Fibroblast Activation Protein (FAP) targeting homodimeric FAP inhibitor radiotheranostics: a step to improve tumor

Euy Sung Moon1, Sanjana Ballal2, Madhav Prasad Yadav2

  • 1Department of Chemistry-TRIGA Site, Johannes Gutenberg University Mainz 55128 Mainz, Germany.

Insights

Developing dimeric fibroblast activation protein (FAP) inhibitors improved tumor targeting in PET imaging. These new FAP inhibitors show enhanced retention and accumulation in tumors compared to earlier versions.

Area of Science:

  • Nuclear Medicine
  • Radiopharmaceutical Chemistry
  • Oncology Imaging

Background:

  • Fibroblast activation protein (FAP) is a target for cancer imaging and therapy.
  • Current FAP-targeting radiopharmaceuticals have limitations, including short tumor retention and rapid renal clearance.
  • Monomeric FAP inhibitors based on UAMC1110 show potential but require optimization for improved in vivo performance.

Purpose of the Study:

  • To develop novel dimeric FAP inhibitors to enhance tumor residence time and accumulation.
  • To evaluate the radiochemical properties and in vitro characteristics of dimeric FAP inhibitors.
  • To compare the in vivo performance of dimeric FAP inhibitors against monomeric counterparts and a standard PET tracer in human subjects.

Main Methods:

  • Synthesis of homodimeric FAP inhibitor conjugates: DOTA.(SA.FAPi)2 and DOTAGA.(SA.FAPi)2.
  • Radiochemical evaluation using Gallium-68 (Ga-68) labeling, assessing radiochemical yields.
  • In vitro characterization of [68Ga]Ga-DOTAGA.(SA.FAPi)2, including stability, lipophilicity, and FAP binding affinity (IC50).
  • Human PET/CT scans comparing [68Ga]Ga-DOTAGA.(SA.FAPi)2 with [68Ga]Ga-DOTA.SA.FAPi and [18F]FDG.

Main Results:

  • Successful radiolabeling of dimeric conjugates with Ga-68 achieved high radiochemical yields.
  • In vitro studies demonstrated excellent affinity and selectivity of [68Ga]Ga-DOTAGA.(SA.FAPi)2 for FAP, with low nanomolar IC50 values.
  • Human PET/CT imaging revealed significantly higher tumor uptake and prolonged tumor retention for [68Ga]Ga-DOTAGA.(SA.FAPi)2 compared to the monomeric [68Ga]Ga-DOTA.SA.FAPi.

Conclusions:

  • Dimeric FAP inhibitors demonstrate improved in vivo performance in human PET imaging.
  • The enhanced tumor accumulation and retention of dimeric FAP inhibitors represent an advancement over monomeric agents.
  • Dimeric structures hold promise for developing next-generation FAP inhibitors with prolonged uptake for potential radiotherapeutic applications.