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Lead-it-EAZY! GMP-compliant production of [ 212 Pb]Pb-PSC-PEG 2 -TOC
Journal article   Open access   Peer reviewed

Lead-it-EAZY! GMP-compliant production of [ 212 Pb]Pb-PSC-PEG 2 -TOC

Marc Pretze, Enrico Michler, David Kästner, Falk Kunkel, Edwin A Sagastume, Michael K Schultz and Jörg Kotzerke
EJNMMI radiopharmacy and chemistry, Vol.9(1), 81
11/27/2024
DOI: 10.1186/s41181-024-00305-8
PMCID: PMC11602913
PMID: 39604560
url
https://doi.org/10.1186/s41181-024-00305-8View
Published (Version of record) Open Access

Abstract

Background Recently, radiotheranostics comprising the true matched radionuclide pair 203/212Pb could serve as real dosimetric planning utility using 203Pb-radiolabelled pharmaceuticals before therapy with 212Pb-radiolabelled counterparts. 212Pb might act as the missing radionuclide therapy between standard β– therapies (e.g. with 177Lu or 90Y), in some cases leading to β– resistance and highly cytotoxic α therapies (e.g. with 225Ac) leading in some cases to renal insufficiency or even renal failure, due to the daughter nuclide 213Bi, which accumulates in > 90% within the kidneys during 225Ac therapy. 212Pb converts to 212Bi by β–-decay and the following pathway of decay bears in sum only one α decay, which certainly happens within the targeted tumour tissue. Following daughter nuclides (e.g. 208Tl), which could distribute in organs at risk have only β− or γ decay, which is not as cytotoxic as α decay. Results By ingenious customization of the standard cassettes of the ML EAZY it was possible to adapt the manual radiosynthesis of [212Pb]Pb-PSC-PEG2-TOC ([212Pb]Pb-VMT-α-NET) to a GMP-compliant synthesis module. The whole process of production, namely conditioning of C18 cartridge for purification, elution of the 224Ra/212Pb-generator, radiolabelling, C18 purification and sterile filtration performed automatically within one hour to access [212Pb]Pb-VMT-α-NET for patient application. [212Pb]Pb-VMT-α-NET was radiolabelled with high radiochemical purity > 95% and high radiochemical yield > 95% with molar activity ~ 15.8 MBq/nmol. Conclusions The Lead-it-EAZY process performed stable and robust over ten radiosyntheses and yielded sterile [212Pb]Pb-VMT-α-NET in high purity for patient application. By changing the precursor this process could easily be adapted to other 212Pb-radiopharmaceuticals.
Automation GMP-compliant 212Pb Neuroendocrine tumour Somatostatin receptor VMT-α-GEN VMT-α-NET TOC Targeted alpha-therapy

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