Exploitation of CD133 for the targeted imaging of lethal prostate cancer

Purpose: Aggressive variant prostate cancer (AVPC) is a non-androgen receptor-driven form of disease that arises in men who have failed standard-of-care therapies. Therapeutic options for AVPC are limited, and the development of novel therapeutics is significantly hindered by the inability to accurately quantify patient response to therapy by imaging. Imaging modalities that accurately and sensitively detect the bone and visceral metastases associated with AVPC do not exist. Experimental Design: This study investigated the transmembrane protein CD133 as a targetable cell surface antigen in AVPC. We evaluated the expression of CD133 by microarray and immunohistochemistry analysis. The imaging potential of the CD133-targeted IgG (HA10 IgG) was evaluated in preclinical prostate cancer models using two different imaging modalities: near-infrared and positron emission tomography (PET) imaging. Results: Evaluation of the patient data demonstrated that CD133 is overexpressed in a specific phenotype of AVPC that is androgen receptor-indifferent and neuroendocrine differentiated. Additionally, HA10 IgG was selective for CD133-expressing tumors in all preclinical imaging studies. PET imaging with [89Zr]Zr-HA10 IgG revealed a mean %ID/g of 24.30±3.19 in CD133-positive metastatic lesions as compared to 11.82±0.57 in CD133-negative lesions after 72 hours (p=0.0069). Ex vivo biodistribution showed similar trends as signals were increased by nearly 3-fold in CD133-positive tumors (p