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Research ArticleRadiochemistry

Molecular Imaging of ABCB1 and ABCG2 Inhibition at the Human Blood–Brain Barrier Using Elacridar and 11C-Erlotinib PET

Remy B. Verheijen, Maqsood Yaqub, Emilia Sawicki, Olaf van Tellingen, Adriaan A. Lammertsma, Bastiaan Nuijen, Jan H.M. Schellens, Jos H. Beijnen, Alwin D.R. Huitema, N. Harry Hendrikse and Neeltje Steeghs
Journal of Nuclear Medicine June 2018, 59 (6) 973-979; DOI: https://doi.org/10.2967/jnumed.117.195800
Remy B. Verheijen
1Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Maqsood Yaqub
2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Emilia Sawicki
1Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Olaf van Tellingen
3Department of Bio-Pharmacology/Mouse Cancer Clinic, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Adriaan A. Lammertsma
2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Bastiaan Nuijen
1Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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Jan H.M. Schellens
4Department of Clinical Pharmacology and Medical Oncology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
5Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Jos H. Beijnen
1Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
5Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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Alwin D.R. Huitema
1Department of Pharmacy and Pharmacology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
6Department of Clinical Pharmacy, Utrecht University Medical Center, Utrecht, The Netherlands; and
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N. Harry Hendrikse
2Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands
7Department of Clinical Pharmacology and Pharmacy, VU University Medical Center, Amsterdam, The Netherlands
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Neeltje Steeghs
4Department of Clinical Pharmacology and Medical Oncology, The Netherlands Cancer Institute–Antoni van Leeuwenhoek, Amsterdam, The Netherlands
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  • FIGURE 1.
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    FIGURE 1.

    Schematic of clinical study design.

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    FIGURE 2.

    (Left) Elacridar plasma concentrations in ng/mL for increasing oral dose of elacridar (0, 10, 25, and 50 mg/kg). (Right) Erlotinib brain-to-plasma ratios at same increasing doses of elacridar in WT mice (n = 4). Group of Abcb1a/b;Abcg2 knockout mice was used as positive controls (n = 5).

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    FIGURE 3.

    (Left) Representative summation images of Abcb1a/b;Abcg2 knockout mouse (bottom) and WT mouse (top). Arrows indicate brain. (Right) 11C-erlotinib percentage injected dose (%ID) per gram of brain determined ex vivo in knockout and WT mice. Erlotinib brain penetration was significantly higher in knockout mice (n = 2 per group).

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    FIGURE 4.

    11C-erlotinib PET before (top) and after (bottom) elacridar for subject 4.

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    FIGURE 5.

    11C-erlotinib whole-brain activity as SUV vs. time (in minutes) for patients before and after administration of elacridar (n = 5).

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    FIGURE 6.

    11C-erlotinib brain VT ratio vs. elacridar exposure (n = 5).

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    TABLE 1

    K1, K2, and VT of Brain 11C-Erlotinib Before and After Elacridar Administration in Cancer Patients (n = 5)

    11C-erlotinib before elacridar11C-erlotinib after elacridar
    Patient no.K1K2VTK1K2VTVT ratio
    10.0120.0300.3950.0110.0360.3120.790
    20.0150.0900.1670.0130.0660.1981.186
    3—*—*—*0.0140.0800.179—*
    40.0100.0600.1600.0170.0760.2211.381
    50.120.1000.1280.0140.1230.1160.906
    Mean ± SD0.012 ± 0.0020.070 ± 0.0320.213 ± 0.1230.014 ± 0.0020.076 ± 0.0310.205 ± 0.0711.066 ± 0.268
    • ↵* Data were excluded because peak uptake was missed during first scan.

    • Ratio is based on patients evaluable in both scans.

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Journal of Nuclear Medicine: 59 (6)
Journal of Nuclear Medicine
Vol. 59, Issue 6
June 1, 2018
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Molecular Imaging of ABCB1 and ABCG2 Inhibition at the Human Blood–Brain Barrier Using Elacridar and 11C-Erlotinib PET
Remy B. Verheijen, Maqsood Yaqub, Emilia Sawicki, Olaf van Tellingen, Adriaan A. Lammertsma, Bastiaan Nuijen, Jan H.M. Schellens, Jos H. Beijnen, Alwin D.R. Huitema, N. Harry Hendrikse, Neeltje Steeghs
Journal of Nuclear Medicine Jun 2018, 59 (6) 973-979; DOI: 10.2967/jnumed.117.195800

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Molecular Imaging of ABCB1 and ABCG2 Inhibition at the Human Blood–Brain Barrier Using Elacridar and 11C-Erlotinib PET
Remy B. Verheijen, Maqsood Yaqub, Emilia Sawicki, Olaf van Tellingen, Adriaan A. Lammertsma, Bastiaan Nuijen, Jan H.M. Schellens, Jos H. Beijnen, Alwin D.R. Huitema, N. Harry Hendrikse, Neeltje Steeghs
Journal of Nuclear Medicine Jun 2018, 59 (6) 973-979; DOI: 10.2967/jnumed.117.195800
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Keywords

  • Erlotinib
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  • Molecular imaging
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