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68Ga-Trivehexin is an investigative PET radiopharmaceutical targeting the “cancer integrin” αvβ6, a tumor cell biomarker which is highly expressed by various carcinomas [1]. Feasibility of targeting αvβ6-integrin for cancer imaging has been demonstrated in preclinical and first clinical applications [2, 3, 4, 5], warranting a clinical study of 68Ga-Trivehexin (NCT05799274).
The image shows a 68Ga-Trivehexin PET/CT (146 MBq, 60 min p.i. static scan, 5 bed positions) of a male patient (50 y, 69 kg), acquired as part of primary staging before therapy planning of a histologically confirmed pancreatic ductal adenocarcinoma (PDAC) in the pancreatic corpus. Furthermore, a tonsillar carcinoma, metastasized to the right cervical side with subsequent surgical resection and chemo-radiotherapy, was known. The lateral MIP (scaled to SUV 12) and corresponding coronal fusion (A) showed intense uptakes in the cerebellopontine angle (1, SUVmax 18.5) corresponding to a brain metastasis; in a supraclavicular metastasis (2, SUVmax 12.7); in the pancreatic corpus (3, SUVmax 17.0); and in retrocrural and retroperitoneal PDAC metastases (4, SUVmax 13.3). B, C, and D show coronal and transversal PET slices and fusion, respectively, of the cerebellopontine metastasis, which was subsequently confirmed by MRI (not shown). Left tumor exstirpation yielded a specimen for histological classification of the brain metastasis as squamous cell carcinoma (SCC) with basaloid growth, p40 and p63 positive. Cranial and supraclavicular metastases were thus assigned to tonsillar carcinoma without association to HPV according to immunohistochemistry. Altogether, 68Ga-Trivehexin PET/CT revealed two αvβ6-integrin expressing tumors, PDAC and SCC, and furthermore a metastasis of the latter in the brain, which is obviously not easily possible with [18F]FDG.
Data availability
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.
References
Niu J, Li Z. The roles of integrin αvβ6 in cancer. Cancer Lett. 2017;403:128–37.
Altmann A, Sauter M, Roesch S, Mier W, Warta R, Debus J, Dyckhoff G, Herold-Mende C, Haberkorn U. Identification of a Novel ITGαvβ6-Binding peptide using protein separation and Phage Display. Clin Cancer Res. 2017;23:4170–80.
Kimura RH, Wang L, Shen B, Huo L, Tummers W, Filipp FV, et al. Evaluation of integrin αvβ6 cystine knot PET tracers to detect cancer and idiopathic pulmonary fibrosis. Nat Commun. 2019;10:4673.
Hausner SH, Bold RJ, Cheuy LY, Chew HK, Daly ME, Davis RA, et al. Preclinical Development and First-in-human imaging of the integrin αvβ6 with [18F]αvβ6-Binding peptide in metastatic carcinoma. Clin Cancer Res. 2019;25:1206–15.
Quigley NG, Steiger K, Hoberück S, Czech N, Zierke MA, Kossatz S, et al. PET/CT imaging of head-and-neck and pancreatic cancer in humans by targeting the Cancer integrin αvβ6 with Ga-68-Trivehexin. Eur J Nucl Med Mol Imaging. 2022;49:1136–47.
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Open Access funding enabled and organized by Projekt DEAL.
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Conceived and designed the experiment: Jana Rehm, Johannes Notni, Jörg Kotzerke. Performed the experiments: Jana Rehm, Robert Winzer. Analyzed the data: Robert Winzer, Jana Rehm. Wrote the original manuscript: Jana Rehm. All authors approved the final version of the manuscript.
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The data analysis received approval from the responsible local ethics committees (EK-242052023).
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Competing interests
Johannes Notni: co-inventor of patents related to 68Ga-Trivehexin; co-founder, shareholder, and CSO of TRIMT GmbH (Radeberg, Germany); member of the scientific advisory board of Radiopharm Theranostics LLC (Carlton, Australia). All other authors declare that they have no competing interests.
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Rehm, J., Winzer, R., Notni, J. et al. Concomitant metastatic head-and-neck cancer and pancreatic cancer assessed by αvβ6-integrin PET/CT using 68Ga-Trivehexin: incidental detection of a brain metastasis. Eur J Nucl Med Mol Imaging (2024). https://doi.org/10.1007/s00259-024-06750-6
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DOI: https://doi.org/10.1007/s00259-024-06750-6