Phase I study to assess safety, biodistribution and radiation dosimetry for 89 Zr-girentuximab in patients with renal cell carcinoma

• Published in: European journal of nuclear medicine and molecular imaging Vol. 48; no. 10; p. 3277
• Main Authors: Merkx, Robin I J, Lobeek, Daphne, Konijnenberg, Mark, Jiménez-Franco, Luis David, Kluge, Andreas, Oosterwijk, Egbert, Mulders, Peter F A, Rijpkema, Mark
• Format: Journal Article
• Language: English
• Published: Germany 01.09.2021
• Subjects: Antibodies, Monoclonal; Carcinoma, Renal Cell - diagnostic imaging; Carcinoma, Renal Cell - radiotherapy; Humans; Kidney Neoplasms - diagnostic imaging; Positron Emission Tomography Computed Tomography; Positron-Emission Tomography; Radiometry; Tissue Distribution; Zirconium-89; RCC; Organ-based dosimetry; Girentuximab
• ISSN: 1619-7089

In this phase I study, we evaluated the safety, biodistribution and dosimetry of [ Zr]Zr-DFO-girentuximab ( Zr-girentuximab) PET/CT imaging in patients with suspicion of clear cell renal cell carcinoma (ccRCC). Ten eligible patients received an intravenous administration of 37 MBq (± 10%) of Zr-girentuximab at mass doses of 5 mg or 10 mg. Safety was evaluated according to the NCI CTCAE (version 4.03). Biodistribution and normal organ dosimetry was performed based on PET/CT images acquired at 0.5, 4, 24, 72 and 168 h post-administration. Additionally, tumour dosimetry was performed in patients with confirmed ccRCC and visible tumour uptake on PET/CT imaging. Zr-girentuximab was administered in ten patients as per protocol. No treatment-related adverse events ≥ grade 3 were reported. Zr-girentuximab imaging allowed successful differentiation between ccRCC and non-ccRCC lesions in all patients, as confirmed with histological data. Dosimetry analysis using OLINDA/EXM 2.1 showed that the organs receiving the highest doses (mean ± SD) were the liver (1.86 ± 0.40 mGy/MBq), the kidneys (1.50 ± 0.22 mGy/MBq) and the heart wall (1.45 ± 0.19 mGy/MBq), with a mean whole body effective dose of 0.57 ± 0.08 mSv/MBq. Tumour dosimetry was performed in the 6 patients with histologically confirmed ccRCC resulting in a median tumour-absorbed dose of 4.03 mGy/MBq (range 1.90-11.6 mGy/MBq). This study demonstrates that Zr-girentuximab is safe and well tolerated for the administered activities and mass doses and allows quantitative assessment of Zr-girentuximab PET/CT imaging in patients with suspicion of ccRCC. NCT03556046-14th of June, 2018.