Abstract 5744: Preclincial therapy of androgen independent prostate cancer using combinationLu-177-BB2r targeting peptides and docetaxel

Introduction: The bombesin receptor subtype 2 (BB2r) is an attractive target for the selective delivery of peptide receptor targeted radiation therapy for androgen independent prostate cancer (AIPC). Earlier work from our group has focused on the use of the BB2r agonist 177 Lu-177-DOTA-8-AOC-BBN(7-14)NH 2 administered concurrently with docetaxel to achieve tumor control in flank xenograft models of AIPC. We now present a direct comparison of 177 Lu-BB2r agonist verses 177 Lu-BB2r antagonist demonstrating the superiority of employing the BB2r antagonist, RM2, for the treatment of AIPC using a SCID mouse model. Methods: DOTA-8-AOC-BBN(7-14)NH 2 was synthesized in house. RM2 was commercially synthesized. 177 Lu radiolabeled peptides were prepared and purified using analytical HPLC resulting in a high specific activity preparation. The AIPC tumor bearing mice were created following bilateral flank inoculation of 1X10 6 PC-3 cells. Pharmacokinetic analysis and Micro-SPECT imaging of 177 Lu-RM2 was conducted out to 14 days post administration. Survival study design compared a 177 Lu-BB2r agonist /docetaxel arm with a 177 Lu-BB2r antagonist /docetaxel arm including a non-treated tumor bearing control arm. Multi-modal therapy consisting of docetaxel (8mg/kg; administered weekly) and 177 Lu-BB2r peptide therapy (37MBq/25g; administered weekly) was delivered for six consecutive weeks. Subjects were removed from study based on evidence of morbidity and body condition score. Results: Pharmacokinetic analysis and Micro-SPECT imaging of 177 Lu-RM2 demonstrated prolonged tumor retention with minimal non-target tissue accumulation observed within 24 hours post administration. Survival analysis at Day 100 demonstrated that 67% of the mice in the multi-modal BB2r antagonist therapy arm (chemo + targeted 177 Lu radiation therapy) were responding to treatment as compared to a 17% survival of the combination BB2r agonist/chemotherapy arm only arm at the same time point. 177 Lu-RM2 antagonist therapy demonstrated tumor regression and complete control whereas 177 Lu agonist therapy tumor regression was short lived with complete regrowth observed 45 days following last treatment. Conclusions: Our preclinical data suggests that 177 Lu-BB2r antagonist therapy is superior to 177 Lu-BB2r agonist therapy when used concurrently with docetaxel employing a preclinical model of AIPC. The use of 177 Lu-BB2r antagonists permits accurate SPECT imaging of therapeutic agent localization at prolonged times post injection. More extensive evaluation of 177 Lu-BB2r antagonist therapy for AIPC are warranted to exploit the potential of these agents for clinical use. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5744. doi:1538-7445.AM2012-5744