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Synthesis and Preclinical Evaluation of a Novel FAPI-04 Dimer for Cancer Theranostics

Xuan ZhongDepartment of Nuclear Medicine, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou 225300, ChinaJingru GuoDepartment of Pharmaceutical Analysis, China Pharmaceutical University, Nanjing 210009, ChinaXiuping HanDepartment of Nuclear Medicine, Nanjing Medical University Affiliated Nanjing Hospital, Nanjing 210029, ChinaWenyu WuDepartment of Nuclear Medicine, Nanjing Medical University Affiliated Nanjing Hospital, Nanjing 210029, ChinaRui YangDepartment of Nuclear Medicine, Nanjing Medical University Affiliated Nanjing Hospital, Nanjing 210029, ChinaJun ZhangDepartment of Nuclear Medicine, The Affiliated Taizhou People’s Hospital of Nanjing Medical University, Taizhou 225300, ChinaGuoqiang ShaoDepartment of Nuclear Medicine, Nanjing Medical University Affiliated Nanjing Hospital, Nanjing 210029, China
2023en
ABI

Аннотация

Overexpression of fibroblast activation protein (FAP) in cancer-associated fibroblasts in a wide variety of tumors enables a highly selective targeting strategy using FAP inhibitors (FAPIs). Quinoline-based FAPIs labeled with radionuclides have been widely developed for tumor-targeted nuclear medicine imaging. However, the short retention time of FAPIs at the tumor site limits their application in radionuclide therapy. In this study, a novel FAPI-04 dimer was synthesized and labeled with radionuclides to prolong the retention time in tumors for imaging and therapy. To prepare the FAPI-04 dimer complex, DOTA-Suc-Lys-(FAPI-04)2, we used Fmoc-Lys(Boc)–OH as the linker to conjugate two FAPI-04 structures by an amide reaction. The resulting product was further modified by DOTA groups to allow for conjugation with radioactive metals. Both [68Ga]Ga-(FAPI-04)2 and [177Lu]Lu-(FAPI-04)2 showed a radiochemical purity of >99% and remained stable in vitro. In vivo, micro-PET images of SKOV3, A431, and H1299 xenografts revealed that the tumor uptake of [68Ga]Ga-(FAPI-04)2 was about twice that of [68Ga]Ga-FAPI-04 and that the accumulation of [68Ga]Ga-(FAPI-04)2 at the tumor site did not significantly decrease even 3h after injection. The tumor–abdomen ratio of [68Ga]Ga-(FAPI-04)2 images was significantly higher than that of [18F]F-FDG images. For radionuclide therapy, [177Lu]Lu-(FAPI-04)2 effectively retarded tumor growth and displayed good tolerance. In conclusion, the DOTA-Suc-Lys-(FAPI-04)2 design enhanced its uptake in FAP-expressing tumors, improved its retention time at the tumor site, and produced high-contrast imaging in xenografts after radionuclide labeling. Furthermore, it showed a noticeable antitumor effect. DOTA-Suc-Lys-(FAPI-04)2 provides a new approach for applying FAPI derivatives in tumor theranostics.

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