New PSMA-Targeting Ligands: Transformation from Diagnosis (Ga-68) to Radionuclide Therapy (Lu-177).

Prostate-specific membrane antigen (PSMA) is a promising target for the diagnosis and radionuclide therapy of prostate cancer. This study reports conversion of a previously reported 68 Ga-imaging agent, [ 68 Ga]Ga-P16-093, to a Lu-177 radionuclide therapeutic agent. Substitution of the HBED-CC metal chelating group with DOTA(GA) 2 led to P17-087 ( 4 ) and P17-088 ( 7 ). Both agents showed excellent PSMA binding affinity (IC 50 = 10-30 nM) comparable to that of recently FDA-approved [ 177 Lu]Lu-PSMA-617 (Pluvicto). Biodistribution studies in PSMA expressing tumor bearing mice showed that [ 177 Lu]Lu- 4 exhibited very high tumor uptake and a fast blood clearance similar to those of [ 177 Lu]Lu-PSMA-617. Conversely, [ 177 Lu]Lu- 7 , containing an albumin binder, extended its blood half-life and exhibited significantly higher uptake and longer tumor residence time than [ 177 Lu]Lu- 4 and [ 177 Lu]Lu-PSMA-617. The switch from chelator HBED-CC to DOTA(GA) 2 and the switch from the imaging isotope gallium-68 to the therapeutic isotope lutetium-177 have successfully transformed a PSMA-targeting agent from diagnosis to promising radionuclide therapeutic agents.