American Association for Cancer Research
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Supplementary Figure S1. Decay chain of thorium-227. from In Vitro and In Vivo Efficacy of a Novel CD33-Targeted Thorium-227 Conjugate for the Treatment of Acute Myeloid Leukemia

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posted on 2023-04-03, 14:47 authored by Urs B. Hagemann, Katrine Wickstroem, Ellen Wang, Adam O. Shea, Kristine Sponheim, Jenny Karlsson, Roger M. Bjerke, Olav B. Ryan, Alan S. Cuthbertson

Thorium-227 is purified from actinium-227 (227Ac). Thorium-227 decays via its alpha- and beta-emitting daughters to stable nonradioactive 207Pb. The energy emitted at each decay step (in MeV) are summarized. When thorium-227 decays to radium-223, the 3,2-HOPO chelator is unable to retain the daughter nuclide radium-223 which will detach from the antibody-chelator conjugate.



The clinical efficacy of the first approved alpha pharmaceutical, Xofigo (radium-223 dichloride, 223RaCl2), has stimulated significant interest in the development of new alpha-particle emitting drugs in oncology. Unlike radium-223 (223Ra), the parent radionuclide thorium-227 (227Th) is able to form highly stable chelator complexes and is therefore amenable to targeted radioimmunotherapy. We describe the preparation and use of a CD33-targeted thorium-227 conjugate (CD33-TTC), which binds to the sialic acid receptor CD33 for the treatment of acute myeloid leukemia (AML). A chelator was conjugated to the CD33-targeting antibody lintuzumab via amide bonds, enabling radiolabeling with the alpha-emitter 227Th. The CD33-TTC induced in vitro cytotoxicity on CD33-positive cells, independent of multiple drug resistance (MDR) phenotype. After exposure to CD33-TTC, cells accumulated DNA double-strand breaks and were arrested in the G2 phase of the cell cycle. In vivo, the CD33-TTC demonstrated antitumor activity in a subcutaneous xenograft mouse model using HL-60 cells at a single dose regimen. Dose-dependent significant survival benefit was further demonstrated in a disseminated mouse tumor model after single dose injection or administered as a fractionated dose. The data presented support the further development of the CD33-TTC as a novel alpha pharmaceutical for the treatment of AML. Mol Cancer Ther; 15(10); 2422–31. ©2016 AACR.