[CANCER RESEARCH 58. 437-441. February I. 1998]
Comparison of 1!1In-labeled Somatostatin Analogues for Tumor Scintigraphy and
Radionuclide Therapy1
Marion de Jong,2 Wout A. P. Breeman, Willem H. Bakker, Peter P. M. Kooij, Bert F. Bernard,
Leo J. Hofland, Theo J. Visser, Ananth Srinivasan, Michelle A. Schmidt, Jack L. Erion, Joseph E. Bugaj,
Helmut R. Macke, and Eric P. Krenning
Departments of Nuclear Medicine {M. d. J.. W. A. P. B.. W. H. B.. P. P. M. K., B. F. B.. E. P. K.¡ and Internal Medicine HI ¡LJ. H.. T. J. V.. E. P. K.¡. University Hospital
Dijkziat, 3015 CD Rotterdam, the Netherlands: Mallinckrndt Medical, St. Louis. Missouri 63134 ¡A.S.. M. A. S.. J. L. E., J. E. B.¡; und Department of Nuclear Medicine.
Kunlanspital Basel. CH-4D3I Basel. Switzerland ¡H.R. M.I
ABSTRACT
We evaluated the following '"In-labeled somatostatin (SS) analogues
(diethylenetriaminepentaacetic acid, Oil'A: tetraazacyclododecanetet-
raacetic acid, DOTA): [DTPA°loctreotide, |DTPA",Tyr'loctreotide,
[DTPA°,D-Tyr'loctreotide. |DTPA°,Tyr']octreotate (Thr(ol) in octreotide
replaced with Thr|, and [DOTA°,Tyr'loctreotide, in vitro and in vivo.
In vitro, all compounds .showed high and specific binding to SS recep
tors in mouse pituitary AtT20 tumor cell membranes, and K '.,,,s were in
the nanomolar range. Furthermore, all compounds showed specific inter-
nalization in rat pancreatic tumor cells; uptake of |'"ln-
DTPA",Tyr*]octreotate was the highest of the compounds tested, and that
of |l"ln-DTPA0,l)-Tyr'loctreotide was the lowest. Biodistribution exper
iments in rats showed that, 4, 24, and 48 h after injection of |'"ln-
DTPA°,Tyr']octreotide, |mIn-DTPA0.Tyr3loctreotate, and ('"In-
DOTA°,Tyr'loctreotide, radioactivity in the octreotide-binding, receptor-
expressing tissues and tumor-to-blood ratios were significantly higher
than those after injection of ["'In-DTPA"]octreotide. Uptake of l'"ln-
DTPA°,Tyr']octreotate in the target organs was also, in vivo, the highest
of the radiolabeled peptides tested, whereas that of ['"in-DTPA",!)-
Tyr'loctreotide was the lowest. Uptake of |"'ln-DTPA",Tyr*loctreotide,
['"ln-DTPA",TyrJloctreotate, and ['"ln-DOTA0,TyrJloctreotide in tar
get tissues was blocked by >90% by 0.5 mg of unlabeled octreotide,
indicating specific binding to the octreotide receptors. Blockade of ['"In-
DTPA°,D-Tyr'loctreotide was >70%. In conclusion, radiolabeled
[DTPA°,Tyr<loctreotide and, especially, (DTPA",Tyr'|octreotate and
their DOTA-coupled counterparts are most promising for scintigraphy
and radionuclide therapy of SS receptor-positive tumors in humans.
INTRODUCTION
Radiolabeled tumor receptor-binding peptides can be used for in
vivo scintigraphic imaging. An example is SS,3 which binds to its
receptors on tumors of neuroendocrine origin ( 1). The native peptide.
however, is susceptible to very rapid enzymatic degradation (2) and is.
therefore, not useful for in vivo application. Therefore, more stable
synthetic SS analogues have been developed; e.g., the octapeptide
octreotide (Fig. 1: Ref. 3). Because octreotide cannot be radiolabeled
easily with a -y-emitting radionuclide. Tyr'-octreotide was developed,
allowing radioiodination of the molecule (Fig. 1). This compound,
radiolabeled with 125Ior I23I, was the first used in in vitro SS receptor
studies (4). tumor scintigraphy in animals (4). and in humans (1, 5).
["'ln-DTPA"]octreotide. consisting of the octapeptide octreotide and
the chelator DTPA (Fig. 1), enabling radiolabeling with a radiometal
Received 8/6/97; accepted 12/3/97.
The costs of publication of this article were defrayed in part by the payment of page
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1This work was supported by Swiss National Science Foundation Gram 31-42516/94
and the "Regionale Krebsliga beider Basel" (both to H. R. M.).
- To whom requests for reprints should be addressed, at Department of Nuclear
Medicine. V220. University Hospital Rotterdam. 3015 GD Rotterdam, the Netherlands.
Phone: 31 104635781; Fax: 31 104635997; E-mail: dejongC»'nuge.azr.nl.
3 The abbreviations used are: SS, somatostatin; DTPA. diethylenetriaminepentaacetic
acid: DOTA, tetraa/.acyclododecanetetraacelic acid; AUC, area under the curve; 7rlD,
percentage injected dose.
like '"In, was the next SS analogue to be synthesized for scintigraphy
of SS receptor-positive lesions in vivo. We have described its advan
tages over radioiodinated Tyr3-octreotide and its use for scintigraphic
imaging of SS receptor-positive lesions (6. 7).
A new and fascinating application is the use of radiolabeled oct
reotide for radionuclide therapy. Promising results with regard to
tumor growth inhibition have been reported in humans using ['"in-
DTPA"]octreotide (8). A ß particle emitter, such as ""Y, may, in
certain cases, appear more suitable for this purpose than the Auger
electron emitter '"In. However. '"'Y-DTPA is unstable, resulting
in hematopoietic toxicity in vivii; therefore, Tyr'-octreotide has
been derivatized with the DOTA chelator (Fig. 1). enabling stable
radiolabeling with **'Â¥ and "'in. (Pre)clinical studies with
[DOTA".Tyr']oetreotide showed favorable biodistribution and tumor
uptake characteristics (9-11).
The success of the therapeutic strategy relies upon the amount of
radioligand. which can be concentrated within tumor cells, and this
will, among other things, be determined by the rates of internalization.
degradation, and recycling of both ligand and receptor. We have
evaluated and compared the different mentioned "'in-chelator-pep-
tide constructs, and we have also studied some new. recently synthe
sized SS analogues, with regard to binding to octreotide receptors on
mouse pituitary tumor cell membranes and internalization in rat
pancreatic tumor cells. Furthermore, biodistribution in tumor-bearing
rats was investigated in vivo. The newly synthesized analogues tested
were [DTPA°,D-Tyr']octreotide and [DTPA°.Tyr;l]octreotate (struc
tures shown in Fig. 1).
MATERIALS AND METHODS
Labeling of Octreotide Derivatives. |DTPA"|octreotide and ' "inCI, were
provided by Mallinckrodt Medical (Petten. the Netherlands), and octreotide
was supplied by Sando/. (Basel. Switzerland). |DOTA".Tyr'|octreolide was
synthesized by H. R. M., and [DTPA",D-Tyr']octreotide. [DTPA".Tyr'l-
octreotide. and [DTPA".Tyr']octreotale were synthesized by A. S. '"In label
ing of the DTPA-analogues was as described for |DTPA"|octreotide (12),
and '"In-labeling of |DOTA".Tyr']octreotide (9) and '"l-labeling of
[Tyrl|octreotide (4) were performed as described.
In Vitro Receptor Binding Studies. Receptor binding assays were carried
out using [I2'l-Tyr']octreotide (2200 Ci/mmol) as radioligand using mouse
AtT2() pituitary tumor cell membranes (13).
Internalization. AR42J cells were grown in RPMI 1640 (Life Technolo
gies. Inc., Grand Island, NY), CA20948 cells were grown in DMEM (Life
Technologies, Inc.). and ARO cells were grown in DMEM/FI2 (Lite Tech
nologies, Inc.): tor all cell lines, medium was supplemented with 2 mM
glutamine and l()'/r FCS. Before the experiment, subcontinent cell cultures
were transferred to six-well plates.
The binding of the radiolabeled peptides to tumor cells and subsequent
internalization were studied essentially as described (14). In short, before the
experiments, cells were washed, and incubation was started by addition of 1 ml
of internalization medium/well (culture medium without PCS but with 1%
BSA) with 80 kBq of peptide (O.I nM concentration). Cells were incubated at
37°Cfor indicated periods of time. To determine nonspecific internalization.
cells were incubated with an excess unlabeled octreotide (0.1 /¿M). Cellular
437
Research.
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