Neue Entwicklungen auf dem Gebiet der Theranostik

Wolfgang Weber

doi:10.1055/a-0851-1511

Der Nuklearmediziner, Table of Contents

Der Nuklearmediziner 2019; 42(01): 68-75
DOI: 10.1055/a-0851-1511

Theranostik

Neue Entwicklungen auf dem Gebiet der Theranostik

New developments in the field of theranostics

Wolfgang Weber

Klinik und Poliklinik für Nuklearmedizin, Klinikum rechts der Isar, Technische Universität München, München

› Author Affiliations

Abstract

Zusammenfassung

Diese Übersichtsarbeit stellt neue Radiopharmaka für die Tumordiagnostik und -therapie vor, die erfolgversprechende präklinische Ergebnisse gezeigt haben und aktuell in klinischen Studien untersucht werden. Dazu gehören mehrere radioaktiv markierte Antikörper wie ¹³¹I-Omburtamab, ein gegen das B7-H3-Protein gerichteter Antikörper, der zur Therapie von Neuroblastomen eingesetzt wird; HuMab-5B1, ein ⁸⁹Zr/¹⁷⁷Lu markierter Antikörper zur Therapie von CA19-9 exprimierenden Tumoren und ¹⁷⁷Lu-Lilotomab, ein Antikörper gegen das Oberflächenantigen CD37 für die Therapie von B-Zell-Lymphomen. Weitere Beispiele sind der Neurotensin Rezeptor Ligand ¹¹¹In/¹⁷⁷Lu-3B-227 für die Diagnostik und Therapie von verschiedenen Tumorerkrankungen, insbesondere Adenokarzinomen des Pankreas und der Phospholipidether ¹³¹I/¹²⁴I-CLR1404, der wahrscheinlich aufgrund einer veränderten Membranstruktur in verschiedenen Tumorzelltypen angereichert wird. Neben diesen, von Tumorzellen exprimierten Zielstrukturen wird auch das Fibroblasten Aktivierungs Protein (FAP), das im Tumorstroma gebildet wird, als Zielstruktur für die Bildgebung und Therapie eingesetzt (⁶⁸Ga/⁹⁰Y-FAPI-04). Diese neuen Radiopharmaka haben das Potenzial für die Therapie einer ganzen Reihe von Tumorerkrankungen und ihre Effektivität sollte in systematischen Studien untersucht werden.

Abstract

This review discusses new radiopharmaceuticals for the diagnosis and therapy of malignant tumors that have shown promising results in preclinical studies and are currently undergoing initial clinical studies. These include several radiolabeled antibodies, such as ¹³¹I-Omburtamab, a monoclonal antibody directed against the B7-H3 protein on the surface of Neuroblastoma cells, HuMab-5B1, a ⁸⁹Zr/¹⁷⁷Lu-labeled monoclonal antibody for the treatment of CA19-9 expressing malignancies, and ¹⁷⁷Lu-Lilotomab, a CD37 antibody for the treatment of B-cell lymphomas. Other examples include the neurotensin receptor ligand ¹¹¹In/¹⁷⁷Lu-3B-227 for imaging and therapy of several malignancies and specifically adenocarcinomas of the pancreas. The Phospholipidether ¹³¹I/¹²⁴I-CLR1404 has been shown to be accumulate in a variety of malignancies, probably because of an altered membrane structure of cancer cells. In addition to these ligands that target molecules expressed by cancer cells there are also targets for radionuclide therapy in the tumor stroma. Fibroblast activation protein (FAP) is expressed by fibroblasts in the tumor stroma and has been successfully used as ta target for imaging a variety of malignancies with ⁶⁸Ga-FAPI-04. In addition, ⁹⁰Y-FAPI-04 has been used for the treatment of selected patients with FAP positive tumor stroma. In conclusion, there is a variety of new radiopharmaceuticals for theranostic applications. Further systematic testing of these compounds in clinical trials is warranted.

Schlüsselwörter

Omburtamab - HuMab 5B1 - Lilotomab - FAPi - 3BP-227

Keywords

Omburtamab - HuMab 5B1 - Lilotomab - FAPi - 3BP-227

Full Text

References

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