Primary Preclinical and Clinical Evaluation of 68Ga-DOTA-TMVP1 as a Novel VEGFR-3 PET Imaging Radiotracer in Gynecological Cancer

Clin Cancer Res. 2020 Mar 15;26(6):1318-1326. doi: 10.1158/1078-0432.CCR-19-1845. Epub 2019 Dec 16.

Abstract

Purpose: Tumor periphery and lymph nodes of tumor-induced lymphangiogenesis often abundantly express VEGFR-3. In our previous study, we identified a 5-amino acid peptide named TMVP1, which binds specifically to VEGFR-3. The objective of this study was to develop a novel 68Ga-labeled TMVP1 for VEGFR-3 PET imaging and to investigate its safety, biodistribution, and tumor-localizing efficacy in xenograft tumor models and a small cohort of patients with recurrent ovarian and cervical cancer.

Experimental design: The DOTA-conjugated TMVP1 peptide was labeled with radionuclide 68Ga. SPR and saturation binding assays were used for the receptor-binding studies. Gynecologic xenograft tumors were employed for small-animal PET imaging and biodistribution of 68Ga-DOTA-TMVP1 in vivo. In the clinical study, 5 healthy volunteers and 8 patients with gynecologic cancer underwent whole-body PET/CT after being injected with 68Ga-DOTA-TMVP1.

Results: DOTA-TMVP1 was successfully labeled with 68Ga. LECs showed higher binding capacity with 68Ga-DOTA-TMVP1 than LEC(shVEGFR-3) and human umbilical vein endothelial cells. In mice with subcutaneous C33-A and SKOV-3 xenografts, the tracer was rapidly eliminated through the kidney to the bladder, and the small-animal PET/CT helped to clearly visualize the tumors. In patients with recurrent ovarian cancer and cervical cancer, tracer accumulation well above the background level was demonstrated in most identified sites of disease; especially with recurrent endodermal sinus tumors, the diagnostic value of 68Ga-DOTA-TMVP1 was comparable with that of 18F-FDG PET/CT.

Conclusions: 68Ga-DOTA-TMVP1 is a potential PET tracer for imaging VEGFR-3 with favorable pharmacokinetics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cell Line, Tumor
  • Drug Evaluation, Preclinical
  • Female
  • Fluorodeoxyglucose F18 / chemistry
  • Fluorodeoxyglucose F18 / pharmacokinetics*
  • Heterocyclic Compounds, 1-Ring / chemistry
  • Heterocyclic Compounds, 1-Ring / pharmacokinetics*
  • Humans
  • Mice
  • Mice, Inbred BALB C
  • Mice, Nude
  • Ovarian Neoplasms / diagnostic imaging
  • Ovarian Neoplasms / metabolism
  • Ovarian Neoplasms / pathology*
  • Peptide Fragments / chemistry
  • Peptide Fragments / pharmacokinetics*
  • Positron Emission Tomography Computed Tomography / methods*
  • Radiopharmaceuticals / chemistry
  • Radiopharmaceuticals / pharmacokinetics
  • Tissue Distribution
  • Uterine Cervical Neoplasms / diagnostic imaging
  • Uterine Cervical Neoplasms / metabolism
  • Uterine Cervical Neoplasms / pathology*
  • Vascular Endothelial Growth Factor Receptor-3 / metabolism*
  • Xenograft Model Antitumor Assays

Substances

  • Heterocyclic Compounds, 1-Ring
  • Peptide Fragments
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • 1,4,7,10-tetraazacyclododecane- 1,4,7,10-tetraacetic acid
  • FLT4 protein, human
  • Vascular Endothelial Growth Factor Receptor-3