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177Lu-labeled DOTA-EB-RGD as a candidate for thyroid cancer therapy
Sonam Kumari, Rhitajit Sarkar, Zhantong Wang, Shilpa Thakur, Laura Abaandou, Oksana Gavrilova, Huiyan Lu, Noha Behairy, Lixin Lang, Dale Kiesewetter, Vasyl Vasko, Joanna Klubo-Gwiezdzinska
Sonam Kumari, Rhitajit Sarkar, Zhantong Wang, Shilpa Thakur, Laura Abaandou, Oksana Gavrilova, Huiyan Lu, Noha Behairy, Lixin Lang, Dale Kiesewetter, Vasyl Vasko, Joanna Klubo-Gwiezdzinska
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Research Article Endocrinology Oncology

177Lu-labeled DOTA-EB-RGD as a candidate for thyroid cancer therapy

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Abstract

Integrin αVβ3, a transmembrane receptor involved in tumor growth and metastasis, specifically recognizes and binds proteins with the Arg-Gly-Asp (RGD) peptide sequence. Using mRNA and/or protein expression data from 496 thyroid cancer (TC) samples in The Cancer Genome Atlas, 14 TC cell lines, and 70 TC and 10 normal thyroid tissues, we found that papillary TC exhibits the highest αVβ3 integrin expression. We then evaluated the therapeutic efficacy of a radiolabeled RGD analog, 177Lu-DOTA-EB-cRGDfK, in TC. Genetic knockout and overexpression of αVβ3 in TC cell lines confirmed the target specificity of 177Lu-DOTA-EB-cRGDfK. In mouse xenograft models established from human TC cell lines with high αVβ3 expression, 177Lu-DOTA-EB-cRGDfK demonstrated superior antitumor efficacy compared with standard-of-care lenvatinib and placebo. However, no synergistic benefit was observed with combination therapy. Biodistribution studies identified the kidneys as the dose-limiting organ. RNA-seq analysis of resected tumors demonstrated that 177Lu-DOTA-EB-cRGDfK induced a type I IFN response, characterized by upregulation of IFI6, IFIT1-2, and MX1, compared with both lenvatinib-treated tumors and placebo. These findings identify αVβ3 integrin as a promising therapeutic target in a subset of TCs and demonstrate that 177Lu-DOTA-EB-cRGDfK exhibits superior efficacy to lenvatinib, supporting its potential clinical translation for progressive TC refractory to standard therapies.

Authors

Sonam Kumari, Rhitajit Sarkar, Zhantong Wang, Shilpa Thakur, Laura Abaandou, Oksana Gavrilova, Huiyan Lu, Noha Behairy, Lixin Lang, Dale Kiesewetter, Vasyl Vasko, Joanna Klubo-Gwiezdzinska

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Figure 6

Immunohistochemistry of tumor tissues.

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Immunohistochemistry of tumor tissues.
(A) Representative images of immu...
(A) Representative images of immunostaining for αVβ3 integrin, proliferation marker PCNA, and survival marker survivin (placebo n = 7, lenvatinib n = 7, 177Lu-DOTA-EB-RGD n = 6, 177Lu-DOTA-EB-RGD + lenvatinib n = 6). Original magnification, ×200. Scale bars: 100 μm. (B) Quantitative analysis of immunostaining of different groups with respect to control showing that compared to the tumors treated with placebo, the expression of integrin αVβ3 dimers (1-way ANOVA, Kruskal-Wallis) was significantly reduced in lenvatinib (P = 0.001), 177Lu monotherapy group (P = 0.01), and 177Lu+L combination therapy (P = 0.01). Proliferation marker PCNA (1-way ANOVA, Kruskal-Wallis) was significantly reduced in the tumors exposed to combination therapy with 177Lu+L (P = 0.004) and monotherapy with lenvatinib with respect to placebo (P < 0.001). Also, in comparison with the tumors treated with placebo (Welch’s t test), survivin (cancer cells’ survival marker) was found to be significantly reduced in 177Lu+L combination therapy (P = 0.03) and 177Lu monotherapy (P = 0.006).

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