Theranostic imaging of lymphoma using radiolabelled αCD19-antibodies

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Published: 25 Apr 2018
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Dr Dominik Sonanini - Tübingen University Hospital, Tübingen, Germany

Dr Sonanini speaks with ecancer at AACR 2018 about using a radiolabeled CD-19 antibody to determine patient eligibility for targeted therapies and monitor responses.

He outlines the facilities developed at the University of Tübingen to monitor and proceed with patients currently participating in trials, and discusses the increasing utility of imaging in oncology.

Our work focussed on the theranostic translational imaging using radiolabelled antibodies for PET imaging. We believe that PET imaging with these radiolabelled antibodies can help in patient stratification regarding the receptor status of people and to follow the biodistribution of these antibodies and to see or to detect offsite accumulation of these antibodies. Our work here, presented at the AACR, was about lymphoma imaging using the CD19 antibody. As we see, CD19 has emerged as an excellent target for lymphoma patients with the CAR-T cell therapies or B-specific antibodies or other FC optimised antibodies. But almost 50% of the people don’t respond to this therapy. With a radiolabelled antibody before therapy starts we aim to select patients who are eligible for this therapy and who might respond rather to the therapy than other patients who do not.

How is this labelling being deployed so far?

We developed a GMP conform radiolabelling facility at Tübingen to be ready for clinical studies. We have taken much effort in developing these kappa labelled antibodies in preclinical mouse models. We already have had six patients measured and imaged for PET imaging in the clinics and we detected many lymphoma sites of these patients in bone marrow, in all lymphoma sites, mediastinal and peritoneal lymphoma sites. Therefore we believe that it’s quite a good imaging modality to stratify those people and the next steps will be now that we correlate accumulation of this radiolabelled antibody to a therapy response. So we try to do first imaging with these CD19 radiolabelled antibodies and then we offer a CD19 targeted therapy and then we correlate this PET imaging with the therapy response of this targeted therapy.

Have you noticed imaging become increasingly important in oncology?

Definitely. As we see here, for example, today, there are other excellent works doing on this, as Anna Wu for example, she presented CD4 and CD8 antibody imaging possibilities to select patients or to see early response to immunotherapies. I think not only histology is important, we need in vivo receptor status regarding, for example, tumour heterogeneity and receptor heterogeneity. We think that imaging is therefore very important it will develop more and more in the next years with new imaging modalities such as simultaneous PET/MRI technique which is very sensitive and specific. So I really believe that it’s upcoming and getting more and more important in oncology and other subjects as well.