Novel dimeric dual-modality FAP-targeted agents with favorable tumor retention for image-guided surgery: a

Giacomo Gariglio1, Thomas Hasenöhrl2, Katerina Bendova3

  • 1Department of Nuclear Medicine, Medical University of Innsbruck, 6020, Innsbruck, Austria.

Abstract

Insights

Novel dimeric fibroblast activation protein (FAP) imaging agents were developed. The s775z dye enhanced uptake and reduced off-target accumulation, showing promise for dual-modality cancer surgery guidance.

Area of Science:

  • Oncology
  • Radiochemistry
  • Medical Imaging

Background:

  • Complete and minimally invasive cancer surgery requires improved tools for planning and guidance.
  • Targeting fibroblast activation protein (FAP) is a promising strategy for enhancing surgical outcomes.
  • Developing dual-modality imaging agents offers potential for comprehensive intraoperative visualization.

Purpose of the Study:

  • To develop novel dimeric, dual-modality fibroblast activation protein (FAP)-targeted imaging agents.
  • To investigate the influence of different near-infrared cyanine-7 dyes on the properties of these agents.
  • To evaluate the potential of these agents for surgical planning and intraoperative guidance.

Main Methods:

  • Synthesis of four dual-modality ligands based on the Fusarinine C scaffold.
  • Evaluation of FAP specificity and retention in cellular and xenograft tumor models.
  • Labeling promising candidates with 67/68Ga and in vivo assessment using PET/CT, SPECT/CT, and NIR fluorescence imaging.

Main Results:

  • The s775z dye incorporation improved cellular uptake and in vivo biodistribution, enhancing blood clearance and reducing off-target accumulation.
  • PET/CT, SPECT/CT, and fluorescence imaging demonstrated sustained tumor uptake for 67Ga-s775z-FFAPi and 67Ga-IRDye-FFAPi.
  • Two dimeric FAP-targeting agents provided satisfactory tumor visualization with good background contrast.

Conclusions:

  • Novel dimeric FAP-targeting agents were successfully developed and evaluated for dual-modality applications.
  • The s775z-containing agent demonstrated superior properties for in vivo imaging.
  • These agents show potential for preoperative nuclear imaging and fluorescence-guided surgery in preclinical models.

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