![]() ![]() The synthesis of Ga-DOTA-TATE from a 68Ge/ 68Ga-generator is straightforward, reliable and allows for the decentralized production of the radionuclide and probe without the need of a cyclotron on site. With the FDA-approval of the commercial kit NETSPOT, Ga-DOTA-TATE has become the de facto standard for NET-imaging in the US 2. The diagnostic arm of the theranostic approach to managing patients with neuroendocrine tumors (NETs) utilizes β +-emitter-labeled somatostatin receptor (SSTR)-targeting ligands for tumor localization, staging, and therapy selection with positron emission tomography-computed tomography (PET/CT) 1. Here, we review the current state of probe-development from a translational viewpoint and make a case for a clinically viable, 18F-labeled alternative to the current standard Ga-DOTA-TATE. The clinical introduction of an 18F-labeled SSTR-imaging probe can help mitigate the shortcomings of the generator-based synthesis approach, but despite extensive research efforts, none of the proposed 18F-labeled SSAs has been translated past prospective first-in-humans studies so far. The synthesis of 68Ga-labeled SSAs from a 68Ge/ 68Ga-generator is straightforward and allows for a decentralized production, but there are economic and logistic difficulties associated with these approaches that warrant the search for a viable, generator-independent alternative. Driven by the demand for PET/CT imaging of NETs, a commercial kit for the production of Ga-DOTA-TATE (NETSPOT) was approved by the U.S. PET/CT imaging with SSAs such as Ga-DOTA-TATE, Ga-DOTA-TOC, and Ga-DOTA-NOC allows for NET staging with high accuracy and is used to qualify patients for RLT. On the diagnostics side, the field is currently dominated by 68Ga-labeled SSAs for the molecular imaging of NETs with positron emission tomography-computed tomography (PET/CT). With the Neuroendocrine Tumor Therapy (NETTER-1) phase 3 trial reporting encouraging results in the treatment of well-differentiated, metastatic midgut NETs, peptide radioligand therapy (RLT) with the 177Lu-labeled somatostatin analog (SSA) Lu-DOTA-TATE is now anticipated to become the standard of care. The development of theranostic pairs comprising somatostatin receptor (SSTR)-targeting nuclear imaging probes and therapeutic agents for the treatment of patients with neuroendocrine tumors (NETs) has been a driving force behind this development. The trend to inform personalized molecular radiotherapy with molecular imaging diagnostics, a concept referred to as theranostics, has transformed the field of nuclear medicine in recent years. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |