Preparation and Preliminary Evaluation of a Novel 68Ga-Labeled Linear Peptide PET Probe Targeting Nectin-4.

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Objectives: Nectin-4 has been successfully used as a target for tumor therapy. Although several bicyclic peptides and antibodies, Nectin-4 positron emission tomography (PET) probes, have been reported for tumor imaging and expression detection, their production costs or pharmacokinetics still need further improvement. This study developed a novel linear peptide PET probe for rapid examination of Nectin-4-related tumors. Methods: [68Ga]Ga-NOTA-SP was prepared by a one-step chelation reaction, and its quality control was carried out by using radio-high-performance liquid chromatography and thin-layer chromatography. Molecular docking was used to predict the predominant binding of NOTA-SP to Nectin-4. Cell experiments using SW780 cells and PET/computed tomography (CT) imaging, using the SW780 tumor model, were performed to assess the specific binding and targeting ability of [68Ga]Ga-NOTA-SP to Nectin-4. Normal BALB/c mice were used to investigate the plasma concentration-time curves. Results: Under optimal labeling conditions, the labeling efficiency of [68Ga]Ga-NOTA-SP can reach above 95%, with a molar-specific activity of 2.45 MBq/nmol and high in vitro stability. The high specificity of [68Ga]Ga-NOTA-SP to Nectin-4 is demonstrated by molecular docking and cell uptake experiment, showing a binding energy of -5.4 kcal/mol and Kd value of 2.483 nM, which was further confirmed by PET-CT imaging. Conclusions: [68Ga]Ga-NOTA-SP using a linear peptide as a vector shows favorable pharmacokinetics and specific targeting ability to Nectin-4, enabling rapid tumor mouse model imaging. It would be a promising PET/CT imaging probe for optimizing Nectin-4-related tumor diagnoses and therapy.

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Nectin cell adhesion molecule 4 (Nectin-4) is overexpressed in various malignant tumors and has emerged as a promising target for tumor imaging. Bicyclic peptides, known for their conformational rigidity, metabolic stability, and membrane permeability, are ideal tracers for positron emission tomography (PET) imaging. In this study, we evaluated the feasibility of visualizing Nectin-4-positive tumors using radiolabeled bicyclic peptide derivatives and optimized the pharmacokinetics of radiotracers by introducing PEG chains of different lengths. Five PEGylated radiotracers radiolabeled with 68Ga3+ exhibited high radiochemical purity and stability. As the chain length increased, the Log D values decreased from -2.32 ± 0.13 to -2.50 ± 0.16, indicating a gradual increase in the hydrophilicity of the radiotracers. In vitro cell-binding assay results showed that the PEGylated bicyclic peptide exhibits nanomolar affinity, and blocking experiments confirmed the specific binding of the tracers to the Nectin-4 receptor. In vivo PET imaging and biodistribution studies in SW780 and 5637 xenograft mice showed that [68Ga]Ga-NOTA-PEG12-BP demonstrated optimal pharmacokinetics, characterized by rapid and good tumor uptake, faster background clearance, and improved tumor-to-tissue contrast. Finally, compared with 18F-FDG, PET imaging, in vivo blocking assays of [68Ga]Ga-NOTA-PEG12-BP and histological staining confirmed that specific tumor uptake was mediated by Nectin-4 receptors. The results indicated that [68Ga]Ga-NOTA-PEG12-BP was a promising PET radiotracer for Nectin-4 targeting, with applications for clinical translation.

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IntroductionParallel to the advances in diagnostic imaging using positron emission tomography (PET), and availability of new systemic treatment options, the treatment paradigm in oncology has shifted towards more aggressive therapeutic interventions to include cytoreductive techniques and metastasectomies. Intraoperative localization of PET positive recurrent/metastatic lesions can be facilitated using a hand-held PET probe.Materials and methodsRecords of patients who underwent PET probe-guided surgery were reviewed. Surgical indications and operative targets were determined based on diagnostic PET/PET-CT images performed prior to probe-guided surgical planning. PET probe-guided surgery was performed on a separate day using a high-energy gamma probe (PET probe, Care Wise Medical, Morgan Hills CA) 2–6 hours post-injection of 5–15 mCi FDG. Probe count rates, target-to-background ratios, and lesion detection success were analyzed.ResultsTwenty-four patients underwent PET probe-guided surgery; one patient had two PET-probe guided surgeries resulting in a total of 25 cases (5 colorectal cancer cases, 4 thyroid cancer cases, 6 lymphoma cancer cases, and 10 other cancer cases). Surgical indication was diagnostic exploration in 6 cases with lymphoma and 1 case with head and neck cancer (28%). The remaining 18 cases (72%) underwent PET probe-guided surgery with a therapeutic intent in a recurrent or metastatic disease setting. All the lesions identified and targeted on a preoperative FDG-PET scan were detected by the PET probe with satisfactory in-vivo lesion count rates and a TBR of ≥ 1.5. PET probe allowed localization of lesions that were non-palpable and non-obvious at surgical exploration in 8 patients.ConclusionThe use of the PET probe improves the success of surgical exploration in selected indications. Separate day protocol is clinically feasible allowing for flexible operating room scheduling.

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  • Research Article
  • Cite Count Icon 13
  • 10.3390/ijms24087031
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  • Sep 22, 2025
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