astatine and Thyroid-Neoplasms

Astatine (

Topics: Adenocarcinoma; Animals; Astatine; Humans; Iodine Radioisotopes; Mice; Thyroid Neoplasms; Transplantation, Heterologous

Radioactive iodine has long been used clinically for patients with differentiated thyroid cancer. Radioiodine(131I) is used for the ablation of thyroid remnants or treatment of metastatic thyroid cancer. However, some patients with multiple metastases are refractory to repetitive 131I treatment, despite the targeted regions showing sufficient iodine uptake. In such patients, β- particle therapy using 131I is inadequate and another strategy is needed using more effective radionuclide targeting the sodium/iodide symporter(NIS). Astatine(211At)is receiving increasing attention as an α-emitter for targeted radionuclide therapy. 211At is a halogen element with similar chemical properties to iodine. α particles emitted from 211At has higher linear energy transfer as compared to β particles from 131I and exert a better therapeutic effect by inducing DNA double strand breaks and free radical formation. We showed that increase of the radiochemical purity of astatide of 211At solution by addition of ascorbic acid was associated with significantly enhanced uptake of 211At by both normal thyroid tissue and differentiated thyroid cancer cells. The treatment effect of 211At solution in the K1-NIS xenograft model was dose-dependent and was associated with prolonged survival, suggesting the potential applicability of targeted α therapy for the treatment of advanced differentiated thyroid cancer. Thus, targeted α therapy using 211At is highly promising for the treatment of advanced differentiated thyroid cancer. We have already started the clinical trial of 211At-NaAt in Osaka University Hospital since November 2021 after getting the approval by IRB and PMDA investigation. We would like to get the proof of concept that astatine can be used safely and effectively in patients, aiming at the drug approval as a targeted α therapeutic from Japan.

Topics: Adenocarcinoma; Astatine; Clinical Trials as Topic; Humans; Iodine Radioisotopes; Thyroid Neoplasms

Free 211At has been proposed for therapy of anaplastic thyroid carcinoma (ATC). However, no extensive biodistribution study comparing tumor-bearing and nontumor-bearing mice has previously been performed. The aim of this study was to perform a complete evaluation of the biodistribution of 211At, both for normal and ATC-bearing mice. For comparison, the biodistribution of 125I- was simultaneously studied. Dosimetric evaluations were performed to investigate if (211)At can be used for therapy of ATC.. Athymic nude mice were subcutaneously injected with either of two human ATC cell lines, HTh83 and KAT-4. Tumor-bearing and nontumor-bearing mice were injected intravenously with 0.3 MBq 211At and 0.3 MBq 125I- simultaneously. The mice were sacrificed 4-24 hours after injection, and the activity concentrations in tissues were determined.. Except for the thyroid, the concentration of 211At was higher than that of 125I- in the tissues. The uptake of 211At was primarily high in NIS-expressing organs. Furthermore, the absorbed doses to these organs were higher than both tumor types.. The biodistribution of 211At and 125I- differed in this animal model. The higher mean absorbed dose from 211At in several organs than in tumor tissue restricts the possibility of using free 211At for therapy of ATC.

Topics: Animals; Astatine; Cell Line, Tumor; Female; Health; Humans; Iodine Radioisotopes; Mice; Mice, Inbred BALB C; Mice, Nude; Neoplasm Transplantation; Radiometry; Thyroid Neoplasms; Xenograft Model Antitumor Assays

The sodium/iodide symporter (NIS) has been recognized as an attractive target for radioiodine-mediated cancer gene therapy. In this study we investigated the role of human NIS for cellular uptake of the high LET alpha-emitter astatine-211 ((211)At) in comparison with radioiodine as a potential radionuclide for future applications. A mammalian NIS expression vector was constructed and used to generate six stable NIS-expressing cancer cell lines (three derived from thyroid carcinoma, two from colon carcinoma, one from glioblastoma). Compared with the respective control cell lines, steady state radionuclide uptake of NIS-expressing cell lines increased up to 350-fold for iodine-123 ((123)I), 340-fold for technetium-99m pertechnetate ((99m)TcO(4)(-)) and 60-fold for (211)At. Cellular (211)At accumulation was found to be dependent on extracellular Na(+) ions and displayed a similar sensitivity towards sodium perchlorate inhibition as radioiodide and (99m)TcO(4)(-) uptake. Heterologous competition with unlabelled NaI decreased NIS-mediated (211)At uptake to levels of NIS-negative control cells. Following uptake both radioiodide and (211)At were rapidly (apparent t(1/2) 3-15 min) released by the cells as determined by wash-out experiments. Data of scintigraphic tumour imaging in a xenograft nude mice model of transplanted NIS-modified thyroid cells indicated that radionuclide uptake in NIS-expressing tumours was up to 70 times ((123)I), 25 times ((99m)TcO(4)(-)) and 10 times ((211)At) higher than in control tumours or normal tissues except stomach (3-5 times) and thyroid gland (5-10 times). Thirty-four percent and 14% of the administered activity of (123)I and (211)At, respectively, was found in NIS tumours by region of interest analysis ( n=2). Compared with cell culture experiments, the effective half-life in vivo was greatly prolonged (6.5 h for (123)I, 5.2 h for (211)At) and preliminary dosimetric calculations indicate high tumour absorbed doses (3.5 Gy/MBq(tumour) for (131)I and 50.3 Gy/MBq(tumour) for (211)At). In conclusion, NIS-expressing tumour cell lines of different origin displayed specific radionuclide uptake in vitro and in vivo. We provide first direct evidence that the high-energy alpha-emitter (211)At is efficiently transported by NIS. Application of (211)At may direct higher radiation doses to experimental tumours than those calculated for (131)I. Thus, (211)At may represent a promising alternative radionuclide for future NIS-based tumour thera

Topics: Adenocarcinoma; Adenocarcinoma, Papillary; Animals; Astatine; Biomarkers, Tumor; Colonic Neoplasms; Gene Expression; Glioblastoma; Humans; Iodine Radioisotopes; Mice; Mice, Nude; Neoplasm Transplantation; Radionuclide Imaging; Radiopharmaceuticals; Reference Values; Reproducibility of Results; Sensitivity and Specificity; Sodium Pertechnetate Tc 99m; Symporters; Thyroid Neoplasms; Tissue Distribution; Tumor Cells, Cultured

Topics: Adenocarcinoma; Alpha Particles; Animals; Astatine; Humans; Injections, Intravenous; Male; Mice; Mice, Nude; Neoplasm Transplantation; Thyroid Neoplasms; Tissue Distribution; Transplantation, Heterologous

The concentrations of 211At and 125I were measured in various tissues in nude mice bearing xenografts of human thyroid tissue (fetal and malignant). The relative concentration of the two halogens was obtained at 4 and 24 h after injection. Samples were taken of the host blood, muscle and thyroid gland and the grafted tissues. The mouse thyroid concentrated 125I more efficiently than 211At but the human grafts concentrated both halogens about equally.

Topics: Adenocarcinoma; Animals; Astatine; Autoradiography; Carcinoma; Fetus; Humans; Injections, Intraperitoneal; Iodine Radioisotopes; Male; Mice; Mice, Nude; Thyroid Gland; Thyroid Neoplasms

Therapy of carcinoma of the thyroid may include the use of the radionuclide 131I, which localizes to thyroid tissue. In considering the use of another halogen, the alpha particle emitting radionuclide astatine, 211At, there is also the requirement that it too can be taken up by the thyroid. However, in view of its short half-life (7.2 h) it is important that its transport in the blood is not a factor likely to render it less available. For example, retention of 211At by red cells may retard its uptake by the thyroid. This in vitro investigation of the partitioning of the 211At between erythrocytes and plasma indicates that it is not strongly bound by the red cells in blood.

Topics: Animals; Astatine; Blood Cells; Kinetics; Mice; Thyroid Neoplasms