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Boschi A, Urso L, Uccelli L, Martini P, Filippi L. 99mTc-labeled FAPI compounds for cancer and inflammation: from radiochemistry to the first clinical applications. EJNMMI Radiopharm Chem 2024; 9:36. [PMID: 38695960 PMCID: PMC11065808 DOI: 10.1186/s41181-024-00264-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 04/22/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND In recent years, fibroblast activating protein (FAP), a biomarker overexpressed by cancer-associated fibroblasts, has emerged as one of the most promising biomarkers in oncology. Similarly, FAP overexpression has been detected in various fibroblast-mediated inflammatory conditions such as liver cirrhosis and idiopathic pulmonary fibrosis. Along this trajectory, FAP-targeted positron emission tomography (PET), utilizing FAP inhibitors (FAPi) labeled with positron emitters, has gained traction as a powerful imaging approach in both cancer and inflammation. However, PET represents a high-cost technology, and its widespread adoption is still limited compared to the availability of gamma cameras. To address this issue, several efforts have been made to explore the potential of [99mTc]Tc-FAPi tracers as molecular probes for imaging with gamma cameras and single photon emission computed tomography (SPECT). MAIN BODY Several approaches have been investigated for labeling FAPi-based compounds with 99mTc. Specifically, the mono-oxo, tricarbonyl, isonitrile, and HYNIC strategies have been applied to produce [99mTc]Tc-FAPi tracers, which have been tested in vitro and in animal models. Overall, these labeling approaches have demonstrated high efficiency and strong binding. The resulting [99mTc]Tc-FAPi tracers have shown high specificity for FAP-positive cells and xenografts in both in vitro and animal model studies, respectively. However, the majority of [99mTc]Tc-FAPi tracers have exhibited variable levels of lipophilicity, leading to preferential excretion through the hepatobiliary route and undesirable binding to lipoproteins. Consequently, efforts have been made to synthesize more hydrophilic FAPi-based compounds to improve pharmacokinetic properties and achieve a more favorable biodistribution, particularly in the abdominal region. SPECT imaging with [99mTc]Tc-FAPi has yielded promising results in patients with gastrointestinal tumors, demonstrating comparable or superior diagnostic performance compared to other imaging modalities. Similarly, encouraging outcomes have been observed in subjects with gliomas, lung cancer, breast cancer, and cervical cancer. Beyond oncological applications, [99mTc]Tc-FAPi-based imaging has been successfully employed in myocardial and idiopathic pulmonary fibrosis. CONCLUSIONS This overview focuses on the various radiochemical strategies for obtaining [99mTc]Tc-FAPi tracers, highlighting the main challenges encountered and possible solutions when applying each distinct approach. Additionally, it covers the preclinical and initial clinical applications of [99mTc]Tc-FAPi in cancer and inflammation.
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Affiliation(s)
- Alessandra Boschi
- Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, Via L. Borsari, 46, 44121, Ferrara, Italy
| | - Luca Urso
- Department of Translational Medicine, University of Ferrara, Via Fossato di Mortara, 70 c/o viale Eliporto, 44121, Ferrara, Italy
- Nuclear Medicine Unit, Ferrara Hospital, Via A. Moro, 8, 44124, Ferrara, Italy
| | - Licia Uccelli
- Department of Translational Medicine, University of Ferrara, Via Fossato di Mortara, 70 c/o viale Eliporto, 44121, Ferrara, Italy.
- Nuclear Medicine Unit, Ferrara Hospital, Via A. Moro, 8, 44124, Ferrara, Italy.
| | - Petra Martini
- Department of Environmental and Prevention Sciences, University of Ferrara, Via L. Borsari, 46 44121, Ferrara, Italy.
| | - Luca Filippi
- Nuclear Medicine Unit, Department of Oncohaematology, Fondazione PTV Policlinico Tor Vergata University Hospital, Rome, Italy
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Abstract
The knowledge on element 43 (Tc) of the periodic table, built over the years through the contributions given by the close relationship between chemistry and nuclear medicine, allowed the development of new and increasingly effective radiopharmaceuticals useful both as perfusion and target specific imaging agents for SPECT (single photon emission tomography). Among the manifold Tc-compounds, Tc(V) nitrido complexes played a relevant role in the search for new technetium-99m radiopharmaceuticals, providing efficient labeling procedures that can be conveniently exploited for the design and synthesis of agents, also incorporating small organic molecules or peptides having defined structural features. With this work, we present an overview of four decades of research on the chemistry and on the nuclear medicine applications of Tc(V) nitrido complexes.
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Ma H, Li S, Wu Z, Liu J, Liu H, Guo X. Comparison of ⁹⁹mTc-N-DBODC5 and ⁹⁹mTc-MIBI of myocardial perfusion imaging for diagnosis of coronary artery disease. BIOMED RESEARCH INTERNATIONAL 2013; 2013:145427. [PMID: 23841052 PMCID: PMC3693116 DOI: 10.1155/2013/145427] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 05/20/2013] [Indexed: 11/28/2022]
Abstract
Despite recent advances in therapeutic and diagnostic approaches, coronary artery disease (CAD) and its related cardiac disorders represent the most common cause of death in the United States. Nuclear myocardial perfusion imaging (MPI) technologies play a pivotal role in the diagnosis and treatment design for CAD. Recently, in order to develop improved MPI agents for diagnosis of CAD, (99m)Tc-[bis(dimethoxypropylphosphinoethyl)-ethoxyethyl-amine(PNP5)]-[bis(N-ethoxyethyl)dithiocarbamato(DBODC)]nitride(N-DBODC5)((99m)Tc-N-DBODC5) with a faster liver clearance than conventional single-photon emission computed tomography (SPECT) imaging agents (technetium 99m sestamibi ((99m)Tc-MIBI) or technetium 99m tetrofosmin) has been introduced. In preclinical and phase I studies, (99m)Tc-N-DBODC5 has shown characteristics of an essentially ideal MPI tracer. Importantly, however, there is no data to support the use of (99m)Tc-N-DBODC5 to evaluate myocardial ischemia in patients with suspected CAD. The present study was designed to assess the clinical value of this agent; the findings of stress and rest MPI after the administration of this agent were compared to those of stress and rest (99m)Tc-MIBI, as well as those of coronary angiography, with respect to the detection of CAD. Our findings indicated the usefulness of (99m)Tc-N-DBODC5 as a promising MPI agent.
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Affiliation(s)
- Haiyan Ma
- Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, 85 Jiefang South Road, Taiyuan, Shanxi 030001, China
| | - Sijin Li
- Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, 85 Jiefang South Road, Taiyuan, Shanxi 030001, China
| | - Zhifang Wu
- Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, 85 Jiefang South Road, Taiyuan, Shanxi 030001, China
| | - Jianzhong Liu
- Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, 85 Jiefang South Road, Taiyuan, Shanxi 030001, China
| | - Haiyan Liu
- Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, 85 Jiefang South Road, Taiyuan, Shanxi 030001, China
| | - Xiaoshan Guo
- Department of Nuclear Medicine, First Affiliated Hospital of Shanxi Medical University, 85 Jiefang South Road, Taiyuan, Shanxi 030001, China
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Wei L, Bensimon C, Lockwood J, Yan X, Fernando P, Glenn Wells R, Duan Y, Chen YX, Russell Redshaw J, Covitz PA, Ruddy TD. Synthesis and characterization of 123I-CMICE-013: A potential SPECT myocardial perfusion imaging agent. Bioorg Med Chem 2013; 21:2903-11. [DOI: 10.1016/j.bmc.2013.03.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2013] [Revised: 03/16/2013] [Accepted: 03/26/2013] [Indexed: 10/27/2022]
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Mendes F, Gano L, Fernandes C, Paulo A, Santos I. Studies of the myocardial uptake and excretion mechanisms of a novel 99mTc heart perfusion agent. Nucl Med Biol 2011; 39:207-13. [PMID: 22079035 DOI: 10.1016/j.nucmedbio.2011.08.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 08/01/2011] [Accepted: 08/08/2011] [Indexed: 11/20/2022]
Abstract
INTRODUCTION (99m)Tc-TMEOP is a novel heart perfusion radiotracer exhibiting high initial and persistent heart uptake associated with rapid blood and liver clearance. This study aimed at determining the mechanisms of myocardial localization and fast liver clearance of (99m)Tc-TMEOP. METHODS Subcellular distribution of (99m)Tc-TMEOP was determined in excised rat heart tissue by differential centrifugation. The effect of cyclosporin A on the pharmacokinetic behaviour of (99m)Tc-TMEOP was evaluated by both ex vivo biodistribution and in vivo planar imaging studies. RESULTS Subcellular distribution studies showed that more than 73% of (99m)Tc-TMEOP was associated with the mitochondrial fraction. Comparison with subcellular distribution of (99m)Tc-sestamibi showed no significant difference in the mitochondrial accumulation between the two tracers. Biodistribution studies in the presence of cyclosporin A revealed an increase in kidneys and liver uptake of (99m)Tc-TMEOP, suggesting the involvement of multidrug resistance transporters in determining its pharmacokinetic profile. CONCLUSIONS The heart uptake mechanism of (99m)Tc-TMEOP is similar to that of the other reported monocationic (99m)Tc cardiac agents and is associated with its accumulation in the mitochondria. Cyclosporin A studies indicate that the fast liver and kidney clearance kinetics is mediated by P-glycoprotein (Pgp), supporting the potential interest of this radiotracer for imaging Pgp function associated with multidrug-resistant tumours.
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Affiliation(s)
- Filipa Mendes
- Unidade de Ciências Químicas e Radiofarmacêuticas, Instituto Tecnológico e Nuclear, Estrada Nacional 10, 2686-953 Sacavém, Portugal.
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Goethals LR, Santos I, Caveliers V, Paulo A, De Geeter F, Lurdes PG, Fernandes C, Lahoutte T. Rapid hepatic clearance of 99mTc-TMEOP: a new candidate for myocardial perfusion imaging. CONTRAST MEDIA & MOLECULAR IMAGING 2010; 6:178-88. [DOI: 10.1002/cmmi.413] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2010] [Revised: 06/29/2010] [Accepted: 07/29/2010] [Indexed: 11/06/2022]
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Bolzati C, Cavazza-Ceccato M, Agostini S, Tisato F, Bandoli G. Technetium and rhenium in five-coordinate symmetrical and dissymmetrical nitrido complexes with alkyl phosphino-thiol ligands. Synthesis and structural characterization. Inorg Chem 2009; 47:11972-83. [PMID: 19007158 DOI: 10.1021/ic801436d] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The reactivity of bulky alkylphosphino-thiol ligands (PSH) toward nitride-M(V, VI) (M = Tc/Re) precursors was investigated. Neutral five-coordinate monosubstituted complexes of the type [M(N)(PS)Cl(PPh(3))] (Tc1-4, Re1-2) were prepared in moderate to high yields. It was found that these [M(N)(PS)Cl(PPh(3))] species underwent ligand-exchange reactions under mild conditions when reacted with bidentate mononegative ligands having soft donor atoms such as dithiocarbamates (NaL(n)) to afford stable dissymmetrical mixed-substituted complexes of the type [M(N)(PS)(L(n))] (Tc5,8-10, Re5-9) containing two different bidentate chelating ligands bound to the [M[triple bond]N](2+) moiety. In these reactions, the dithiocarbamate replaced the two labile monodentate ligands (Cl and PPh(3)) leaving the [M(N)(PS)](+) building block intact. In the above reactions, technetium and rhenium were found to behave in a similar way. Instead, under more drastic conditions, reactions of PSH with [M(N)Cl(2)(PPh(3))(2)] gave a mixture of monosubstituted [M(N)(PS)Cl(PPh(3))] and bis-substituted species [M(N)(PS)(2)] (Tc11-14) in the case of technetium, whereas only monosubstituted [M(N)(PS)Cl(PPh(3))] complexes were recovered for rhenium. All isolated products were characterized by elemental analysis, IR and multinuclear ((1)H, (13)C, and (31)P) NMR spectroscopies, ESI MS spectrometry, and X-ray crystal structure determination of the representative monosubstituted [Tc(N)(PStbu)Cl(PPh(3))] (Tc4) and mixed-substituted [Re(N)(PScy)(L(3))] (Re7) and [Re(N)(PSiso)(L(4))] (Re9) complexes. The latter rhenium complexes represent the first example of a square-pyramidal nitrido Re species with the basal plane defined by a PS(3) donor set. Monosubstituted [M(N)(PS)Cl(PPh(3))] species bearing the substitution-inert [M(N)(PS)](+) moieties act as suitable building blocks proposed for the construction of new classes of dissymmetrical nitrido compounds with potential application in the development of essential and target specific (99m)Tc and (188)Re radiopharmaceuticals for imaging and therapy, respectively.
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Zhang WC, Fang W, Li B, Wang XB, He ZX. Experimental Study of [ 99mTc(PNP5) (DBODC)] + as a New Myocardial Perfusion Imaging Agent. Cardiology 2009; 112:89-97. [DOI: 10.1159/000141013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2007] [Accepted: 02/08/2008] [Indexed: 11/19/2022]
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Mathur A, Mallia MB, Subramanian S, Banerjee S, Kothari K, Dhotare B, Sarma HD, Venkatesh M. 99mTcN complexes of tert-butyl dithiocarbamate and methoxyisobutyl dithiocarbamate as myocardial and brain imaging agents. Nucl Med Commun 2005; 26:1013-9. [PMID: 16208180 DOI: 10.1097/01.mnm.0000183793.51474.2f] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Two ligands viz. tert-butyl dithiocarbamate (TBDTC) and methoxyisobutyl dithiocarbamate (MIBDTC), which are analogous to the tert-butyl isonitrile (TBI) and sestamibi (MIBI) ligands, were synthesized and labelled with the [99mTcN] core to evaluate their potential as myocardial agents. As these complexes have low molecular weights, and are neutral and lipophilic in nature, they have a tendency to cross the blood-brain barrier and thus deserve evaluation as potential brain perfusion imaging agents. METHODS The dithiocarbamate ligands were synthesized from their respective amines, i.e., tert-butylamine and methoxyisobutylamine, by reacting with carbon disulfide in dry ether in the presence of crushed sodium hydroxide. The ligands were characterized by elemental analyses. The 99mTc-nitrido intermediate was prepared from 99mTcO(-)4 using commercially available nitrido kits. The complexation was carried out by mixing the freshly prepared 99mTc-nitrido intermediate and the ligand followed by incubation at room temperature for 10 min. These complexes were characterized by high-performance liquid chromatography (HPLC) using a C-18 reversed phase column with acetonitrile:water as the mobile phase, and by paper electrophoresis. Biodistribution studies were carried out in normal Swiss mice. RESULTS The ligands were synthesized in near quantitative yields. They were radiolabelled in > 95% yields using the 99mTc-nitrido core, at low ligand concentrations of 0.01 mg . ml(-1) (5.8 x 10(-5) M) for TBDTC and 1 mg . ml(-1) (4.8 x 10(-3) M) for MIBDTC, respectively. Both the complexes were found to be neutral and eluted out as single species in HPLC. Both the complexes showed myocardial as well as brain uptake. The 99mTcN(TBDTC)2 complex showed a better heart/blood and heart/lung ratio when compared to 99mTcN(NOEt)2, an agent in phase III clinical trials proposed for myocardial imaging. This complex also showed brain uptake (3.74%ID/g) at 10 min post-injection (p.i.) with brain/blood ratios better than that of the standard agent 99mTc-D,L-HMPAO at all time points studied. 99mTcN(MIBDTC)2 showed myocardial uptake of 6.41%ID/g at 5 min p.i., which decreased to 1.76%ID/g, 60 min p.i. 99mTcN(MIBDTC)2 also showed good brain uptake (3.21%ID/g at 5 min p.i.) but relatively fast washout (1.33%ID/g at 60 min p.i.) from the target organ. CONCLUSION Both the complexes under study showed myocardial as well as brain uptake. The results obtained with 99mTcN(TBDTC)2 shows promise towards its development as a potential brain imaging agent.
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Affiliation(s)
- Anupam Mathur
- Medical and Biological Products Program, Board of Radiation and Isotope Technology, Mumbai, 400094, India
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Hamel M, Grach G, Abrunhosa I, Gulea M, Masson S, Vazeux M, Drabowicz J, Mikolajczyk M. Asymmetric oxidation of sulfenates to sulfinates as a new route to optically active ortho-phosphorylated phenyl sulfoxides. ACTA ACUST UNITED AC 2005. [DOI: 10.1016/j.tetasy.2005.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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