First-in-human uPAR PET: Imaging of Cancer Aggressiveness
Morten Persson, Dorthe Skovgaard, Malene Brandt-Larsen, Camilla Christensen, Jacob Madsen, Carsten H Nielsen, Tine Thurison, Thomas Levin Klausen, Søren Holm, Annika Loft, Anne Kiil Berthelsen, Michael Ploug, Helle Pappot, Klaus Brasso, Niels Kroman, Liselotte Højgaard, Andreas Kjaer, Morten Persson, Dorthe Skovgaard, Malene Brandt-Larsen, Camilla Christensen, Jacob Madsen, Carsten H Nielsen, Tine Thurison, Thomas Levin Klausen, Søren Holm, Annika Loft, Anne Kiil Berthelsen, Michael Ploug, Helle Pappot, Klaus Brasso, Niels Kroman, Liselotte Højgaard, Andreas Kjaer
Abstract
A first-in-human clinical trial with Positron Emission Tomography (PET) imaging of the urokinase-type plasminogen activator receptor (uPAR) in patients with breast, prostate and bladder cancer, is described. uPAR is expressed in many types of human cancers and the expression is predictive of invasion, metastasis and indicates poor prognosis. uPAR PET imaging therefore holds promise to be a new and innovative method for improved cancer diagnosis, staging and individual risk stratification. The uPAR specific peptide AE105 was conjugated to the macrocyclic chelator DOTA and labeled with (64)Cu for targeted molecular imaging with PET. The safety, pharmacokinetic, biodistribution profile and radiation dosimetry after a single intravenous dose of (64)Cu-DOTA-AE105 were assessed by serial PET and computed tomography (CT) in 4 prostate, 3 breast and 3 bladder cancer patients. Safety assessment with laboratory blood screening tests was performed before and after PET ligand injection. In a subgroup of the patients, the in vivo stability of our targeted PET ligand was determined in collected blood and urine. No adverse or clinically detectable side effects in any of the 10 patients were found. The ligand exhibited good in vivo stability and fast clearance from plasma and tissue compartments by renal excretion. In addition, high uptake in both primary tumor lesions and lymph node metastases was seen and paralleled high uPAR expression in excised tumor tissue. Overall, this first-in-human study therefore provides promising evidence for safe use of (64)Cu-DOTA-AE105 for uPAR PET imaging in cancer patients.
Keywords: PET; clinical trial; uPAR.
Conflict of interest statement
Competing interests: MPE, JM & AK are inventor of a patent on the composition of matter of uPAR PET. MPE, JM, CHN & AK are co-founders of a start-up company (Curasight) that has licensed the uPAR PET patent and is currently raising funds to commercialize uPAR PET technology. Pending patent for MPE, JM & AK: Positron Emitting Radionuclides Labeled Peptides for Human uPAR PET Imaging (WO 2014/086364 A1). The authors declare that their spouses, partners, or children have no financial relationships relevant to the submitted work. Inquiries should be directed to the corresponding author.
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