscandium-Based Radiopharmaceuticals

Three isotopes of scandium─43Sc, 44Sc, and 47Sc─have attracted increasing attention as potential candidates for use in imaging and therapy, respectively, as well as for possible theranostic use as an elementally matched pair. Here, we present the octadentate chelator 3,4,3-(LI-1,2-HOPO) (or HOPO), an effective chelator for hard cations, as a potential ligand for use in radioscandium constructs with simple radiolabeling under mild conditions. HOPO forms a 1:1 Sc-HOPO complex that was fully characterized, both experimentally and theoretically. [47Sc]Sc-HOPO exhibited good stability in chemical and biological challenges over 7 days. In healthy mice, [43,47Sc]Sc-HOPO cleared the body rapidly with no signs of demetalation. HOPO is a strong candidate for use in radioscandium-based radiopharmaceuticals.

Metal-Ligand Interactions in Scandium Complexes with Radiopharmaceutical Applications

The radioisotopes of scandium (43Sc, 44Sc, and 47Sc) are potential candidates for use in imaging and therapy both separately and as elementally matched pairs for radiotheranostics. In the present study the bonding interactions of Sc3+ with 18 hepta- to decadentate ligands are compared using density functional theory (DFT) calculations. The bonding analysis is based on the natural bond orbital (NBO) model. The main contributions to the bonding were assessed using natural energy decomposition analysis (NEDA). Most of the ligands have anionic character (charges from 2- to 8-); thus the electrical term determines the major differences in the interaction energies. However, interesting features were found in the covalent contributions manifested by the ligand → Sc3+ charge transfer (CT) interactions. Significant differences could be observed in the energetic contributions of the N and O donors to the total CT.

DEVELOPMENT AND ESTIMATION OF HUMAN DOSIMETRY OF A NEW 47SC-RISEDRONATE FOR RADIOPHARMACEUTICAL APPLICATION

Bisphosphonate risedronate (2-(3-pyridinyl)-1-hydroxyethane diphosphonic acid) was radiolabeled with scandium-47 (47Sc) as potential therapeutic radiopharmaceutical for skeletal metastases. Its time-dependent biodistribution in mice was measured and its human dosimetry was derived. The labelling process was performed at 95 °C for 30 min. The stability of the radio-conjugate was tested in human serum at 37 °C and its biodistribution was studied in balb/c mice. The radiochemical yield of ≥90% was obtained corresponding to a specific activity of 277 MBq/mg. The radio-conjugate showed good stability in human serum up to 48 h. A high bone uptake by 48 h post-injection was achieved, which suggests that 47Sc-risedronate may be therapeutically beneficial for the palliation of painful bone metastasis. The estimated absorbed dose coefficient and the time-integrated activity coefficient (ã (rs, TD)) in the bone were 1.35 mGy/MBq and 31.04 (Bq-h/Bq), respectively. The absorbed doses to non-osseous normal organs were much lower than that to the bone.

Synthesis, solid-state, solution, and theoretical characterization of an "in-cage" scandium-NOTA complex

Developing chelators that strongly and selectively bind rare-earth elements (Sc, Y, La, and lanthanides) represents a longstanding fundamental challenge in inorganic chemistry. Solving these challenges is becoming more important because of increasing use of rare-earth elements in numerous technologies, ranging from paramagnets to luminescent materials. Within this context, we interrogated the complexation chemistry of the scandium(III) (Sc³⁺) trication with the hexadentate 1,4,7-triazacyclononane-1,4,7-triacetic acid (H₃NOTA) chelator. This H₃NOTA chelator is often regarded as an underperformer for complexing Sc³⁺. A common assumption is that metalation does not fully encapsulate Sc³⁺ within the NOTA^3- macrocycle, leaving Sc³⁺ on the periphery of the chelate and susceptible to demetalation. Herein, we developed a synthetic approach that contradicted those assumptions. We confirmed that our procedure forced Sc³⁺ into the NOTA^3- binding pocket by using single crystal X-ray diffraction to determine the Na[Sc(NOTA)(OOCCH₃)] structure. Density functional theory (DFT) and ⁴⁵Sc nuclear magnetic resonance (NMR) spectroscopy showed Sc³⁺ encapsulation was retained when the crystals were dissolved. Solution-phase and DFT studies revealed that [Sc(NOTA)(OOCCH₃)]^1- could accommodate an additional H₂O capping ligand. Thermodynamic properties associated with the Sc-OOCCH₃ and Sc-H₂O capping ligand interactions demonstrated that these capping ligands occupied critical roles in stabilizing the [Sc(NOTA)] chelation complex.

Prospects for the production of radioisotopes and radiobioconjugates for theranostics

The development of diagnostic methods in medicine as well as the progress in the synthesis of biologically active compounds allows the use of selected radioisotopes for the simultaneous diagnosis and treatment of diseases, especially cancerous ones, in patients. This approach is called theranostic. This review article includes chemical and physical characterization of chosen theranostic radioisotopes and their compounds that are or could be useful in nuclear medicine.

High purity 47Sc production using high-energy photons and natural vanadium targets

Scandium-47 (⁴⁷Sc) is of high value for targeted radiotherapy and theranostics; we report a novel, cost-effective approach to produce high-purity ⁴⁷Sc via photonuclear reactions with natural vanadium. Irradiation at 20 MeV photon end-point energy produces >99.998% pure ⁴⁷Sc, while irradiation at 38 MeV produces 98.8 ± 1.6% pure ⁴⁷Sc. Experimental data suggest producing greater than 100 mCi (3700 MBq) of ⁴⁷Sc using this approach may be feasible. Future research into refinement and scale-up to support pre-clinical research is recommended.

Production of scandium radionuclides for theranostic applications: towards standardization of quality requirements

In the frame of "precision medicine", the scandium radionuclides have recently received considerable interest, providing personalised adjustment of radiation characteristics to optimize the efficiency of medical care or therapeutic benefit for particular groups of patients. Radionuclides of scandium, namely scandium-43 and scandium-44 (43/44Sc) as positron emitters and scandium-47 (47Sc), beta-radiation emitter, seem to fit ideally into the concept of theranostic pair. This paper aims to review the work on scandium isotopes production, coordination chemistry, radiolabeling, preclinical studies and the very first clinical studies. Finally, standardized procedures for scandium-based radiopharmaceuticals have been proposed as a basis to pave the way for elaboration of the Ph.Eur. monographs for perspective scandium radionuclides.

Recent Advances in Radiometals for Combined Imaging and Therapy in Cancer

Nuclear medicine is defined as the use of radionuclides for diagnostic and therapeutic applications. The imaging modalities positron emission tomography (PET) and single-photon emission computed tomography (SPECT) are based on γ-emissions of specific energies. The therapeutic technologies are based on β^- -particle-, α-particle-, and Auger electron emitters. In oncology, PET and SPECT are used to detect cancer lesions, to determine dosimetry, and to monitor therapy effectiveness. In contrast, radiotherapy is designed to irreparably damage tumor cells in order to eradicate or control the disease's progression. Radiometals are being explored for the development of diagnostic and therapeutic radiopharmaceuticals. Strategies that combine both modalities (diagnostic and therapeutic), referred to as theranostics, are promising candidates for clinical applications. This review provides an overview of the basic concepts behind therapeutic and diagnostic radiopharmaceuticals and their significance in contemporary oncology. Select radiometals that significantly impact current and upcoming cancer treatment strategies are grouped as clinically suitable theranostics pairs. The most important physical and chemical properties are discussed. Standard production methods and current radionuclide availability are provided to indicate whether a cost-efficient use in a clinical routine is feasible. Recent preclinical and clinical developments and outline perspectives for the radiometals are highlighted in each section.

Expanding PET-applications in life sciences with positron-emitters beyond fluorine-18

Positron-emission-tomography (PET) has become an indispensable diagnostic tool in modern nuclear medicine. Its outstanding molecular imaging features allow repetitive studies on one individual and with high sensitivity, though no interference. Rather few positron-emitters with near favourable physical properties, i.e. carbon-11 and fluorine-18, furnished most studies in the beginning, preferably if covalently bound as isotopic label of small molecules. With the advancement of PET-devices the scope of in vivo research in life sciences and especially that of medical applications expanded, and other than "standard" PET-nuclides received increasing significance, like the radiometals copper-64 and gallium-68. Especially during the last decades, positron-emitters of other chemical elements have gotten into the focus of interest, concomitant with the technical advancements in imaging and radionuclide production. With known nuclear imaging properties and main production methods of emerging positron-emitters their usefulness for medical application is promising and even proven for several ones already. Unfortunate decay properties could be corrected for, and β+-emitters, especially with a longer half-life, provided new possibilities for application where slower processes are of importance. Further on, (bio)chemical features of positron-emitters of other elements, among there many metals, not only expanded the field of classical clinical investigations, but also opened up new fields of application. Appropriately labelled peptides, proteins and nanoparticles lend itself as newer probes for PET-imaging, e.g. in theragnostic or PET/MR hybrid imaging. Furthermore, the potential of non-destructive in-vivo imaging with positron-emission-tomography directs the view on further areas of life sciences. Thus, exploiting the excellent methodology for basic research on molecular biochemical functions and processes is increasingly encouraged as well in areas outside of health, such as plant and environmental sciences.

[nat/44Sc(pypa)]-: Thermodynamic Stability, Radiolabeling, and Biodistribution of a Prostate-Specific-Membrane-Antigen-Targeting Conjugate

⁴⁴Sc is an attractive positron-emitting radionuclide for PET imaging; herein, a new complex of the Sc³⁺ ion with nonmacrocyclic chelator H₄pypa was synthesized and characterized with high-resolution electrospray-ionization mass spectrometry (HR-ESI-MS), as well as different nuclear magnetic resonance (NMR) spectroscopic techniques (¹H, ¹³C, ¹H-¹³C HSQC, ¹H-¹³C HMBC, COSY, and NOESY). In aqueous solution (pH = 7), [Sc(pypa)]^- presented two isomeric forms, the structures of which were predicted using density functional theory (DFT) calculation with a small energy difference of 22.4 kJ/mol, explaining their coexistence. [Sc(pypa)]^- was found to have superior thermodynamic stability (pM = 27.1) compared to [Sc(AAZTA)]^- (24.7) and [Sc(DOTA)]^- (23.9). In radiolabeling, [⁴⁴Sc][Sc(pypa)]^- formed efficiently at RT in 15 min over a range of pH (2-5.5), resulting in a complex that is highly stable (>99%) in mouse serum over at least six half-lives of scandium-44. Similar labeling efficiency was observed with the PSMA (prostate-specific membrane antigen)-targeting H₄pypa-C7-PSMA617 at pH = 5.5 (RT, 15 min), confirming negligible disturbance from the bifunctionalization on scandium-44 scavenging. Moreover, the kinetic inertness of the radiocomplex was proved in vivo. Surprisingly, the molar activity was found to have profound influence on the pharmacokinetics of the radiotracers where lower molar activity drastically reduced the background accumulations, particularly, kidney, and thus, yielded a much higher tumor-to-background contrast.

Radionuclide generators: the prospect of availing PET radiotracers to meet current clinical needs and future research demands

Targeted molecular imaging with positron emission tomography (PET) constitutes a successful technique for detecting and diagnosing disease conditions promptly and accurately, and for effectively prognosticating outcomes and treating patients with a tailored and more individualized intervention. In order to expand the success of PET in nuclear medicine, it is important to assure access to radiotracers of desired quantities and qualities. In this context, the benefit of accessing PET radiotracers through a radionuclide generator (RNG) cannot be overstated, as generators offer the potential of enriching the PET radiotracer arsenal at the medical centers both with and without onsite cyclotrons. While RNG technology to avail PET tracers is in its infancy, their use is expected to revitalize current PET practices and seems poised to broaden the palette of PET in nuclear medicine in the foreseeable future. In this review, we discuss the principles of RNGs, assess major parent/daughter pairs of interest for PET, RNGs currently in use in clinical PET, and identify the potentially useful RNGs which have made substantial progress or are likely to be used in daily clinical practices in the near future. Availability of the parent radionuclides required for PET RNGs is an important criterion and hence their production will also be reviewed. This overview outlines a critical assessment of RNGs to avail PET tracers, the contemporary status of RNGs, and key challenges and apertures to the near future.

Radioactive Main Group and Rare Earth Metals for Imaging and Therapy

Radiometals possess an exceptional breadth of decay properties and have been applied to medicine with great success for several decades. The majority of current clinical use involves diagnostic procedures, which use either positron-emission tomography (PET) or single-photon imaging to detect anatomic abnormalities that are difficult to visualize using conventional imaging techniques (e.g., MRI and X-ray). The potential of therapeutic radiometals has more recently been realized and relies on ionizing radiation to induce irreversible DNA damage, resulting in cell death. In both cases, radiopharmaceutical development has been largely geared toward the field of oncology; thus, selective tumor targeting is often essential for efficacious drug use. To this end, the rational design of four-component radiopharmaceuticals has become popularized. This Review introduces fundamental concepts of drug design and applications, with particular emphasis on bifunctional chelators (BFCs), which ensure secure consolidation of the radiometal and targeting vector and are integral for optimal drug performance. Also presented are detailed accounts of production, chelation chemistry, and biological use of selected main group and rare earth radiometals.

Promising Scandium Radionuclides for Nuclear Medicine: A Review on the Production and Chemistry up to In Vivo Proofs of Concept

Scandium radionuclides have been identified in the late 1990s as promising for nuclear medicine applications, but have been set aside for about 20 years. Among the different isotopes of scandium, ⁴³Sc and ⁴⁴Sc are interesting for positron emission tomography imaging, whereas ⁴⁷Sc is interesting for therapy. The ⁴⁴Sc/⁴⁷Sc or ⁴³Sc/⁴⁷Sc pairs could be thus envisaged as true theranostic pairs. Another interesting aspect of scandium is that its chemistry is governed by the trivalent ion, Sc³⁺. When combined with its hardness and its size, it gives this element a lanthanide-like behavior. It is then also possible to use it in a theranostic approach in combination with ¹⁷⁷Lu or other lanthanides. This article aims to review the progresses that have been made over the last decade on scandium isotope production and coordination chemistry. It also reviews the radiolabeling aspects and the first (pre) clinical studies performed.

Production of Sc medical radioisotopes with proton and deuteron beams

Proton and deuteron beams (15.3 and 6.8 MeV, respectively) extracted from the PETtrace medical cyclotron at the Radiopharmaceuticals Production and Research Centre in the University of Warsaw, Heavy Ion Laboratory, 28 MeV protons from the C30 cyclotron at the National Centre for Nuclear Research, Świerk, near Warsaw and 33 MeV protons from the ARRONAX accelerator, Nantes were used to produce and investigate the medically interesting Sc radioisotopes. Both natural and isotopically enriched CaCO₃ and TiO₂ targets were used (⁴²Ca, ⁴³Ca, ⁴⁴Ca, ⁴⁸Ca, ⁴⁸Ti). The production efficiency and isotopic purity were determined and are reported here for the highest commercially available enrichments of the target material. The Thick Target Yield, Activities at the End of Bombardment (EOB) and the relative activities of produced impurities at EOB are reported for ⁴³Sc, ^44gSc, ^44mSc and ⁴⁷Sc produced with particle energies below 33 MeV.

Scandium and terbium radionuclides for radiotheranostics: current state of development towards clinical application

Currently, different radiometals are in use for imaging and therapy in nuclear medicine: ⁶⁸Ga and ¹¹¹In are examples of nuclides for positron emission tomography (PET) and single photon emission computed tomography (SPECT), respectively, while ¹⁷⁷Lu and ²²⁵Ac are used for β⁻- and α-radionuclide therapy. The application of diagnostic and therapeutic radionuclides of the same element (radioisotopes) would utilize chemically-identical radiopharmaceuticals for imaging and subsequent treatment, thereby enabling the radiotheranostic concept. There are two elements which are of particular interest in this regard: Scandium and Terbium. Scandium presents three radioisotopes for theranostic application. ⁴³Sc (T_1/2 = 3.9 h) and ⁴⁴Sc (T_1/2 = 4.0 h) can both be used for PET, while ⁴⁷Sc (T_1/2 = 3.35 d) is the therapeutic match—also suitable for SPECT. Currently, ⁴⁴Sc is most advanced in terms of production, as well as with pre-clinical investigations, and has already been employed in proof-of-concept studies in patients. Even though the production of ⁴³Sc may be more challenging, it would be advantageous due to the absence of high-energetic γ-ray emission. The development of ⁴⁷Sc is still in its infancy, however, its therapeutic potential has been demonstrated preclinically. Terbium is unique in that it represents four medically-interesting radioisotopes. ¹⁵⁵Tb (T_1/2 = 5.32 d) and ¹⁵²Tb (T_1/2 = 17.5 h) can be used for SPECT and PET, respectively. Both radioisotopes were produced and tested preclinically. ¹⁵²Tb has been the first Tb isotope that was tested (as ¹⁵²Tb-DOTATOC) in a patient. Both radionuclides may be of interest for dosimetry purposes prior to the application of radiolanthanide therapy. The decay properties of ¹⁶¹Tb (T_1/2 = 6.89 d) are similar to ¹⁷⁷Lu, but the coemission of Auger electrons make it attractive for a combined β⁻/Auger electron therapy, which was shown to be effective in preclinical experiments. ¹⁴⁹Tb (T_1/2 = 4.1 h) has been proposed for targeted α-therapy with the possibility of PET imaging. In terms of production, ¹⁶¹Tb and ¹⁵⁵Tb are most promising to be made available at the large quantities suitable for future clinical translation. This review article is dedicated to the production routes, the methods of separating the radioisotopes from the target material, preclinical investigations and clinical proof-of-concept studies of Sc and Tb radionuclides. The availability, challenges of production and first (pre)clinical application, as well as the potential of these novel radionuclides for future application in nuclear medicine, are discussed.

Current advances in ligand design for inorganic positron emission tomography tracers 68Ga, 64Cu, 89Zr and 44Sc

A key part of the development of metal based Positron Emission Tomography probes is the chelation of the radiometal. In this review the recent developments in the chelation of four positron emitting radiometals, ⁶⁸Ga, ⁶⁴Cu, ⁸⁹Zr and ⁴⁴Sc, are explored. The factors that effect the chelation of each radio metal and the ideal ligand system will be discussed with regards to high in vivo stability, complexation conditions, conjugation to targeting motifs and complexation kinetics. A series of cyclic, cross-bridged and acyclic ligands will be discussed, such as CP256 which forms stable complexes with ⁶⁸Ga under mild conditions and PCB-TE2A which has been shown to form a highly stable complex with ⁶⁴Cu. ⁸⁹Zr and ⁴⁴Sc have seen significant development in recent years with a number of chelates being applied to each metal - eight coordinate di-macrocyclic terephthalamide ligands were found to rapidly produce more stable complexes with ⁸⁹Zr than the widely used DFO.

Electron linear accelerator production and purification of scandium-47 from titanium dioxide targets

The photonuclear production of no-carrier-added (NCA) ⁴⁷Sc from solid ^NatTiO₂ and the subsequent chemical processing and purification have been developed. Scandium-47 was produced by the ⁴⁸Ti(γ,p)⁴⁷Sc reaction with Bremsstrahlung photons produced from the braking of electrons in a high-Z (W or Ta) convertor. Production yields were simulated with the PHITS code (Particle and Heavy Ion Transport-code System) and compared to experimental results. Irradiated TiO₂ targets were dissolved in fuming H₂SO₄ in the presence of Na₂SO₄ and ⁴⁷Sc was purified using the commercially available Eichrom DGA resin. Typical ⁴⁷Sc recovery yields were >90% with excellent specific activity for small batches (<185 MBq batches).

Radioimmunotherapy for delivery of cytotoxic radioisotopes: current status and challenges

INTRODUCTION

Radioimmunotherapy (RIT) with monoclonal antibodies and their fragments labelled with radionuclides emitting α -particles, β-particles or Auger electrons have been used for many years in the development of anticancer strategies. While RIT has resulted in approved radiopharmaceuticals for the treatment of hematological malignancies, its use in solid tumors still remains challenging.

AREAS COVERED

In this review, we discuss the exciting progress towards elucidating the potential of current and novel radioimmunoconjugates and address the challenges for translation into clinical practice.

EXPERT OPINION

There are still technical and logistical challenges associated with the use of RIT in routine clinical practice, including development of novel and more specific targeting moieties, broader access α to α-emitters and better tailoring of pre-targeting approaches. Moreover, improved understanding of the heterogeneous nature of solid tumors and the critical role of tumor microenvironments will help to optimize clinical response to RIT by delivering sufficient radiation doses to even more radioresistant tumor cells.

Development of bone seeker radiopharmaceuticals by Scandium-47 and estimation of human absorbed dose

In this study labeling EDTMP (ethylenediamine tetra(methylene phosphonic acid)) and HEDP (Hydroxyethylidene-1, 1-Diphosphonic Acid) as the carrier ligands with Scandium-47 were investigated. The biokinetics of the bone seeking of labeled ligands with Scandium-47 were assessed by measuring the skeletal absorbed dose and then the mice data extrapolated to human absorbed dose and compared with the ^186/188Rhenium-HEDP, ¹⁵³Samarium-EDTMP dosimetry data estimated by other researchers. Because the availability of ⁴⁷Sc was limited we performed some preliminary studies using ⁴⁶Sc.

Production and purification of Scandium-47: A potential radioisotope for cancer theranostics

In this study, production of ⁴⁷Sc radionuclide by irradiating the natural titanium dioxide powder (TiO₂) in the fast neutron flux (~3*10¹³ncm^-2s^-1) for 4 days in Tehran Research Reactor (TRR, Iran) and separation from titanium target was investigated. The study showed the feasibility of production ⁴⁷Sc by TRR. The separation efficiency and radiochemical purity (ScCl₃) of radio-scandium, ⁴⁷Sc radionuclide purity were obtained 98%, 99% and 88% respectively.

Scandium(iii) complexes of monophosphorus acid DOTA analogues: a thermodynamic and radiolabelling study with 44Sc from cyclotron and from a 44Ti/44Sc generator

The influence of the phosphonic/phosphinic acid pendant arm in DOTA derivatives on properties of their Sc³⁺ complexes and efficiency of their ⁴⁴Sc labelling were investigated.

Production, biodistribution, and dosimetry of (47)Sc-1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene phosphonic acid as a bone-seeking radiopharmaceutical

In this study 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetramethylene phosphonic acid (DOTMP) was used as the polyaminophosphonic acid carrier ligand and the therapeutic potential of the bone seeking radiopharmaceutical (47)Sc-DOTMP was assessed by measuring its dosage-dependent skeletal uptake and then the absorbed radiation dose of human organs was estimated. Because of limited availability of (47)Sc we performed some preliminary studies using (46)Sc. (46)Sc was produced with a specific activity of 116.58 MBq/mg (3.15 mCi/mg) and radionuclide purity of 98%. (46)Sc-DOTMP was prepared and an activity of 1.258 MBq (34 μCi) at a chelant-to-metal ratio of 60:1 was administered to five groups of mice with each group containing 3 mice that were euthanized at 4, 24, 48, 96 and 192 h post administration. The heart, lungs, liver, spleen, kidneys, intestine, skin, muscle, and a femur were excised, weighed, and counted. The data were analyzed to determine skeletal uptake and source organ residence times and cumulated activities for (47)Sc-DOTMP. (46)Sc-DOTMP complex was prepared in radiochemical purity about 93%. In vitro stability of complex was evaluated at room temperature for 48 h. Biodistribution studies of complex in mice were studied for 7 days. The data were analyzed to estimate skeletal uptake and absorbed radiation dose of human organs using biodistribution data from mice. By considering the results, (47)Sc-DOTMP is a possible therapeutic agent for using in palliation of bone pain due to metastatic skeletal lesions from several types of primary cancers in prostate, breast, etc.

A comparative thermodynamic study of the formation of scandium complexes with DTPA and DOTA

The complexation of scandium(iii) by various polyaminopolycarboxylic ligands (DTPA and DOTA) was studied by capillary electrophoresis with ICP-MS detection in 0.1 mol L⁻¹ NaCl ionic strength solutions at 25 °C.

Matching chelators to radiometals for radiopharmaceuticals

Radiometals comprise many useful radioactive isotopes of various metallic elements. When properly harnessed, these have valuable emission properties that can be used for diagnostic imaging techniques, such as single photon emission computed tomography (SPECT, e.g.(67)Ga, (99m)Tc, (111)In, (177)Lu) and positron emission tomography (PET, e.g.(68)Ga, (64)Cu, (44)Sc, (86)Y, (89)Zr), as well as therapeutic applications (e.g.(47)Sc, (114m)In, (177)Lu, (90)Y, (212/213)Bi, (212)Pb, (225)Ac, (186/188)Re). A fundamental critical component of a radiometal-based radiopharmaceutical is the chelator, the ligand system that binds the radiometal ion in a tight stable coordination complex so that it can be properly directed to a desirable molecular target in vivo. This article is a guide for selecting the optimal match between chelator and radiometal for use in these systems. The article briefly introduces a selection of relevant and high impact radiometals, and their potential utility to the fields of radiochemistry, nuclear medicine, and molecular imaging. A description of radiometal-based radiopharmaceuticals is provided, and several key design considerations are discussed. The experimental methods by which chelators are assessed for their suitability with a variety of radiometal ions is explained, and a large selection of the most common and most promising chelators are evaluated and discussed for their potential use with a variety of radiometals. Comprehensive tables have been assembled to provide a convenient and accessible overview of the field of radiometal chelating agents.