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Research ArticleClinical Investigation
Open Access

Phase I Study of [68Ga]Ga-Anti-CD206-sdAb for PET/CT Assessment of Protumorigenic Macrophage Presence in Solid Tumors (MMR Phase I)

Odrade Gondry, Catarina Xavier, Laurens Raes, Johannes Heemskerk, Nick Devoogdt, Hendrik Everaert, Karine Breckpot, Quentin Lecocq, Lore Decoster, Christel Fontaine, Denis Schallier, Sandrine Aspeslagh, Ilse Vaneycken, Geert Raes, Jo A. Van Ginderachter, Tony Lahoutte, Vicky Caveliers and Marleen Keyaerts
Journal of Nuclear Medicine September 2023, 64 (9) 1378-1384; DOI: https://doi.org/10.2967/jnumed.122.264853
Odrade Gondry
1MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Catarina Xavier
1MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
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Laurens Raes
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Johannes Heemskerk
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Nick Devoogdt
1MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
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Hendrik Everaert
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Karine Breckpot
3Laboratory for Molecular and Cellular Therapy, Vrije Universiteit Brussel, Brussels, Belgium;
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Quentin Lecocq
3Laboratory for Molecular and Cellular Therapy, Vrije Universiteit Brussel, Brussels, Belgium;
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Lore Decoster
4Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Christel Fontaine
4Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Denis Schallier
4Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Sandrine Aspeslagh
4Department of Medical Oncology, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Ilse Vaneycken
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Geert Raes
5Cellular and Molecular Immunology, Lab of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium; and
6Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium
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Jo A. Van Ginderachter
5Cellular and Molecular Immunology, Lab of Cellular and Molecular Immunology, Vrije Universiteit Brussel, Brussels, Belgium; and
6Myeloid Cell Immunology Lab, VIB Center for Inflammation Research, Brussels, Belgium
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Tony Lahoutte
1MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Vicky Caveliers
1MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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Marleen Keyaerts
1MIMA, Department of Medical Imaging, Vrije Universiteit Brussel, Brussels, Belgium;
2Nuclear Medicine Department, Universitair Ziekenhuis Brussel, Brussels, Belgium;
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  • FIGURE 1.
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    FIGURE 1.

    Schematic representation of study procedures over time. IMP = investigational medicinal product.

  • FIGURE 2.
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    FIGURE 2.

    Normal biodistribution of [68Ga]Ga-NOTA-anti-CD206-sdAb. (A) Anterior maximum intensity projections of patient 1 at 11 min (left), 90 min (center), and 150 min (right) after injection. (B) Axial PET/CT fusion image at 90 min after injection, showing uptake in liver, spleen, kidneys, and adrenals (arrows). No tracer uptake is visible in lung lesion of this patient.

  • FIGURE 3.
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    FIGURE 3.

    Relative organ uptake over time. Data are decay-corrected to time of injection and shown as mean ± SD in 6 patients. %IA = percentage injected activity; pi = after injection.

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    FIGURE 4.

    Time–activity curve for total blood volume and total plasma volume, expressed as percentage injected activity (%IA). Data are presented as mean ± SD of 7 patients.

  • FIGURE 5.
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    FIGURE 5.

    Uptake of [68Ga]Ga-NOTA-anti-CD206-sdAb in patient 1 (A–C) and patient 2 (D–F), both with non–small cell lung carcinoma and residual lesion in lung region during treatment. (A and D) Uptake in lung lesion (arrow) on PET/CT (top) and PET (bottom) images 90 min after injection. Coronal PET images show lesional uptake, indicated by ellipsoid in left lung, for [68Ga]Ga-NOTA-anti-CD206-sdAb (B) and [18F]FDG performed 15 wk after study participation (C) of patient 1, who showed long-term disease remission. Coronal PET images show lesional uptake, indicated by ellipsoid in left lung of patient 2, for [68Ga]Ga-NOTA-anti-CD206-sdAb (E) and [18F]FDG performed 11 wk later (F). This patient showed disease progression on these [18F]FDG PET/CT images.

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    TABLE 1.

    Patient Characteristics

    Patient no.Age (y)SexCancer typeECOG scoreCurrent therapyPrevious lines
    163MaleNSCLC0Pembrolizumab0
    269MaleNSCLC1Durvalumab1
    364MaleNSCLC1Pembrolizumab0
    454MaleNSCLC1Nivolumab3
    556MaleNSCLC0Atezolizumab2
    666MaleAtypical carcinoid1Watchful waiting1
    755MaleRenal cell carcinoma1Nivolumab3
    • ECOG = Eastern Cooperative Oncology Group; NSCLC = non–small cell lung carcinoma.

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    TABLE 2.

    Organ Doses and Effective Dose

    OrganMale organ doseFemale organ dose
    Kidneys0.241 ± 0.0480.263 ± 0.0517
    Liver0.135 ± 0.01380.181 ± 0.0188
    Spleen0.119 ± 0.03390.145 ± 0.0415
    Urinary bladder wall0.0477 ± 0.01180.0634 ± 0.0161
    Adrenals0.0475 ± 0.01290.0561 ± 0.0150
    Thyroid0.0287 ± 0.02070.0346 ± 0.0250
    Red bone marrow0.0267 ± 0.00380.0260 ± 0.0035
    Heart wall0.0244 ± 0.02440.0288 ± 0.0059
    Osteogenic cells0.0214 ± 0.00250.0288 ± 0.0034
    Effective dose, ICRP 1030.0219 ± 0.00100.0269 ± 0.0012
    Effective dose, ICRP 600.0217 ± 0.00120.0271 ± 0.0015
    • ICRP = International Commission on Radiological Protection.

    • Organ doses are in milligrays per megabecquerel. Effective doses are in millisieverts per megabecquerel.

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    TABLE 3.

    SUVs in Selected Lesions

    Patient no.Lesion-of-inclusion locationInjected activity (MBq)SUVpeakSUVmaxDisease progression after injection*Time to progression after injection (mo)Time to death after injection (mo)
    1Left upper lobe1741.01.2No—Alive*
    2Left upper lobe1843.24.0Yes212
    3Mediastinal adenopathy1811.01.1No—Alive*
    4Left upper lobe236NA2.3Yes16
    6L3 vertebra1.82.0Yes920
    Scapula1851.82.4
    Subpleural left2.02.4
    7Left iliac wing1830.71.0No—Alive*
    • — = no disease progression; * = patient still alive; NA = not applicable.

    • Progression is based on PERCIST criteria or, if no [18F]FDG PET/CT data were available, on iRECIST criteria (38,39).

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Journal of Nuclear Medicine: 64 (9)
Journal of Nuclear Medicine
Vol. 64, Issue 9
September 1, 2023
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Phase I Study of [68Ga]Ga-Anti-CD206-sdAb for PET/CT Assessment of Protumorigenic Macrophage Presence in Solid Tumors (MMR Phase I)
Odrade Gondry, Catarina Xavier, Laurens Raes, Johannes Heemskerk, Nick Devoogdt, Hendrik Everaert, Karine Breckpot, Quentin Lecocq, Lore Decoster, Christel Fontaine, Denis Schallier, Sandrine Aspeslagh, Ilse Vaneycken, Geert Raes, Jo A. Van Ginderachter, Tony Lahoutte, Vicky Caveliers, Marleen Keyaerts
Journal of Nuclear Medicine Sep 2023, 64 (9) 1378-1384; DOI: 10.2967/jnumed.122.264853

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Phase I Study of [68Ga]Ga-Anti-CD206-sdAb for PET/CT Assessment of Protumorigenic Macrophage Presence in Solid Tumors (MMR Phase I)
Odrade Gondry, Catarina Xavier, Laurens Raes, Johannes Heemskerk, Nick Devoogdt, Hendrik Everaert, Karine Breckpot, Quentin Lecocq, Lore Decoster, Christel Fontaine, Denis Schallier, Sandrine Aspeslagh, Ilse Vaneycken, Geert Raes, Jo A. Van Ginderachter, Tony Lahoutte, Vicky Caveliers, Marleen Keyaerts
Journal of Nuclear Medicine Sep 2023, 64 (9) 1378-1384; DOI: 10.2967/jnumed.122.264853
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  • CD206
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