Preclinical evaluation of investigational radiopharmaceutical RISAD-P intended for use as a diagnostic and molecular radiotherapy agent for prostate cancer

Prostate. 2015 Jan;75(1):8-22. doi: 10.1002/pros.22885. Epub 2014 Oct 4.

Abstract

Background: The androgen receptor (AR) plays a dominant role in the pathogenesis of prostate cancer. 5-Radioiodo-3'-O-(17β-succinyl-5α-androstan-3-one)-2'-deoxyuridin-5'-yl phosphate (RISAD-P) is an AR-targeting reagent developed for noninvasive assessment of AR and proliferative status of the AR-expressing tumors, and for molecular radiotherapy with Auger electron-emitting radionuclides. In this study, the preclinical toxicity and targeting potential of RISAD-P was evaluated.

Methods: Effects of nonradioactive ISAD-P and RISAD-P labeled with (123) I, (124) I, and (125) I were evaluated in male mice. Expanded-acute single dose toxicity studies, hematologic toxicity, liver and kidney function, pharmacokinetics, biodistribution, and imaging studies were conducted. Imaging and pilot therapy studies were conducted in transgenic mice.

Results: RISAD-P is not toxic at doses projected for clinical use. Its tissue distribution compares favorably with the distribution reported for (18) F-dihydrotestosterone derivatives. RISAD-P has excellent prostate cancer targeting properties. One hour after (125) IRISAD-P administration, nearly 10% of the injected dose is associated with prostate tumor. The tumor clearance is biphasic and plateaus between 24 and 48 hr post-injection. The estimated radiation doses calculated for 1 g tumor using the MIRD convention are well within the therapeutic range with values of 170, 250, 1,240 Gy × MBq(-1) × g(-1) for (125) I-, (123) I-, and (124) I-labeled RISAD-P, respectively. The transient uptake of radioactivity is observed in the genitourinary tract and stomach. Without the potassium iodide blockade, thyroid uptake is also observed.

Conclusions: Biodistribution, toxicity, and radiation dosimetry studies suggest that RISAD-P holds characteristics of a promising candidate for imaging of AR expression and tumor proliferation, as well as molecular radiotherapy for metastatic or locally, regionally advanced prostate cancer.

Keywords: Auger electrons; androgen receptor; molecular radiotherapy; prostate cancer; theranostic.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Androstanols / pharmacokinetics
  • Androstanols / toxicity*
  • Animals
  • Deoxyuracil Nucleotides / pharmacokinetics
  • Deoxyuracil Nucleotides / toxicity*
  • Drug Evaluation, Preclinical
  • Drugs, Investigational
  • Iodine Radioisotopes*
  • Kidney / drug effects*
  • Liver / drug effects*
  • Male
  • Mice
  • Mice, Transgenic
  • Pilot Projects
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / radiotherapy*
  • Radiopharmaceuticals
  • Radiotherapy Dosage
  • Receptors, Androgen / metabolism*
  • Tissue Distribution

Substances

  • 5-iodo-3'-O-(17beta-succinyl-5alpha-androstan-3-one)-2'-deoxyuridine 5'-monophosphate
  • Androstanols
  • Deoxyuracil Nucleotides
  • Drugs, Investigational
  • Iodine Radioisotopes
  • Radiopharmaceuticals
  • Receptors, Androgen