Preliminary efficacy of [90Y]DOTA-biotin-avidin radiotherapy against non-muscle invasive bladder cancer

Eur J Nucl Med Mol Imaging. 2023 Feb;50(3):692-700. doi: 10.1007/s00259-022-06027-w. Epub 2022 Nov 9.

Abstract

Purpose: Bladder cancer represents 3% of all new cancer diagnoses per year. We propose intravesical radionuclide therapy using the β-emitter 90Y linked to DOTA-biotin-avidin ([90Y]DBA) to deliver short-range radiation against non-muscle invasive bladder cancer (NMIBC).

Material and methods: Image-guided biodistribution of intravesical DBA was investigated in an animal model by radiolabeling DBA with the 68Ga and dynamic microPET imaging following intravesical infusion of [68Ga]DBA for up to 4 h and post-necropsy γ-counting of organs. The antitumor activity of [90Y]DBA was investigated using an orthotopic MB49 murine bladder cancer model. Mice were injected with luciferase-expressing MB49 cells and treated via intravesical administration with 9.2 MBq of [90Y]DBA or unlabeled DBA 3 days after the tumor implantation. Bioluminescence imaging was conducted after tumor implantation to monitor the bladder tumor growth. In addition, we investigated the effects of [90Y]DBA radiation on urothelial histology with immunohistochemistry analysis of bladder morphology.

Results: Our results demonstrated that DBA is contained in the bladder for up to 4 h after intravesical infusion. A single dose of [90Y]DBA radiation treatment significantly reduced growth of MB49 bladder carcinoma. Attaching 90Y-DOTA-biotin to avidin prevents its re-absorption into the blood and distribution throughout the rest of the body. Furthermore, immunohistochemistry demonstrated that [90Y]DBA radiation treatment did not cause short-term damage to urothelium at day 10, which appeared similar to the normal urothelium of healthy mice.

Conclusion: Our data demonstrates the potential of intravesical [90Y]DBA as a treatment for non-muscle invasive bladder cancer.

Keywords: Avidin; Bladder cancer; Intravesical radionuclide therapy; [90Y]DOTA-biotin-avidin.

MeSH terms

  • Animals
  • Avidin / therapeutic use
  • Gallium Radioisotopes
  • Mice
  • Mice, Inbred DBA
  • Non-Muscle Invasive Bladder Neoplasms*
  • Tissue Distribution
  • Urinary Bladder Neoplasms* / diagnostic imaging
  • Urinary Bladder Neoplasms* / drug therapy
  • Urinary Bladder Neoplasms* / radiotherapy

Substances

  • DOTA-biotin
  • Avidin
  • Gallium Radioisotopes