目的:PSMA(前列腺特异性膜抗原)在前列腺癌(PrCa)细胞上高表达,并广泛用作PrCa治疗的归巢靶标。最突出的是,靶向PSMA的缀合物PSMA-617携带DOTA螯合剂,并用治疗性放射性核素如β-发射的of-177或α-发射的act-225标记,已在PrCa患者中显示出临床活性。我们寻求开发PSMA靶向小分子(SMOL)缀合物,在表达PSMA的肿瘤中显示高摄取和快速清除,并且可以很容易地用α发射体钍-227标记(半衰期18.7天)。
方法:鉴定了在表达PSMA的LNCaP细胞上对3H-PSMA-617具有改善的竞争的新型接头基序。开发了一种用羧基修饰的2,3-羟基吡啶酮螯合剂(羧基-HOPO),具有增加的亲水性和用钍-227的强大标记,并允许合成单-,di-,三-,和四聚体缀合物。评估所得单体和多聚体PSMASMOL-TTC(靶向钍缀合物)的细胞结合,内化,和抗增殖活性。在小鼠的ST1273和KUCaP-1PrCa模型中确定了PSMASMOL-TTC的体内抗肿瘤功效,在食蟹猴中评估了它们的生物分布,迷你猪,和老鼠。
结果:单体和多聚体PSMASMOL偶联物在室温下容易被钍-227标记,具有很高的稳定性和良好的结合性,内化,和体外抗增殖活性。在体内,单体,二聚体,三聚体PSMASMOL-TTC显示出快速清除,有效的抗肿瘤功效,以及在小鼠前列腺肿瘤中的高摄取和保留。在肾脏以外的其他器官中未观察到主要的摄取或保留。游离钍-227在骨骼中的低摄取证实了体内高复合物稳定性。唾液腺的摄取仍然不确定,因为小型猪作为相关模型被贬值,而食蟹猴的成像对照失败。
结论:单体和多聚PSMASMOL-TTC在临床前模型中显示出高肿瘤摄取和快速清除,需要进一步的治疗探索。
OBJECTIVE: PSMA (prostate-specific membrane antigen) is highly expressed on prostate cancer (PrCa) cells and extensively used as a homing target for PrCa treatment. Most prominently, PSMA-targeting conjugate PSMA-617, carrying a DOTA chelator and labeled with therapeutic radionuclides like beta-emitting lutetium-177 or alpha-emitting actinium-225, has shown clinical activity in PrCa patients. We sought to develop PSMA-targeting small molecule (SMOL) conjugates that show high uptake in PSMA-expressing tumors and fast clearance, and can easily be labeled with the alpha emitter
thorium-227 (half-life 18.7 days).
METHODS: A novel linker motif with improved competition against 3H-PSMA-617 on PSMA-expressing LNCaP cells was identified. A 2,3-hydroxypyridinone chelator modified with carboxyl groups (carboxy-HOPO) with increased hydrophilicity and robust labeling with
thorium-227 was developed and allowed the synthesis of mono-, di-, tri-, and tetrameric conjugates. The resulting monomeric and multimeric PSMA SMOL-TTCs (targeted
thorium conjugate) were evaluated for cellular binding, internalization, and antiproliferative activity. The in vivo antitumor efficacy of the PSMA SMOL-TTCs was determined in ST1273 and KUCaP-1 PrCa models in mice, and their biodistribution was assessed in cynomolgus monkeys, minipigs, and mice.
RESULTS: The monomeric and multimeric PSMA SMOL conjugates were readily labeled with
thorium-227 at room temperature and possessed high stability and good binding, internalization, and antiproliferative activity in vitro. In vivo, the monomeric, dimeric, and trimeric PSMA SMOL-TTCs showed fast clearance, potent antitumor efficacy, and high uptake and retention in prostate tumors in mice. No major uptake or retention in other organs was observed beyond kidneys. Low uptake of free
thorium-227 into bone confirmed high complex stability in vivo. Salivary gland uptake remained inconclusive as mini pigs were devalidated as a relevant model and imaging controls failed in cynomolgus monkeys.
CONCLUSIONS: Monomeric and multimeric PSMA SMOL-TTCs show high tumor uptake and fast clearance in preclinical models and warrant further therapeutic exploration.