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Targeted α-Particle Therapy: A Clinical Overview, 2008, Vol: 1(3) Pp. 251-253
M. Salvatori, L. Indovina and L. Mansi
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Quantification of SPECT and PET for Drug Development, 2008, Vol: 1(1) Pp. 17-21
Youngho Seo
[Abstract] [Full Text Article]


Applications of Positron Emission Tomography in Neuropsychiatric Pharmaceutical Drug Development, 2008, Vol: 1(1) Pp. 12-16
Jeffrey M. Miller, Dileep Kumar, J. John Mann and Ramin V. Parsey
[Abstract] [Full Text Article]


Radiopharmaceuticals for Drug Development: United States Regulatory Perspective, 2008, Vol: 1(1) Pp. 2-6
Henry F. VanBrocklin
[Abstract] [Full Text Article]


Development of Infection and Inflammation Targeting Compounds, 2008, Vol: 1(1) Pp. 42-48
Peter Laverman, Chantal P. Bleeker-Rovers, Frans H.M. Corstens, Otto C. Boerman and Wim J.G. Oyen
[Abstract] [Full Text Article]


Radiopharmaceuticals, Drug Development and Pharmaceutical Regulations in Europe, 2008, Vol: 1(1) Pp. 7-11
Piero A. Salvadori
[Abstract] [Full Text Article]


99mTc-Labeled Nanobodies: A New Type of Targeted Probes for Imaging Antigen Expression, 2008, Vol: 1(1) Pp. 37-41
Virna Cortez-Retamozo, Tony Lahoutte, Vicky Caveliers, Lea Olive Tchouate Gainkam, Sophie Hernot, Ann Packeu, Filip De Vos, Chris Vanhove, Serge Muyldermans, Patrick De Baetselier and Hilde Revets
[Abstract] [Full Text Article]


Recent Advances in Radiation Therapy of Cancer Cells: A Step towards an Experimental and Systems Biology Framework, 2008, Vol: 1(1) Pp. 22-29
Petar M. Mitrasinovic and Marija L. Mihajlovic
[Abstract] [Full Text Article]


Synthesis and Evaluation of [11C]SB207145 as the First In Vivo Serotonin 5-HT4 Receptor Radioligand for PET Imaging in Man, 2008, Vol: 1(2) Pp. 110-114
A.D. Gee, L. Martarello, J. Passchier, M. Wishart, C. Parker, J. Matthews, R. Comley, R. Hopper and R. Gunn
[Abstract] [Purchase Article]


Editorial: The Role of Radiopharmaceuticals in Drug Discovery, 2008, Vol: 1(1) Pp. 1
Dr. Kalevi Kairemo and Dr. Kim Bergström




Abstracts


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Targeted α-Particle Therapy: A Clinical Overview, 2008, Vol: 1(3)
M. Salvatori, L. Indovina and L. Mansi

Among radionuclides usable for tumor therapy, α-particle emitters are characterized by a very high linear energy transfer (LET) resulting in a larger number of ionizations in a range corresponding to a cell diameter. Therefore, they can determine a stronger therapeutic effect compared to low LET β-particle emitters, producing their ionizations in a range up to many millimeters. In fact, because the distance between the two strands of DNA is almost the same as the distance between two ionizations of α-particles, DNA double strand breaks are induced with a high probability that finally cause cell death due to inefficient repair. Conversely, no therapeutic effect can be determined outside of concentrating sites. Therefore, the short range of α-emitters makes them powerful tools mainly when a therapeutic effect has to be reached in a restricted area, as in the elimination of minimal residual disease or in micro-metastases. Therapeutic efficacy of α-emitter radionuclides has been proven in numerous pre-clinical studies, but up to today only three main human studies are reported, including the treatment of myeloid leukemia by an anti-CD33 monoclonal antibody labelled by bismuth-213 (213Bi), the therapy of patients with bone metastases from hormone-refractory prostate cancer by radium-223 (223Ra) and the loco-regional targeted radiotherapy with astatine-211(211At)-labelled anti-tenascin monoclonal antibody in patients with recurrent malignant brain tumours. The authors reviewed these human reported studies, evaluating perspectives, advantages and limitations of the targeted α-particle therapy.


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Quantification of SPECT and PET for Drug Development, 2008, Vol: 1(1)
Youngho Seo

Development of a new drug faces multi-faceted sequences in the pipeline. Once a drug candidate is identified, evaluation process can be accelerated by in vivo noninvasive imaging because there is a potential to use a smaller number of animals and human subjects. Radionuclide imaging techniques, such as single photon emission computed tomography (SPECT) and positron emission tomography (PET) are directly translatable imaging modalities that can be used in both animal models of disease and humans. In addition, SPECT and PET provide a highly sensitive means to track radiolabeled drugs, for which the imaging process less likely perturbs biological functions of animals and humans. Quantification of SPECT and PET data when used for drug development is elusive. Often times, in vivo SPECT and PET images of any drug candidate are used as ‘flash’ show-and-tell scenarios while actual data are obtained from ex vivo analyses. However, once the need and the degree of quantification are defined carefully, quantification of SPECT and PET can play an important role in drug development and evaluation processes.


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Applications of Positron Emission Tomography in Neuropsychiatric Pharmaceutical Drug Development, 2008, Vol: 1(1)
Jeffrey M. Miller, Dileep Kumar, J. John Mann and Ramin V. Parsey

Positron Emission Tomography (PET) can be used to quantify proteins of interest in the brain, assess the function of these proteins, and quantify cerebral glucose metabolism and blood flow. Its value in neuropsychiatric pharmaceutical drug development is extensive, from the identification of relevant pathophysiology in disease states, to measurement of blood-brain barrier penetration and regional cerebral occupancy of a pharmaceutical agent, to predictions of treatment outcome from a specific pharmacologic intervention in a specific patient. In this paper, we briefly review some basics of brain imaging using PET, and describe its applications to the field of neuropsychiatric pharmaceutical development, including relevant examples from the existing literature. We conclude with a discussion of future developments that will make PET increasingly available and useful for such purposes.


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Radiopharmaceuticals for Drug Development: United States Regulatory Perspective, 2008, Vol: 1(1)
Henry F. VanBrocklin

Imaging with radiopharmaceuticals is playing an increasingly important role in the development of new drugs. At nearly every step of the process imaging may be used to assess the status of the candidate drugs and assist in determining the lead molecules for further evaluation. Incorporating imaging studies into the paradigm may ameliorate the temporal and economic cost of drug development. Since 1975 radiopharmaceuticals have been regulated as drugs and all human studies must be carried out under an investigational new drug (IND) or radioactive drug research committee (RDRC) protocol. The FDA released the exploratory IND guidance in 2006 to highlight the flexibility in the IND process while trying to stimulate new drug entry into the approval pipeline. The exploratory IND also provides a lower threshold for radiopharmaceutical and candidate drug first in human studies, using the microdosing concept, that may not be conducted under an RDRC protocol. The RDRC mechanism permits the basic research studies with limited dose and numbers of subjects. The RDRC regulations are 30 years old and the full IND process remains burdensome for radiopharmaceutical development. Therefore, it is essential that the regulatory framework permit the approval of radiopharmaceuticals for use in humans that is commensurate with the safety and applications of the probes.


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Development of Infection and Inflammation Targeting Compounds, 2008, Vol: 1(1)
Peter Laverman, Chantal P. Bleeker-Rovers, Frans H.M. Corstens, Otto C. Boerman and Wim J.G. Oyen

Nuclear medicine offers powerful noninvasive techniques for visualization of infectious and inflammatory disorders using whole body imaging enabling the determination of both localization and number of inflammatory foci. A wide variety of approaches depicting the different stages of the inflammatory response have been developed. Non-specific radiolabeled compounds, such as 67Ga-citrate and radiolabeled polyclonal human immunoglobulin accumulate in inflammatory foci due to enhanced vascular permeability. Specific accumulation of radiolabeled compounds in inflammatory lesions results from binding to activated endothelium (e.g. radiolabeled anti-E-selectin), the enhanced influx of leukocytes (e.g. radiolabeled autologous leukocytes, anti-granulocyte antibodies or cytokines), the enhanced glucose-uptake by activated leukocytes (18F-fluorodeoxyglucose) or direct binding to micro-organisms (e.g. radiolabeled ciprofloxacin or antimicrobial peptides). Scintigraphy using autologous leukocytes, labeled with 111In or 99mTc, is still considered the ”gold standard” nuclear medicine technique for the imaging of infection and inflammation, but the range of radiolabeled compounds available for this indication is still expanding. Recently, positron emission tomography with 18F-fluorodeoxyglucose has been shown to delineate various infectious and inflammatory disorders with high sensitivity. New developments in peptide chemistry and in radiochemistry will result in specific agents with high specific activity. A gradual shift from non-specific, cumbersome or even hazardous approaches to more sophisticated, specific approaches is ongoing. In this review, the different approaches to scintigraphic imaging of infection and inflammation, already in use or under investigation, are discussed.


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Radiopharmaceuticals, Drug Development and Pharmaceutical Regulations in Europe, 2008, Vol: 1(1)
Piero A. Salvadori

Radiopharmaceuticals have a long tradition of clinical and research applications. Current legislation of developed Countries includes these compounds in the regulatory environment of medicinal products. Products used under a marketing authorisation license and investigational radiopharmaceuticals are then part of the clinical practice and scientific programs. Positron Emission Tomography has induced a strong increase in the number of potentially available radiopharmaceuticals and, beside being a breakthrough in diagnostic nuclear medicine, has demostrated its value as research tool. Drug Development Research is searching new tools for reducing attrition and increasing efficiency in the identification and development of new medicines. Molecular Imaging, PET in particular seems to have important answers to this demand. The regulatory environment in Europe is hence revised in the perspective of utilisation of nuclear molecular imaging as a supporting tool for DDR. Relevant documents from European regulatory Agency (EMEA) as well as their essential impact on radiopharmaceuticals have been summarised and discussed.


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99mTc-Labeled Nanobodies: A New Type of Targeted Probes for Imaging Antigen Expression
, 2008, Vol: 1(1)
Virna Cortez-Retamozo, Tony Lahoutte, Vicky Caveliers, Lea Olive Tchouate Gainkam, Sophie Hernot, Ann Packeu, Filip De Vos, Chris Vanhove, Serge Muyldermans, Patrick De Baetselier and Hilde Revets

Introduction: The development of specific radiolabeled probes towards molecular markers in vivo has gained interest as targeted imaging allows for a more accurate detection of diseases. We investigate the feasibility of targeted imaging of cancer antigens using the variable domain of single chain camelid antibodies (Nanobodies®) labeled with 99mTechnetium. Nanobodies against carcinoembryonic antigen (CEA) were used as a model.

Methods: His6-CEA1 Nanobodies were generated and labeled with 99mTc at their His-tag using Tc(I)-tricarbonyl (Isolink, Mallinckrodt, B.V., Petten, The Netherlands). The normal biodistribution was assessed in healthy athymic mice by ex vivo analysis at 1 and 3 h. In vivo targeting was evaluated in the same mouse model bearing the CEA-positive LS174T tumour or a CEA-negative A431 (human skin carcinoma) control tumour. Pinhole SPECT imaging was performed at 3 hours after intravenous injection of 90 MBq 99mTc-His6-CEA1 using a dual-headed gamma camera equipped with pinhole collimators.

Results: Radiolabeling efficiency was > 95%. General biodistribution showed intense renal uptake and marked liver accumulation. Using pinhole-SPECT, the average uptake of 99mTc- His6-CEA1 in LS174T (CEA positive) was significantly higher compared to the A431 (CEA negative) control tumour: respectively 3.2 ± 0.6 %IA/cm3 and 1.1 ± 0.2 %IA/cm3 (p< 0.05).

Conclusion: This study presents effective labeling of Nanobodies with 99mTc using Tc(I)-carbonyl chemistry and shows their potential as a new type of specific probes for imaging antigen expression.


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Recent Advances in Radiation Therapy of Cancer Cells: A Step towards an Experimental and Systems Biology Framework, 2008, Vol: 1(1)
Petar M. Mitrasinovic and Marija L. Mihajlovic

Due to rapid emergence of recombinant and antibody-based reagents targeting specifically biomarkers of disease, radiolabeling of antibodies has enabled the imaging and therapy of various reactive oxygen species (ROS)-mediated pathological conditions, such as cancer. Key contributions to this topic have been dissected through two main standpoints: (1) immunotherapeutics for advanced cancer care, including radiolabeling for cancer imaging and therapy, design and testing of antibodies, and radioimmunotherapy innovations for treating malignancies and (2) search for a more efficient drug-targeted delivery method for cancer therapy. Because tremendous progress has been made in recent years, the future of cancer radioimmunotherapy is suggested to be bright. The question, whether measurement of oxidative damage to DNA has clinical relevance, is addressed. To make biomarkers of oxidatively damaged DNA useful clinical tools, further validation of biomarkers, followed by further elucidation of the role of damage in disease, is suggested. To understand the role of oxidative damage by focusing on cellular processes under oxidative stress conditions, the complementarities of mechanistic cell biology studies and systems biology strategies in identifying new therapeutic targets are demonstrated for liver cancer cells. Since most morphological, physiological and molecular studies on death of cells in tissues have been carried out on isolated cell populations, systems biology is suggested to be a means of overcoming known difficulties manifested by interference and interaction with surrounding cells. The elucidation of fundamental background of the ability of cells to interpret the same signal action in distinct fashions - survival vs. death signal transduction is suggested to facilitate more localized and efficient treatments of various ROS-mediated pathologies.


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Synthesis and Evaluation of [
11C]SB207145 as the First In Vivo Serotonin 5-HT4 Receptor Radioligand for PET Imaging in Man, 2008, Vol: 1(2)
A.D. Gee, L. Martarello, J. Passchier, M. Wishart, C. Parker, J. Matthews, R. Comley, R. Hopper and R. Gunn

The aim of this work was to develop a PET radiotracer which would enable the study of central serotonin 5-H4 receptors in man using positron emission tomography (PET). A procedure was developed for labelling SB207145, a potent and selective 5-H4 antagonist, with the short-lived positron emitting radionuclide 11C. Alkylation of the corresponding desmethyl compound with 11C-methyl iodide afforded [11C]SB207145 in 50 – 60 % radiochemical yield (decay corrected to end of cyclotron bombardment), specific activities of > 50 GBq/μmole and radiochemical purities greater than 95%. PET studies in pig showed [11C]SB207145 rapidly entered the brain reaching peak concentrations at 10 - 20 mins post administration, followed by washout from tissue. In humans the tissue kinetics of the tracer was slower, reaching peak tissue concentrations at 30 – 60 mins post administration. In both species, the observed rank order of regional brain concentrations was striatum > thalamus > cortical regions > cerebellum, consistent with the known distribution and concentration of 5-H4 receptors from in vitro studies. In pig, on administration of 0.5 mg/kg SB207040, a selective 5-H4 antagonist, the specific binding of [11C]SB207145 was reduced to level of the cortex, demonstrating saturability of the 5-H4 receptor population. In conclusion, a new PET radioligand is described which enables the study of 5-H4 receptors in vivo in humans for the first time using PET.


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Editorial: The Role of Radiopharmaceuticals in Drug Discovery, 2008, Vol: 1(1)

In this first thematic issue of Current Radiopharmaceuticals, the contributors have covered in great detail articles relating to the drug development process within the emphasis of the journal scope.

Radionuclide imaging together with other non-invasive imaging techniques have found a prominent place in the whole drug discovery and development process. The application of imaging has the potential to alter the direction of the development process. The fundamental questions to address are when in the development timeline do you use these imaging techniques and what is the current utilization of these imaging technologies?

Novel ‘imaging’ targets may have uncertain relationship to specific disease states. Acceptable target is of little value if its action cannot be modulated by therapeutics. Imaging is a perfect method to assess these target biology questions. Functional imaging endpoints can be used to evaluate target effects in normal and diseased models, in different species, and in the initial clinical studies. The longitudinal results from functional imaging can be extremely valuable in the evaluation of data from early clinical trials. The translational potential of functional imaging techniques is most evident. The uncertainty in potential drug candidates for example the efficacy and toxicity can be quickly addressed to determine the course of action. A preclinical imaging study may produce quantitative results which can answer these types of translational questions.

Interest in functional imaging techniques has been motivated especially by Food and Drug Administration (FDA) exploratory Investigational New Drug (xIND) guidelines. Big Pharma has made substantial investments in imaging centers throughout the world to assist in the drug development process. Especially in the area of oncology research by applying radionuclide imaging techniques to determine the optimal protocol in early clinical trials. It seems evident that non-invasive imaging and especially radionuclide techniques will see increasing use in the drug discovery and development process. In-house imaging resources are increasing together with Contract Research Organisation (CRO) services.

The ideas for these articles in this issue originated from two symposia held in December 2006: one in Geneva organized by GE Healthcare and another in Copenhagen, organized by Encorium and Imanext. These Symposia were dedicated to Imaging in the Drug Development Process. Similarly, The World Pharmaceutical Congress held in June 2007 in Philadelphia had a dedicated two-day symposium for ‘first-in-human’ phase 0 trial and microdosing studies. All these activities demonstrate that imaging will be a keynote figure in constructing new pharmaceuticals, already recognized by authorities. In this issue regulatory aspects have been reviewed both from the EU (Salvadori) and US perspectives (VanBroncklin).

It is hard to imagine future neuropsychiatric pharmaceuticals without any imaging data and is reviewed explicitly by (Parsey et al.). The receptor occupancy studies and brain receptor quantification are an essential part in lead candidate selection (Seo et al.).

Cancer drugs are often chosen for further development according to their tumor targeting abilities. Imaging techniques usually characterize tumor tissue in a different manner; however, radionuclide methods are most effective in the studies of pharmacodynamics and pharmacokinetic models. In this issue the role of systems biology has been reviewed in the development of cancer drugs (Mitrasinovic and Mihajlovic). Drug delivery systems couple the other imaging modalities (e.g. magnetic resonance imaging (MRI), ultrasound (US) and optical) to functional imaging modalities may find application in tumor targeting compounds (Kairemo et al.). Bioengineered chamelid antibodies (nanobodies) are a good example of using radionuclide methods in targeted nanoparticle systems, and possibly in cancer drug applications (Cortez-Retamozo et al.).

Anti-inflammatory and antibiotic drugs are a major group of pharmaceuticals, where tissue targeting maybe of importance. These compounds have been reviewed by (Laverman et al.) in this issue.

New possibilities have been developed to facilitate the drug development process, such as exploratory IND and microdosing. The concept of microdosing was originally linked to accelerator mass spectrometry (AMS), but criteria can be fulfilled with positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging studies. Hopefully, this first issue of Current Radiopharmaceuticals will help the pharmaceutical industry to interact with the functional imaging community. Today, radiopharmaceuticals are a prerequisite for this communication; we hope that Current Radiopharmaceuticals serves as a good forum.


Dr. Kalevi Kairemo
Department of Oncology
Helsinki University Central Hospital
Imanext Ltd, Helsinki
Finland

Dr. Kim Bergström
Laboratory of Radiochemistry
University of Helsinki
Imanext Ltd, Helsinki
Finland




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