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      Leveraging PET to image folate receptor α therapy of an antibody-drug conjugate

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          Abstract

          Background

          The folate receptor α (FRα)-targeting antibody-drug conjugate (ADC), IMGN853, shows great antitumor activity against FRα-expressing tumors in vivo, but patient selection and consequently therapy outcome are based on immunohistochemistry. The aim of this study is to develop an antibody-derived immuno-PET imaging agent strategy for targeting FRα in ovarian cancer as a predictor of treatment success.

          Methods

          We developed [ 89Zr]Zr-DFO-M9346A, a humanized antibody-based radiotracer targeting tumor-associated FRα in the preclinical setting. [ 89Zr]Zr-DFO-M9346A’s binding ability was tested in an in vitro uptake assay using cell lines with varying FRα expression levels. The diagnostic potential of [ 89Zr]Zr-M9346A was evaluated in KB and OV90 subcutaneous xenografts. Following intravenous injection of [ 89Zr]Zr-DFO-M9346A (~90 μCi, 50 μg), PET imaging and biodistribution studies were performed. We determined the blood half-life of [ 89Zr]Zr-DFO-M9346A and compared it to the therapeutic, radioiodinated ADC [ 131I]-IMGN853. Finally, in vivo studies using IMG853 as a therapeutic, paired with [ 89Zr]Zr-DFO-M9346A as a companion diagnostic were performed using OV90 xenografts.

          Results

          DFO-M9346A was labeled with Zr-89 at 37 °C within 60 min and isolated in labeling yields of 85.7 ± 5.7%, radiochemical purities of 98.0 ± 0.7%, and specific activities of 3.08 ± 0.43 mCi/mg. We observed high specificity for binding FRα positive cells in vitro. For PET and biodistribution studies, [ 89Zr]Zr-M9346A displayed remarkable in vivo performance in terms of excellent tumor uptake for KB and OV xenografts (45.8 ± 29.0 %IA/g and 26.1 ± 7.2 %IA/g), with low non-target tissue uptake in other organs such as kidneys (4.5 ± 1.2 %IA/g and 4.3 ± 0.7 %IA/g). A direct comparison of the blood half life of [ 89Zr]Zr-M9346A and [ 131I]-IMGN853 corroborated the equivalency of the radiopharmaceutical and the ADC, paving the way for a companion PET imaging study.

          Conclusions

          We developed a new folate receptor-targeted 89Zr-labeled PET imaging agent with excellent pharmacokinetics in vivo. Good tumor uptake in subcutaneous KB and OV90 xenografts were obtained, and ADC therapy studies were performed with the precision predictor.

          Electronic supplementary material

          The online version of this article (10.1186/s13550-018-0437-x) contains supplementary material, which is available to authorized users.

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          Most cited references22

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          The role of folate receptor alpha in cancer development, progression and treatment: cause, consequence or innocent bystander?

          Folate receptor alpha (FRalpha) is a membrane-bound protein with high affinity for binding and transporting physiologic levels of folate into cells. Folate is a basic component of cell metabolism and DNA synthesis and repair, and rapidly dividing cancer cells have an increased requirement for folate to maintain DNA synthesis, an observation supported by the widespread use of antifolates in cancer chemotherapy. FRalpha levels are high in specific malignant tumors of epithelial origin compared to normal cells, and are positively associated with tumor stage and grade, raising questions of its role in tumor etiology and progression. It has been suggested that FRalpha might confer a growth advantage to the tumor by modulating folate uptake from serum or by generating regulatory signals. Indeed, cell culture studies show that expression of the FRalpha gene, FOLR1, is regulated by extracellular folate depletion, increased homocysteine accumulation, steroid hormone concentrations, interaction with specific transcription factors and cytosolic proteins, and possibly genetic mutations. Whether FRalpha in tumors decreases in vivo among individuals who are folate sufficient, or whether the tumor's machinery sustains FRalpha levels to meet the increased folate demands of the tumor, has not been studied. Consequently, the significance of carrying a FRalpha-positive tumor in the era of folic acid fortification and widespread vitamin supplement use in countries such as Canada and the United States is unknown. Epidemiologic and clinical studies using human tumor specimens are lacking and increasingly needed to understand the role of environmental and genetic influences on FOLR1 expression in tumor etiology and progression. This review summarizes the literature on the complex nature of FOLR1 gene regulation and expression, and suggests future research directions. 2006 Wiley-Liss, Inc.
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            Distribution, functionality and gene regulation of folate receptor isoforms: implications in targeted therapy.

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              Conjugation and radiolabeling of monoclonal antibodies with zirconium-89 for PET imaging using the bifunctional chelate p-isothiocyanatobenzyl-desferrioxamine.

              The positron emitter zirconium-89 ((89)Zr) has very attractive properties for positron emission tomography (PET) imaging of intact monoclonal antibodies (mAbs) using immuno-PET. This protocol describes the step-by-step procedure for the facile radiolabeling of mAbs or other proteins with (89)Zr using p-isothiocyanatobenzyl-desferrioxamine (Df-Bz-NCS). First, Df-Bz-NCS is coupled to the lysine-NH(2) groups of a mAb at pH 9.0 (pre-modification), followed by purification using gel filtration. Next, the pre-modified mAb is labeled at room temperature by the addition of [(89)Zr]Zr-oxalic acid solution followed by purification using gel filtration. The entire process of pre-modification, radiolabeling and purification steps will take about 2.5 h.
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                Author and article information

                Contributors
                brandc@mskcc.org
                Ahmad.sadique06@gmail.com
                jacob.houghton@vanderbilt.edu
                gangangk@mskcc.org
                joe.ponte@immunogen.com
                lewisj2@mskcc.org
                pillarsn@mskcc.org
                konnerj@mskcc.org
                reinert@mskcc.org
                Journal
                EJNMMI Res
                EJNMMI Res
                EJNMMI Research
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2191-219X
                28 August 2018
                28 August 2018
                2018
                : 8
                : 87
                Affiliations
                [1 ]ISNI 0000 0001 2171 9952, GRID grid.51462.34, Department of Radiology, , Memorial Sloan Kettering Cancer Center, ; 1275 York Avenue, New York, NY 10065 USA
                [2 ]ISNI 0000 0001 0170 7903, GRID grid.253482.a, Department of Chemistry, Hunter College and PhD Program in Chemistry, , The Graduate Center of the City University of New York, ; New York, NY USA
                [3 ]GRID grid.420937.b, ImmunoGen, Inc, ; Waltham, MA USA
                [4 ]ISNI 0000 0001 2171 9952, GRID grid.51462.34, Molecular Pharmacology Program, , Memorial Sloan Kettering Cancer Center, ; New York, NY USA
                [5 ]ISNI 000000041936877X, GRID grid.5386.8, Department of Radiology, , Weill Cornell Medical College, ; New York, NY 620 USA
                [6 ]ISNI 0000 0001 2171 9952, GRID grid.51462.34, Department of Medicine, , Memorial Sloan Kettering Cancer Center, ; New York, NY USA
                Article
                437
                10.1186/s13550-018-0437-x
                6113196
                30155674
                99c46818-7b66-4099-b3b7-7ee9a1b985fb
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 9 May 2018
                : 7 August 2018
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100000002, National Institutes of Health;
                Award ID: R01 CA20441
                Award ID: P30 CA008748
                Award Recipient :
                Categories
                Original Research
                Custom metadata
                © The Author(s) 2018

                Radiology & Imaging
                89zr,companion diagnostic,pet imaging,antibody-drug-conjugate
                Radiology & Imaging
                89zr, companion diagnostic, pet imaging, antibody-drug-conjugate

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