ImmunoPET imaging of multiple myeloma with [68Ga]Ga-NOTA-Nb1053

Cheng Wang; Yumei Chen; Yun Nan Hou; Qiufang Liu; Di Zhang; Haitao Zhao; You Zhang; Shuxian An; Lianghua Li; Jian Hou; Gang Huang; Jianjun Liu; Yong Juan Zhao; Weijun Wei

doi:10.1007/s00259-021-05218-1

ImmunoPET imaging of multiple myeloma with [⁶⁸Ga]Ga-NOTA-Nb1053

Eur J Nucl Med Mol Imaging. 2021 Aug;48(9):2749-2760. doi: 10.1007/s00259-021-05218-1. Epub 2021 Feb 5.

Authors

Cheng Wang^#¹, Yumei Chen^#¹, Yun Nan Hou², Qiufang Liu³, Di Zhang¹, Haitao Zhao¹, You Zhang¹, Shuxian An¹, Lianghua Li¹, Jian Hou⁴, Gang Huang^{1

5}, Jianjun Liu⁶, Yong Juan Zhao^{7

8}, Weijun Wei⁹

Affiliations

¹ Department of Nuclear Medicine, Institute of Clinical Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd, Shanghai, 200127, China.
² State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China.
³ Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, China.
⁴ Department of Hematology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁵ Shanghai Key Laboratory of Molecular Imaging, Shanghai University of Medicine and Health Sciences, Shanghai, China.
⁶ Department of Nuclear Medicine, Institute of Clinical Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd, Shanghai, 200127, China. nuclearj@163.com.
⁷ State Key Laboratory of Chemical Oncogenomics, Key Laboratory of Chemical Genomics, School of Chemical Biology and Biotechnology, Peking University Shenzhen Graduate School, Shenzhen, China. zhaoyongjuan@cuhk.edu.cn.
⁸ Ciechanover Institute of Precision and Regenerative Medicine, School of Life and Health Sciences, The Chinese University of Hong Kong, Shenzhen, 518172, China. zhaoyongjuan@cuhk.edu.cn.
⁹ Department of Nuclear Medicine, Institute of Clinical Nuclear Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, 1630 Dongfang Rd, Shanghai, 200127, China. weijun.wei@outlook.com.

^# Contributed equally.

PMID: 33543326
DOI: 10.1007/s00259-021-05218-1

Abstract

Purpose: Multiple myeloma (MM) remains incurable and its diagnosis relies heavily on bone marrow aspiration and biopsy. CD38 is a glycoprotein highly specific for MM. Antibody therapeutics (e.g., daratumumab) targeting CD38 have shown encouraging efficacy in treating MM, either as a monotherapy agent or in combination with other regimens. However, efficient stratification of patients who might benefit from daratumumab therapy and timely monitoring of the therapeutic responses are still clinical challenges. This work aims to devise a CD38-targeted imaging strategy and assess its value in diagnosing MMs.

Methods: By labeling a CD38-specific single domain antibody (Nb1053) with ⁶⁸Ga (t_1/2 = 1.1 h), we developed a CD38-targeted immuno-positron emission tomography (immunoPET) imaging probe [⁶⁸Ga]Ga-NOTA-Nb1053. The probe was developed with good radiochemical yield (> 50%), excellent radiochemical purity (> 99%), and immunoreactivity (> 95%). The diagnostic accuracy of the probe was thoroughly investigated in preclinical MM models.

Results: ImmunoPET imaging with [⁶⁸Ga]Ga-NOTA-Nb1053 specifically depicted all the subcutaneous and orthotopic MM lesions, outperforming the traditional ¹⁸F-fluorodeoxyglucose PET and the nonspecific [⁶⁸Ga]Ga-NOTA-NbGFP immunoPET. More importantly, daratumumab preloading significantly reduced [⁶⁸Ga]Ga-NOTA-Nb1053 uptake in the disseminated bone lesions, indicating the overlapping targeting epitopes of [⁶⁸Ga]Ga-NOTA-Nb1053 with that of daratumumab. Furthermore, premedication with sodium maleate or fructose significantly decreased kidney retention of [⁶⁸Ga]Ga-NOTA-Nb1053 and improved the diagnostic value of the probe in lymphoma models.

Conclusion: This work successfully developed a novel CD38-targeted immunoPET imaging approach that enabled precise visualization of CD38 and diagnosis of MMs. Upon clinical translation, [⁶⁸Ga]Ga-NOTA-Nb1053 immunoPET may serve as a valuable CD38-targeted molecular imaging toolbox, facilitating early diagnosis of MM and precise assessment of the therapeutic responses.

Keywords: CD38; Daratumumab; ImmunoPET; Multiple myeloma; Nanobody.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Cell Line, Tumor
Gallium Radioisotopes*
Heterocyclic Compounds, 1-Ring
Humans
Multiple Myeloma* / diagnostic imaging
Positron-Emission Tomography
Tissue Distribution
Tomography, X-Ray Computed

Substances

Gallium Radioisotopes
Heterocyclic Compounds, 1-Ring
1,4,7-triazacyclononane-N,N',N''-triacetic acid