Kunos Charles A, Fabian Denise, Napier Dana, Stonecypher Mark S, Duncan Ravyn M, Hurt Jason
Department of Radiation Medicine, University of Kentucky, Lexington, KY, United States.
Biospecimen Procurement & Translational Pathology, University of Kentucky, Lexington, KY, United States.
Front Oncol. 2023 Jan 25;13:1126426. doi: 10.3389/fonc.2023.1126426. eCollection 2023.
Pb-DOTAM-GRPR1 is a pharmaceutical radioimmunoconjugate consisiting of an α-particle-emitting radionuclide lead-212 (Pb), a metal chelator DOTAM (1,4,7,10-tetrakis(carbamoylmethyl)-1,4,7,10-tetraazacyclododecane), and a gastrin-releasing peptide receptor (GRPR)-targeted antagonist currently being evaluated as therapy in uterine cervix and other cancer types. Previous studies have revealed that a variable proportion of uterine cervix cancer tumors overexpress the radiopharmaceutical target GRPR when assessed by cell proportion and staining intensity immunoreactive scores (IRS). Tumor response to Pb-DOTAM-GRPR1 strongly associates with GRPR overexpression, and therefore, it seems reasonable to assess uterine cervix cancer GRPR immunoreactivity for greater insight into the feasibility of using Pb-DOTAM-GRPR1 as a radiopharmaceutical treatment.
We examined a series of 33 uterine cervix cancer paraffin-embedded tumors in order to establish whether this tumor type overexpresses GRPR at an IRS score of 6 or higher, as Pb-DOTAM-GRPR1 is currently being evaluated in clinical trials against tumors showing such a level of expression.
The results show that five of five (100%) primary adenocarcinomas and 10 of 16 (63%) primary squamous cell tumors overexpress GRPR at an IRS score of 6 or higher.
The frequency of overexpression in this study suggests that Pb-DOTAM-GRPR1 radiopharmaceutical treatment may be useful in the management of persistent, recurrent, or metastatic uterine cervix cancer patients. A phase I clinical trial involving patients with metastatic uterine cervix cancer is currently underway (NCT05283330).
Pb-DOTAM-GRPR1是一种药物放射性免疫缀合物,由发射α粒子的放射性核素铅-212(Pb)、金属螯合剂DOTAM(1,4,7,10-四(氨甲酰甲基)-1,4,7,10-四氮杂环十二烷)和靶向胃泌素释放肽受体(GRPR)的拮抗剂组成,目前正在作为子宫颈癌和其他癌症类型的治疗方法进行评估。先前的研究表明,当通过细胞比例和染色强度免疫反应评分(IRS)评估时,可变比例的子宫颈癌肿瘤过度表达放射性药物靶点GRPR。肿瘤对Pb-DOTAM-GRPR1的反应与GRPR的过度表达密切相关,因此,评估子宫颈癌GRPR免疫反应性对于更深入了解使用Pb-DOTAM-GRPR1作为放射性药物治疗的可行性似乎是合理的。
我们检查了一系列33个子宫颈癌石蜡包埋肿瘤,以确定这种肿瘤类型是否在IRS评分为6或更高时过度表达GRPR,因为Pb-DOTAM-GRPR1目前正在针对显示这种表达水平的肿瘤进行临床试验评估。
结果显示,5例原发性腺癌中的5例(100%)和16例原发性鳞状细胞肿瘤中的10例(63%)在IRS评分为6或更高时过度表达GRPR。
本研究中过度表达的频率表明,Pb-DOTAM-GRPR1放射性药物治疗可能对持续性复发或转移性子宫颈癌患者的管理有用。一项涉及转移性子宫颈癌患者的I期临床试验目前正在进行中(NCT05283330)。