Phase I Trial of 99mTc-(HE)3-G3, a DARPin-Based Probe for Imaging of HER2 Expression in Breast Cancer.

Abstract

Radionuclide molecular imaging of human epidermal growth factor receptor type 2 (HER2) expression may enable a noninvasive discrimination between HER2-positive and HER2-negative breast cancers for stratification of patients for HER2-targeted treatments. DARPin (designed ankyrin repeat proteins) G3 is a small (molecular weight, 14 kDa) scaffold protein with picomolar affinity to HER2. The aim of this first-in-humans study was to evaluate the safety, biodistribution, and dosimetry of 99mTc-(HE)3-G3. Methods: Three cohorts of patients with primary breast cancer (each including at least 4 patients with HER2-negative and 5 patients with HER2-positive tumors) were injected with 1,000, 2,000, or 3,000 μg of 99mTc-(HE)3-G3 (287 ± 170 MBq). Whole-body planar imaging followed by SPECT was performed at 2, 4, 6, and 24 h after injection. Vital signs and possible side effects were monitored during imaging and up to 7 d after injection. Results: All injections were well tolerated. No side effects were observed. The results of blood and urine analyses did not differ before and after studies. 99mTc-(HE)3-G3 cleared rapidly from the blood. The highest uptake was detected in the kidneys and liver followed by the lungs, breasts, and small intestinal content. The hepatic uptake after injection of 2,000 or 3,000 μg was significantly (P < 0.05) lower than the uptake after injection of 1,000 μg. Effective doses did not differ significantly between cohorts (average, 0.011 ± 0.004 mSv/MBq). Tumor-to-contralateral site ratios for HER-positive tumors were significantly (P < 0.05) higher than for HER2-negative at 2 and 4 h after injection. Conclusion: Imaging of HER2 expression using 99mTc-(HE)3-G3 is safe and well tolerated and provides a low absorbed dose burden on patients. This imaging enables discernment of HER2-positive and HER2-negative breast cancer. Phase I study data justify further clinical development of 99mTc-(HE)3-G3.

• Authors: Olga Bragina, Vladimir Chernov, Alexey Schulga, Elena Konovalova, Eugeniy Garbukov, Anzhelika Vorobyeva, Anna Orlova, Liubov Tashireva, Jens Sörensen, Roman Zelchan, Anna Medvedeva, Sergey Deyev, Vladimir Tolmachev
• Journal: Journal of nuclear medicine : official publication, Society of Nuclear Medicine (J Nucl Med) Vol. 63 Issue 4 Pg. 528-535 (04 2022) ISSN: 1535-5667 [Electronic] United States
• PMID: 34385343 (Publication Type: Clinical Trial, Phase I, Journal Article)
• Copyright: © 2022 by the Society of Nuclear Medicine and Molecular Imaging.

Chemical References

• Designed Ankyrin Repeat Proteins

Topics

• Breast Neoplasms (diagnostic imaging)
• Designed Ankyrin Repeat Proteins
• Female
• Humans
• Radiometry
• Tissue Distribution
• Tomography, Emission-Computed, Single-Photon