Method for detection and localization of malignant human tumours

Abstract

The invention relates to a method of detecting and localizing malignant tumours and their metastases in tissues, which in healthy condition condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin-receptors, in the body of a human being, which comprises (i) administering to said being a composition comprising, in a quantity sufficient for external imaging, a radiolabelled peptide selected from the group consisting of neurotensin (NT), NT-receptor agonists, NT-receptor antagonists, NT analogues and NT derivatives, and thereupon (ii) subjecting said being to external imaging, by radioactive scanning or by magnetic resonance imaging, to determine the targeted sites in the body of said being. The invention further relates to a method for the therapeutic treatment of said malignant tumours by administration of the above-defined peptide, labelled for this purpose, and to the differential-diagnostic assessment and detection of a specific tumour type (i.e. ductal exocrine pancreatic carcinoma) of the pancreas. The invention also relates to a pharmaceutical composition to be used for detection, a pharmaceutical composition to be used for therapy and to a kit for preparing a radiopharmaceutical composition.

1 . A method of detecting and localizing Ductal Exocrine Pancreas tumours and their metastases in tissues, which in healthy condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin-receptors, in the body of a human being, which comprises (i) administering to said being a composition comprising, in a quantity sufficient for external imaging, a peptide selected from the group consisting of neurotensin (NT), NT-receptor agonists, NT-receptor antagonists, NT analogues and NT derivatives, said peptide being labelled with (a) a radioactive metal isotope selected from the group consisting of  99m Tc,  203 Pb,  67 Ga,  68 Ga,  72 As,  111 In,  113m In,  97 Ru,  62 Cu,  64 Cu,  52 Fe,  52m Fe,  52m Mn and  51 Cr, or (b) with a paramagnetic metal atom selected from the group consisting of Cr, Mn, Fe, Co, Ni, Cu, Pr, Nd, Sm, Yb, Gd, Tb, Dy, Ho and Er, or (c) with a radioactive halogen isotope, selected from  123 I,  124 I,  125 I,  131L I,    75 Br,  76 Br, ←Br and  82 Br, and thereupon (ii) subjecting said being to external imaging, by radioactive scanning or by magnetic resonance imaging, to determine the targeted sites in the body of said being in relation to the background activity, in order to allow detection and localization of said tumours in the body.  
     
     
         2 . A method of intraoperatively detecting and localizing Ductal Exocrine Pancreas tumours in tissues, which in healthy condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin-receptors, in the body of a human being, which comprises (i) administering to said being a composition comprising, in a quantity sufficient for detection by a gamma detecting probe, a peptide selected from the group consisting of neurotensin (NT), NT-receptor agonists, NT-receptor antagonists, NT analogues and NT derivatives, said peptide being labelled with  161 Tb,  123 I or  125 I and thereupon (ii), after allowing the active substance to be bound and taken up in said tumours and after blood clearance of radioactivity, subjecting said being to a radioimmunodetection technique in the relevant area of the body of said being, by using a gamma detecting probe.  
     
     
         3 . A method for the therapeutic treatment of Ductal Exocrine Pancreas tumours in tissues, which in healthy condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin-receptors, in the body of a human being, which comprises administering to said being a composition comprising, in a quantity effective for combating or controlling tumours, a peptide selected from the group consisting of Neurotensin (NT), NT-receptor agonists, NT-receptor antagonists, NT analogues and NT derivatives, said peptide being labelled with an isotope selected from the group consisting of  186 Re,  188 Re,  77 As  90 Y,  67 Cu,  169 Er,  121 Sn,  127 Te,  142 Pr,  143 Pr,  198 Au,  199 Au,  161 Tb,  109 Pd,  165 Dy,  149 Pm,  151 Pm,  153 Sm,  157 Gd,  159 Gd,  166 Ho,  172 Tm,  169 Yb,  175 Yb,  177 Lu,  105 Rh,  111 Ag,  124 I and  131 I.  
     
     
         4 . A method as claimed in any of the preceding claims, characterized in that the Ductal Exocrine Pancreatic to be detected or controlled are present in Pancreatic tissue.  
     
     
         5 . A method as claimed in  claim 4 , characterized in that Ductal Exocrine Pancreatic Carcinoma is detected differentially from Endocrine Pancreatic Carcinoma.  
     
     
         6 . A method as claimed in any of the preceding claims, which comprises administering to said living being a composition comprising a labelled peptide, derived from a compound of the general formula  
       
         
           
                 
                 
               
                     
                 
                   H — ( ( ( ( ( ( (pGlu) m  — Leu) n  — Xaa) o  — Glu) p  — Asn) q  — Lys) r  — 
                     
                 
                     
                 
                            1                                 5 
                 
                     
                 
                     Xbb) s  — Xcc — Xdd — Pro — Xee — Ile — Leu — OH 
                 
                     
                 
                                   10                                       (I) 
                 
                     
                 
             
                
                
                
                
                
                
                
                
                
               
            
           
         
       
       or an acid amide thereof, formed between a free NH 2 -group of an amino acid moiety and R 1 COOH, wherein: 
 R 1  is a (C 1 -C 3 )alkanoyl group, an arylcarbonyl group, or an aryl- (C 1 -C 3 ) alkanoyl group; or a lactam thereof, formed between a free NH2 group of an amino acid moiety and a free CO 2 H group of another amino acid moiety; or a conjugate thereof with avidin or biotin; and wherein:  
                   Xaa is Tyr or Phe;           Xbb is Gly, Lys or Pro;           Xcc is Arg, Cit or Lys;           Xdd is Arg, Cit or Lys;           Xee is Tyr, Phe or Trp;             m ,  n ,  o ,  p ,  q ,  r  and  s  each independently are 0 or     1;                                  
 
     
     
         7 . A method as claimed in any of the preceding claims, which comprises administering to said living being a composition comprising a labelled peptide as defined in said preceding claims, wherein said peptide is labelled with a radioactive halogen isotope selected from the group consisting of  123 I,  124 I,  125 I,  131 I,  75 Br,  76 Br,  77 Br and  82 Br, said radioactive halogen isotope being attached to a Tyr or Trp moiety of the peptide, or to the aryl group of substituent R 1 .  
     
     
         8 . A method as claimed in any of the preceding claims  1 - 6 , which comprises administering to said living being a composition comprising a labelled peptide as defined in said preceding claims, wherein said peptide is labelled with a metal atom selected from (a) the group consisting of the radioactive isotopes  99m Tc,  203 Pb,  66 Ga,  67 Ga,  68 Ga,  72 As,  111 In,  113 In,  114m In,  97 Ru,  62 Cu,  64 Cu,  52 Fe,  52m Mn,  5 Cr,  186 Re,  188 Re,  77 As,  90 Y,  67 Cu,  169 Er,  117m Sn,  12 Sn,  127 Te,  142 Pr,  143 Pr,  198 Au,  199 Au,  149 Tb,  161 Tb,  109 Pd,  165 Dy, 149Pm,  151 Pm,  153 Sm,  157 Gd,  166 Ho,  172 Tm,  169 Yb,  175 Yb,  177 Lu,  105 Rh and  111 Ag or (b) the group consisting of the paramagnetic metal atoms Cr, Mn, Fe, Co, Ni, Cu, Pr, Nd, Sm, Yb, Gd, Tb, Dy, Ho and Er; said metal atom being attached to the peptide by means of a chelating group chelating said atom, which chelating group is bound by an amide bond or through a spacing group to the peptide molecule.  
     
     
         9 . A method as claimed in  claim 8 , wherein said composition comprises a peptide labelled with a metal atom, chelated by an N t S (4-t)  tetradentate chelating agent, wherein t=2-4, or by a chelating group derived from ethylene diamine tetra-acetic acid (EDTA), diethylene triamine penta-acetic acid (DTPA), cyclohexyl 1,2-diamine tetra-acetic acid (CDTA), ethyleneglycol-O,O′-bis(2-aminoethyl)-N,N,N′,N′-tetra-acetic acid (EGTA), N,N-bis(hy-droxybenzyl)-ethylenediamine-N,N′-diacetic acid (HBED), triethylene tetramine hexa-acetic acid (TTHA), 1,4,7,10-tetraazacyclododecane-N,N′,N″,N′″-tetra-acetic acid (DOTA), hydroxyethyldiamine triacetic acid (HEDTA), 1,4,8,11-tetra-azacyclotetradecane-N,N′,N′,N′″-tetra-acetic acid (TETA), substituted DTPA, substituted EDTA, or from a compound of the general formula wherein: (II)  
       
         
           
           
               
               
           
         
       
       wherein: 
 R is a branched or non-branched, optionally substituted hydrocarbyl radical, which may be interrupted by one or more hetero-atoms selected from N, O and S and/or by one or more NH groups, and  
 Q is a group which is capable of reacting with an amino group of the peptide and which is preferably selected from the group consisting of carbonyl, carbimidoyl, N—(C 1 -C 6 ) alkylcarbimidoyl, N-hydroxy-carbimidoyl and N—(C 1 -C 6 )alkoxycarbimidoyl; and  
 wherein said optionally present spacing group is a biotinyl moiety or has the general formula  
                     
 wherein R 3  is a C 1 -C 10  alkylene group, a C 1 -C 10  alkylidene group or a C 2 -C 10  alkenylene group, and X is a thiocarbonyl group or a group of the general formula  
                     
 wherein z is 1-5.  
 
     
     
         10 . The use of a labelled peptide selected from the group consisting of neurotensin (NT), NT-receptor agonists, NT-receptor antagonists, NT analogues and NT derivatives, said peptide being labelled with (a) a radioactive metal isotope selected from the group consisting of  99 Tc,  203 Pb,  67 Ga,  68 Ga,  72 As,  111 In,  113m In,  97 Ru,  62 Cu,  64 Cu,  52 Fe,  52m Mn and  51 Cr, or (b) with a paramagnetic metal atom selected from the group consisting of Cr, Mn, Fe, Co, Ni, Cu, Pr, Nd, Sm, Yb, Gd, Tb, Dy, Ho and Er, or (c) with a radioactive halogen isotope, selected from  123 I,  124 I,  125 I,  131 I,  75 Br,  76 Br,  77 Br and  82 Br, for preparing a diagnostic composition for detecting and localizing Ductal Exocrine Pancreas human tumours, including the metastases thereof, in tissues, which in healthy condition condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin-receptors, in the body of a human being.  
     
     
         11 . The use of a labelled peptide peptide selected from the group consisting of Neurotensin (NT), NT-receptor agonists, NT-receptor antagonists, NT analogues and NT derivatives, said peptide being labelled with an isotope selected from the group consisting of  186 Re,  188 Re,  77 As,  90 Y,  67 Cu,  169 Er,  121 Sn,  127 Te,  142 Pr,  143 Pr,  198 Au,  199 Au,  161 Tb,  109 Pd,  165 Dy,  149 Pm,  153 Pm,  153 Sm,  157 Gd,  159 Gd,  166 Ho,  172 Tm,  169 Yb,  175 Yb,  177 Lu,  105 Rh,  111 Ag,  124 I and  131 I, for preparing a pharmaceutical composition for the therapeutic treatment of Ductal Exocrine Pancreas human tumours, including the metastases thereof, in tissues, which in healthy condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin-receptors, in the body of a human being.  
     
     
         12 . A pharmaceutical composition to be used for the method as claimed in  claim 1 ,  2  or  3 , comprising in addition to a pharmaceutically acceptable carrier material and, if desired, at least one pharmaceutically acceptable adjuvant, as the active substance a labelled peptide as defined in  claim 6 , with the proviso that L and a in the general formula I are 1.  
     
     
         13 . A kit for preparing a radiopharmaceutical composition or detecting and localizing or for therapeutic treatment of Ductal Exocrine Pancreas tumours and their metastases in tissues, which in healthy condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin receptors, comprising (i) a peptide as defined in  claim 6 , with the proviso that L and a in the general formula I are 1, to which peptide, if desared, an inert pharmaceutically acceptable carrier and/or formulating agents and/or adjuvants is/are added, (ii) a solution of a salt or chelate of a metal selected from the group consisting of the radioactive isotopes  203 Pb,  66 Ga, 67Ga, 68Ga,  72 As,  111 In,  113m In,  114m In,  97 Ru,  62 Cu,  99m Tc,  186 Re, 188Re,  64 Cu,  52 Fe,  52m Mn,  51 Cr,  77 As,  90 Y,  67 Cu,  169 Er,  117m Sn,  121 Sn,  127 Te,  142 Pr,  143 Pr,  198 Au,  199 Au,  149 Tb,  161 Tb,  109 Pd,  165 Dy,  149 Pm,  151 Pm,  153 Sm,  157 Gd,  166 Ho,  172 Tm,  169 Yb,  175 Yb,  177 Lu,  105 Rh and  111 Ag, and (iii) instructions for use with a prescription for reacting the ingredients present in the kit.  
     
     
         14 . A kit for preparing a radiopharmaceutical composition, for detecting and localizing Ductal Exocrine Pancreas tumours and their metastases in tissues, which in healthy condition and in non-neoplastic conditions of chronic inflammation do not contain substantial quantities of neurotensin receptors, comprising (i) a peptide as claimed in  claim 13 , to which peptide, if desired, an inert pharmaceutically acceptable carrier and/or formulating agents and/or adjuvants is/are added, (ii) a reducing agent, and, if desired, a chelator, said ingredients (i) and (ii) optionally being combined, and (iii) instructions for use with a prescription for reacting the ingredients of the kit with  99m Tc in the form of a pertechnetate solution or with  186 Re or  188 Re in the form of a perrhenate solution.