Title: Novel 99mTc-labeled somatostatin receptor antagonists in the diagnostic algorithm of neuroendocrine neoplasms - a feasibility study
Period: 1. 7. 2019 - 30. 6. 2023
Leading Organization: University Medical Centre Ljubljana
Research Organisations: Jagiellonian University Medical College, National Centre for Nuclear Research, Medizinische Universität Innsbruck, University of Ljubljana (Faculty of Mathematics and Physics)
Principal investigator at UL FMF: Urban Simončič
Research activity: Medical Physics & Theranostics
Neuroendocrine neoplasms (NEN) are a heterogeneous group of malignancies biologically characterized by overexpression of somatostatin receptors (SSTR) on cell membranes. Nuclear medicine is a molecular imaging method able to visualize NEN by means of radiopharmaceuticals that bind to SSTR, allowing prediction and evaluation of response to various therapies available.
Recently, novel radiopharmaceuticals, based on SSTR antagonists, were shown to provide superior SSTR visualization than currently used agonists. The development of a widely available, quantitative imaging methodology in combination with improved single-photon emitting radiopharmaceuticals, presently not available, represents a significant advancement in NEN patient management.
SSTR antagonists are superior to agonists for visualization of NEN. A 99mTc-labelled SSTR antagonist imaged with a quantitative approach serves as an optimal molecular imaging tool for personalized management of NEN patients.
(1) to select a 99mTc-labelled SSTR antagonist and establish a pharmaceutical formulation for NEN imaging; (2) to initiate a clinical feasibility study in NEN patients and (3) develop a robust, reproducible quantitative imaging method.
From two promising new radiopharmaceuticals a superior candidate will be selected for clinical translation and a kit-formulation for radiolabelling developed. Ten NEN patients with proven SSTR expression on agonist imaging will be recruited. Patients will be imaged at predefined time points for assessment of pharmacodynamics, pharmacokinetics and dosimetry using a concurrently developed quantitative imaging protocol.
Expected results and potential clinical impact:
99mTc-labelled SSTR antagonist is expected to be an effective, widely available method for quantitative assessment of SSTR status in NEN. As such, it will decisively influence management of patients with NEN, allowing a personalized therapeutic approach.