First in-human radiation dosimetry of the gastrin-releasing peptide (GRP) receptor antagonist 68Ga-NODAGA-MJ9

Silvano Gnesin; Francesco Cicone; Periklis Mitsakis; Axel Van der Gucht; Sébastien Baechler; Raymond Miralbell; Valentina Garibotto; Thomas Zilli; John O Prior

doi:10.1186/s13550-018-0462-9

First in-human radiation dosimetry of the gastrin-releasing peptide (GRP) receptor antagonist ⁶⁸Ga-NODAGA-MJ9

EJNMMI Res. 2018 Dec 12;8(1):108. doi: 10.1186/s13550-018-0462-9.

Authors

Silvano Gnesin¹, Francesco Cicone², Periklis Mitsakis², Axel Van der Gucht², Sébastien Baechler³, Raymond Miralbell⁴, Valentina Garibotto⁵, Thomas Zilli⁴, John O Prior²

Affiliations

¹ Institute of Radiation Physics, Lausanne University Hospital, Rue du Grand-Pré 1, 1007, Lausanne, Switzerland. silvano.gnesin@chuv.ch.
² Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, Lausanne, Switzerland.
³ Institute of Radiation Physics, Lausanne University Hospital, Rue du Grand-Pré 1, 1007, Lausanne, Switzerland.
⁴ Department of Radiation Oncology, University Hospital of Geneva and Geneva University, Geneva, Switzerland.
⁵ Division of Nuclear Medicine and Molecular Imaging, University Hospital of Geneva and Geneva University, Geneva, Switzerland.

Abstract

Background: Gastrin-releasing peptide receptor antagonists have promise in theranostics of several highly incident tumours, including prostate and breast. This study presents the first human dosimetry of ⁶⁸Ga-NODAGA-MJ9 in the first five consecutive patients with recurrent prostate cancer included in a dual-tracer positron emission tomography (PET) protocol. Five male patients with biochemical relapse of prostate adenocarcinoma underwent four whole-body time-of-flight PET/CT scans within 2 h after tracer injection. To be used as input in OLINDA/EXM 2.0, time-integrated activity coefficients were derived from manually drawn regions of interest over the following body regions: brain, thyroid, lungs, heart, liver, gallbladder, spleen, stomach, kidneys, adrenals, red marrow, pancreas, intestines, urinary bladder and whole body. Organ absorbed doses and effective dose (ED) were calculated with OLINDA/EXM 2.0 using the NURBS voxelized phantoms adjusted to the ICRP-89 organ masses and ICRP103 tissue-weighting factors. Additional absorbed dose estimations were performed with OLINDA/EXM 1.1 to be comparable with similar previous publications.

Results: The body regions receiving the highest absorbed doses were the pancreas, the urinary bladder wall, the small intestine and the kidneys (260, 69.8, 38.8 and 34.8 μGy/MBq respectively). The ED considering a 30-min urinary voiding cycle was 17.6 μSv/MBq in male patients. The increment of voiding time interval produced a significant increase of absorbed doses in bladder, prostate and testes, as well as an increase of ED. ED also increased if calculated with OLINDA/EXM 1.1. These results have been discussed in view of similar publications on bombesin analogues or on other commonly used theranostic peptides.

Conclusions: The pancreas is the most irradiated organ after the injection of ⁶⁸Ga-NODAGA-MJ9, followed by the urinary bladder wall, the small intestine and the kidneys. ED is in the same range of other common ⁶⁸Ga-labelled peptides. Differences with similarly published studies on bombesin analogues exist, and are mainly dependent on the methodology used for absorbed dose calculations.

Trial registration: Clinicaltrial.Gov identifier: NCT02111954 , posted on 11/042014.

Keywords: 68Ga-NODAGA-MJ9; Biochemical relapse; Bombesin; Dosimetry; GRP antagonist; Gastrin-releasing peptide receptor; OLINDA/EXM; PET/CT; Prostate cancer; Theranostics.

Associated data

ClinicalTrials.gov/NCT02111954