First-in-Human Safety, Imaging, and Dosimetry of a Carbonic Anhydrase IX-Targeting Peptide, [68Ga]Ga-DPI-4452, in Patients with Clear Cell Renal Cell Carcinoma

Michael S Hofman; Ben Tran; Darren R Feldman; Anna Pokorska-Bocci; Solen Pichereau; Jonathan Wessen; Mohammad B Haskali; Richard B Sparks; Olena Vlasyuk; Ivana Galetic

doi:10.2967/jnumed.123.267175

First-in-Human Safety, Imaging, and Dosimetry of a Carbonic Anhydrase IX-Targeting Peptide, [⁶⁸Ga]Ga-DPI-4452, in Patients with Clear Cell Renal Cell Carcinoma

J Nucl Med. 2024 Feb 22;65(5):740-743. doi: 10.2967/jnumed.123.267175. Online ahead of print.

Authors

Michael S Hofman^{1

2}, Ben Tran^{3

2}, Darren R Feldman⁴, Anna Pokorska-Bocci⁵, Solen Pichereau⁵, Jonathan Wessen⁵, Mohammad B Haskali^{3

2}, Richard B Sparks⁶, Olena Vlasyuk⁵, Ivana Galetic⁴

Affiliations

¹ Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia; michael.hofman@petermac.org.
² Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.
³ Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
⁴ Memorial Sloan Kettering Cancer Center, Weill Cornell Medical College, New York, New York.
⁵ Debiopharm International SA, Lausanne, Switzerland; and.
⁶ CDE Dosimetry Services, Inc., Knoxville, Tennessee.

Abstract

[⁶⁸Ga]Ga-DPI-4452, a first-in-class carbonic anhydrase IX-binding radiolabeled peptide, is the imaging agent of a theranostic pair with [¹⁷⁷Lu]Lu-DPI-4452, developed for selecting and treating patients with carbonic anhydrase IX-expressing tumors. Here, [⁶⁸Ga]Ga-DPI-4452 imaging characteristics, dosimetry, pharmacokinetics, and safety were assessed in 3 patients with clear cell renal cell carcinoma. Methods: After [⁶⁸Ga]Ga-DPI-4452 administration, patients underwent serial full-body PET/CT imaging. Blood and urine were sampled. Safety was monitored for 7 d after injection. Results: Tumor uptake was observed at all time points (15 min to 4 h). Across 36 lesions, the SUV_max at 1 h after administration ranged from 6.8 to 211.6 (mean, 64.6 [SD, 54.8]). The kidneys, liver, and bone marrow demonstrated low activity. [⁶⁸Ga]Ga-DPI-4452 was rapidly eliminated from blood and urine. No clinically significant toxicity was observed. Conclusion: [⁶⁸Ga]Ga-DPI-4452 showed exceptional tumor uptake in patients with clear cell renal cell carcinoma, with very high tumor-to-background ratios and no significant adverse events, suggesting potential diagnostic and patient selection applications.

Keywords: PET/CT; [68Ga]Ga-DPI-4452; clear cell renal cell carcinoma; theranostic.