Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy

<p>Molecular radiotherapy using&nbsp;<sup>177</sup>Lu-DOTATATE is a most effective treatment for somatostatin receptor&ndash;expressing neuroendocrine tumors. Despite its frequent and successful use in the clinic, little or no radiobiologic considerations are made at the ti...

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Main Authors: O'Neill, E, Kersemans, V, Allen, P, Terry, S, Baguna Torres, J, Mosley, M, Smart, S, Lee, B, Falzone, N, Vallis, K, Konijnenberg, M, De Jong, M, Nonnekens, J, Cornelissen, B
Format: Journal article
Language:English
Published: Society of Nuclear Medicine 2019
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author O'Neill, E
Kersemans, V
Allen, P
Terry, S
Baguna Torres, J
Mosley, M
Smart, S
Lee, B
Falzone, N
Vallis, K
Konijnenberg, M
De Jong, M
Nonnekens, J
Cornelissen, B
author_facet O'Neill, E
Kersemans, V
Allen, P
Terry, S
Baguna Torres, J
Mosley, M
Smart, S
Lee, B
Falzone, N
Vallis, K
Konijnenberg, M
De Jong, M
Nonnekens, J
Cornelissen, B
author_sort O'Neill, E
collection OXFORD
description <p>Molecular radiotherapy using&nbsp;<sup>177</sup>Lu-DOTATATE is a most effective treatment for somatostatin receptor&ndash;expressing neuroendocrine tumors. Despite its frequent and successful use in the clinic, little or no radiobiologic considerations are made at the time of treatment planning or delivery. On positive uptake on octreotide-based PET/SPECT imaging, treatment is usually administered as a standard dose and number of cycles without adjustment for peptide uptake, dosimetry, or radiobiologic and DNA damage effects in the tumor. Here, we visualized and quantified the extent of DNA damage response after&nbsp;<sup>177</sup>Lu-DOTATATE therapy using SPECT imaging with&nbsp;<sup>111</sup>In-anti-&gamma;H2AX-TAT. This work was a proof-of-principle study of this in vivo noninvasive biodosimeter with &beta;-emitting therapeutic radiopharmaceuticals.&nbsp;<strong>Methods:</strong>&nbsp;Six cell lines were exposed to external-beam radiotherapy (EBRT) or&nbsp;<sup>177</sup>Lu-DOTATATE, after which the number of &gamma;H2AX foci and the clonogenic survival were measured. Mice bearing CA20948 somatostatin receptor&ndash;positive tumor xenografts were treated with&nbsp;<sup>177</sup>Lu-DOTATATE or sham-treated and coinjected with&nbsp;<sup>111</sup>In-anti-&gamma;H2AX-TAT,&nbsp;<sup>111</sup>In-IgG-TAT control, or vehicle.&nbsp;<strong>Results:</strong>&nbsp;Clonogenic survival after external-beam radiotherapy was cell-line&ndash;specific, indicating varying levels of intrinsic radiosensitivity. Regarding in vitro cell lines treated with&nbsp;<sup>177</sup>Lu-DOTATATE, clonogenic survival decreased and &gamma;H2AX foci increased for cells expressing high levels of somatostatin receptor subtype 2. Ex vivo measurements revealed a partial correlation between&nbsp;<sup>177</sup>Lu-DOTATATE uptake and &gamma;H2AX focus induction between different regions of CA20948 xenograft tumors, suggesting that different parts of the tumor may react differentially to&nbsp;<sup>177</sup>Lu-DOTATATE irradiation.&nbsp;<strong>Conclusion:</strong>&nbsp;<sup>111</sup>In-anti-&gamma;H2AX-TAT allows monitoring of DNA damage after&nbsp;<sup>177</sup>Lu-DOTATATE therapy and reveals heterogeneous damage responses.</p>
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spelling oxford-uuid:3e827d1d-1ecb-41d8-b3c0-56f7240651282022-03-26T14:25:54ZImaging DNA damage repair in vivo following 177Lu-DOTATATE therapyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:3e827d1d-1ecb-41d8-b3c0-56f724065128EnglishSymplectic Elements at OxfordSociety of Nuclear Medicine2019O'Neill, EKersemans, VAllen, PTerry, SBaguna Torres, JMosley, MSmart, SLee, BFalzone, NVallis, KKonijnenberg, MDe Jong, MNonnekens, JCornelissen, B<p>Molecular radiotherapy using&nbsp;<sup>177</sup>Lu-DOTATATE is a most effective treatment for somatostatin receptor&ndash;expressing neuroendocrine tumors. Despite its frequent and successful use in the clinic, little or no radiobiologic considerations are made at the time of treatment planning or delivery. On positive uptake on octreotide-based PET/SPECT imaging, treatment is usually administered as a standard dose and number of cycles without adjustment for peptide uptake, dosimetry, or radiobiologic and DNA damage effects in the tumor. Here, we visualized and quantified the extent of DNA damage response after&nbsp;<sup>177</sup>Lu-DOTATATE therapy using SPECT imaging with&nbsp;<sup>111</sup>In-anti-&gamma;H2AX-TAT. This work was a proof-of-principle study of this in vivo noninvasive biodosimeter with &beta;-emitting therapeutic radiopharmaceuticals.&nbsp;<strong>Methods:</strong>&nbsp;Six cell lines were exposed to external-beam radiotherapy (EBRT) or&nbsp;<sup>177</sup>Lu-DOTATATE, after which the number of &gamma;H2AX foci and the clonogenic survival were measured. Mice bearing CA20948 somatostatin receptor&ndash;positive tumor xenografts were treated with&nbsp;<sup>177</sup>Lu-DOTATATE or sham-treated and coinjected with&nbsp;<sup>111</sup>In-anti-&gamma;H2AX-TAT,&nbsp;<sup>111</sup>In-IgG-TAT control, or vehicle.&nbsp;<strong>Results:</strong>&nbsp;Clonogenic survival after external-beam radiotherapy was cell-line&ndash;specific, indicating varying levels of intrinsic radiosensitivity. Regarding in vitro cell lines treated with&nbsp;<sup>177</sup>Lu-DOTATATE, clonogenic survival decreased and &gamma;H2AX foci increased for cells expressing high levels of somatostatin receptor subtype 2. Ex vivo measurements revealed a partial correlation between&nbsp;<sup>177</sup>Lu-DOTATATE uptake and &gamma;H2AX focus induction between different regions of CA20948 xenograft tumors, suggesting that different parts of the tumor may react differentially to&nbsp;<sup>177</sup>Lu-DOTATATE irradiation.&nbsp;<strong>Conclusion:</strong>&nbsp;<sup>111</sup>In-anti-&gamma;H2AX-TAT allows monitoring of DNA damage after&nbsp;<sup>177</sup>Lu-DOTATATE therapy and reveals heterogeneous damage responses.</p>
spellingShingle O'Neill, E
Kersemans, V
Allen, P
Terry, S
Baguna Torres, J
Mosley, M
Smart, S
Lee, B
Falzone, N
Vallis, K
Konijnenberg, M
De Jong, M
Nonnekens, J
Cornelissen, B
Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy
title Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy
title_full Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy
title_fullStr Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy
title_full_unstemmed Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy
title_short Imaging DNA damage repair in vivo following 177Lu-DOTATATE therapy
title_sort imaging dna damage repair in vivo following 177lu dotatate therapy
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