Toni A Pringle1, Corey D Chan2,3, Saimir Luli4, Helen J Blair3,5, Kenneth S Rankin2,3, James C Knight1,6. 1. School of Natural and Environmental Sciences, Newcastle University, Newcastle Upon Tyne NE1 7RU, U.K. 2. North of England Bone and Soft Tissue Tumour Service, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Freeman Road, Newcastle Upon Tyne NE7 7DN, U.K. 3. Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE1 7RU, U.K. 4. Preclinical In Vivo Imaging, Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne NE2 4HH, U.K. 5. Wolfson Childhood Cancer Research Centre, Newcastle Upon Tyne NE1 7RY, U.K. 6. Newcastle Centre for Cancer, Newcastle University, Newcastle Upon Tyne NE1 7RU, U.K.
Abstract
Bone sarcomas are devastating primary bone cancers that mostly affect children, young adults, and the elderly. These aggressive tumors are associated with poor survival, and surgery remains the mainstay of treatment. Surgical planning is increasingly informed by positron emission tomography (PET), and tumor margin identification during surgery is aided by near-infrared fluorescence (NIRF) imaging, yet these investigations are confounded by probes that lack specificity for sarcoma biomarkers. We report the development of a dual-modal (PET/NIRF) immunoconjugate ([89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW) that targets MT1-MMP, a matrix metalloproteinase overexpressed in high-grade sarcomas. [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW was synthesized via site-specific chemoenzymatic glycan modification, characterized, and isolated in high specific activity and radiochemical purity. Saturation binding and immunoreactivity assays indicated only minor perturbation of binding properties. A novel mouse model of dedifferentiated chondrosarcoma based on intrafemoral inoculation of HT1080 WT or KO cells (high and low MT1-MMP expression, respectively) was used to evaluate target binding and biodistribution. Fluorescence and Cerenkov luminescence images of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW showed preferential uptake in HT1080 WT tumors. Ex vivo gamma counting revealed that uptake in MT1-MMP-positive tumors was significantly higher than that in control groups. Taken together, [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW is a promising dual-modal sarcoma imaging agent for pre-operative surgical planning and intraoperative surgical guidance.
Bone sarcomas are devastating primary bone cancers that mostly affect children, young adults, and the elderly. These aggressive tumors are associated with poor survival, and surgery remains the mainstay of treatment. Surgical planning is increasingly informed by positron emission tomography (PET), and tumor margin identification during surgery is aided by near-infrared fluorescence (NIRF) imaging, yet these investigations are confounded by probes that lack specificity for sarcoma biomarkers. We report the development of a dual-modal (PET/NIRF) immunoconjugate ([89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW) that targets MT1-MMP, a matrix metalloproteinase overexpressed in high-grade sarcomas. [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW was synthesized via site-specific chemoenzymatic glycan modification, characterized, and isolated in high specific activity and radiochemical purity. Saturation binding and immunoreactivity assays indicated only minor perturbation of binding properties. A novel mouse model of dedifferentiated chondrosarcoma based on intrafemoral inoculation of HT1080 WT or KO cells (high and low MT1-MMP expression, respectively) was used to evaluate target binding and biodistribution. Fluorescence and Cerenkov luminescence images of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW showed preferential uptake in HT1080 WT tumors. Ex vivo gamma counting revealed that uptake in MT1-MMP-positive tumors was significantly higher than that in control groups. Taken together, [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW is a promising dual-modal sarcoma imaging agent for pre-operative surgical planning and intraoperative surgical guidance.
Bone sarcomas are a group of rare, heterogeneous
cancers associated
with poor clinical outcomes that predominantly affect children and
young adults, as well as the elderly.[1] The
mainstay of treatment for bone sarcomas is surgical resection, alongside
chemotherapy and radiotherapy depending on the tumor type; however,
despite imaging and treatment advancements, the 5 year overall survival
rate has remained similar for the past 30 years (53–55%).[2] In older patients, dedifferentiated chondrosarcoma
is a particularly aggressive form of bone sarcoma with a 5 year survival
rate of just 18%.[3]Patients with
primary malignant bone tumors often present with
persistent pain, leading to X-ray and, preferably, MRI investigations.[2] Surgery with or without adjuvant therapy is the
mainstay of treatment for localized or resectable bone sarcomas.[2,5] Pre-operative imaging is performed to locate the tumor and optimize
margins for excision. This is currently often accomplished using two
plane radiographs, along with MRI and CT scans in most cases. Positron
emission tomography (PET) scanning with the glucose metabolism radiotracer 18F-fluorodeoxyglucose ([18F]FDG) has been evaluated
in pre-operative imaging of sarcomas in a recent clinical study.[6] The results from pre-operative imaging are discussed
at multidisciplinary team meetings to determine the best surgical
procedure for each patient, given the high variability between cases.[2] Surgical resection aims to remove the tumor fully
surrounded by healthy tissue to achieve negative tumor margins, while
maintaining as much healthy tissue as possible to maximize the recovery
and functional outcomes for the patient. Following tumor resection,
histological assessment is performed to ensure that negative margins
have been achieved. A negative margin means that the tumor has been
removed completely with no cancer left behind. If the margin is positive,
this indicates that the patient may need further surgery to remove
any residual cancer cells. It is important to achieve negative margins
at the first operation as the risk of bone sarcoma recurrence has
been found to strongly correlate to the incidence of positive tumor
margins after excision.[7] Although pre-operative
imaging techniques can provide good tumor margin identification, it
can be difficult to refer to these images during open resection due
to the changing anatomy intraoperatively.[8]Intraoperative fluorescence-guided surgery (FGS) can aid surgeons
by providing real-time guidance in discerning tumor margins using
near-infrared cameras. Indocyanine green (ICG) is a well-established
near-infrared fluorescence (NIRF) dye that has recently been used
for intraoperative image-guided sarcoma resection[9] and has shown potential to reduce the unexpected positive
margin rate.[10] The preferential tumor uptake
of ICG is non-targeted, occurring due to the enhanced permeability
and retention effect.[11] Due to its lack
of specificity, ICG is limited by issues surrounding off-target and
background fluorescence as the dye can accumulate in necrotic, non-cancerous,
and inflamed tissues.[8,12] Alternatively, targeted approaches
can be used to overcome these issues by conjugating the fluorophore
to a suitable biomarker-specific vector, such as an antibody.[13] However, the lack of clinically validated sarcoma-specific
biomarkers has hampered progress in this area.Membrane type-1
matrix metalloproteinase (MT1-MMP, also known as
MMP-14) is a cell surface enzyme overexpressed in a range of cancers,
including sarcoma, and is associated with tumor growth, invasion,
metastasis, and angiogenesis.[14] MT1-MMP
belongs to a family of MMPs that degrade components of the extracellular
matrix (ECM).[15] The principal role of MT1-MMP
involves degradation and remodeling of collagen and proteoglycans;
however, it also activates other proteolytic MMPs, which themselves
degrade ECM components, leading to increased invasion of the basement
membrane. In addition, MT1-MMP induces epithelial–mesenchymal
transition, a process by which cancer cells undergo changes in their
morphology, leading to a migratory phenotype,[16] promoting extravasation into adjacent blood vessels and metastasis
to distant tissues.[17] Lastly, MT1-MMP binding
to the tissue inhibitor of metalloproteinases 2 (TIMP-2) increases
expression of MMP-2, which is associated with a poor response to chemotherapy
in some bone sarcoma subtypes.[18] MT1-MMP
therefore represents an attractive imaging biomarker of sarcomas.A murine anti-MT1-MMP monoclonal antibody (LEM2/15) that binds
to residues 218–233 of the V–B loop of MT1-MMP with
high affinity (Kd = 0.4 nM) has been used
in two recent studies to facilitate preclinical immunoPET imaging
of MT1-MMP overexpression in pancreatic ductal adenocarcinoma and
glioma.[19,20] In both cases, the method for labeling LEM2/15
with the PET radiometal zirconium-89 (89Zr) was based upon
conventional non-site-specific conjugation of an isothiocyanate-functionalized
derivative of desferrioxamine (DFO) to the ε-amino group of
any accessible lysine residue on the antibody, resulting in heterogeneous
mixtures of products that can be difficult to chemically define due
to highly variable degrees of labeling. Furthermore, this non-site-specific
approach can lead to reductions in the immunoreactivity of the radioimmunoconjugate
(RIC) due to modifications at the antigen binding domain. An alternative
bioconjugation strategy based on site-specific chemoenzymatic modification
of IgG heavy chain glycans was first applied to RICs by Zeglis et al.(21) This approach enables
precise control of the conjugation sites and stoichiometry, resulting
in a greatly reduced distribution of products, which is especially
important in dual-modal RICs due to the attachment of two different
reporter moieties. The administration of a single dual-modal antibody,
in contrast to a mixture of monomodal radio- and fluorophore-labeled
antibodies, is advantageous as it avoids differing pharmacokinetic
profiles and ensures co-localization of signal from each modality.
In addition, the synthesis, preclinical evaluation, and clinical translation
of a single dual-modal antibody is more economical and less laborious
relative to the development of two distinct agents.[22]We report the development of a dual-modal (PET/NIRF)
imaging agent
based on a site-specifically glycoengineered anti-MT1-MMP (LEM2/15.8)
immunoconjugate for pre-operative PET-based assessment and FGS of
MT1-MMP-overexpressing sarcomas. Preclinical evaluation of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW was facilitated by radioligand
binding assays, radio-immunohistochemistry, and in vivo experiments. In order to maximize the clinical translatability of
our in vivo study, we developed a murine model of
MT1-MMP-expressing dedifferentiated chondrosarcoma by intrafemoral
orthotopic injection, allowing us to investigate the dual-modal agent
with clinical relevance to the sarcoma field.
Results and Discussion
Synthesis and Characterization of Antibody Conjugates
Dual-labeled RICs were prepared by a four-step synthesis involving
the chemoenzymatic modification of the heavy chain glycans of either
anti-MT1-MMP or mouse IgG1 control antibodies with dibenzocyclooctyne
(DBCO)-modified derivatives of DFO and IRDye800CW (Figure ).
Figure 1
Scheme of the chemoenzymatic
approach used to synthesize the dual-modal
(PET/NIRF) RICs based on site-specific modification of the N-linked
biantennary glycans situated on the heavy chain of the antibody.
Scheme of the chemoenzymatic
approach used to synthesize the dual-modal
(PET/NIRF) RICs based on site-specific modification of the N-linked
biantennary glycans situated on the heavy chain of the antibody.The overall synthetic yields of the radiolabeling
precursors DFO-anti-MT1-MMP-IRDye800CW
and DFO-IgG-IRDye800CW were 46.15 ± 10.14% (n = 7) and 68.44 ± 3.60% (n = 3), respectively.
The degree of labeling of IRDye800CW (DOLIRDye800CW) for
anti-MT1-MMP and IgG antibodies was determined using UV–Vis
spectroscopy to be 1.74 ± 0.47 (n = 7) and 1.41
± 0.68 (n = 3), respectively. High-performance
liquid chromatography coupled with electrospray ionization-quadrupole-time
of flight-mass spectrometry (LC ESI-QTOF MS) analysis of the conjugates
was performed to assess the site-specific nature of the conjugation
method (Figure S1). As expected, the spectra
showed an increase in mass of the heavy chain of the azide and DFO/IRDye800CW-modified
antibodies compared to the unmodified Ab. The light chain of all anti-MT1-MMP
Ab samples remained the same mass throughout (24,080 Da).
Radiolabeling and Characterization
Radiochemical yields
(RCY) were determined by radio-instant thin layer chromatography (radio-iTLC)
to be 66 ± 28% (n = 5) for the anti-MT1-MMP
RIC and 74 ± 22% (n = 3) for the IgG control
(Figure S2). Size exclusion chromatography
enabled the isolation of both RICs in excellent radiochemical purity
(>99%) and high specific activity (0.1 MBq/μg).[23]Site-specific modification of the N-linked
glycans
on the heavy chains of the anti-MT1-MMP antibody was confirmed by
sodium dodecyl-sulfate polyacrylamide gel electrophoresis (SDS-PAGE)
under reducing conditions (Figure ). Fluorescence imaging and autoradiography analysis
revealed co-localization of both IRDye800CW and 89Zr with
the bands corresponding to the heavy chains (∼50 kDa), with
no evidence of non-specific conjugation on the light chains (∼25
kDa).
Figure 2
SDS-PAGE of unmodified anti-MT1-MMP (lane 2), DFO-anti-MT1-MMP-IRDye800CW
(lane 3), and [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW (lane
4) compared to a protein ladder (lane 1, masses shown on the left).
The gel was run under reducing conditions, stained with Coomassie
Fluor Orange, and analyzed by fluorescence imaging and autoradiography.
SDS-PAGE of unmodified anti-MT1-MMP (lane 2), DFO-anti-MT1-MMP-IRDye800CW
(lane 3), and [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW (lane
4) compared to a protein ladder (lane 1, masses shown on the left).
The gel was run under reducing conditions, stained with Coomassie
Fluor Orange, and analyzed by fluorescence imaging and autoradiography.The solution stability of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
in phosphate buffered saline (PBS), mouse serum, and human serum was
assessed daily by radio-iTLC over 7 days at 25 and 37 °C. At
25 °C, the RIC remained >95% intact in all solutions over
7 days
(Figure S3). At 37 °C, the stability
of the RIC remained high (>80%) in both human and mouse serum over
7 days, although a decline in stability was evident in PBS from day
5 and only 49% of the RIC remained intact at day 7. This is most likely
due to the absence of serum proteins in PBS, such as the free radical
scavenger albumin, which would otherwise impart a minor radioprotective
effect.[24]The immunoreactive fraction
of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
was >95%, indicating that the site-specific bioconjugation strategy
effectively preserved the antigen binding fragment with only minimal
impact upon epitope binding (Figure A). Furthermore, the high binding affinity of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW determined in HT1080 WT
cells (wild-type cells, high MT1-MMP expression; Kd = 17.4 nM) and negligible binding to HT1080 KO cells
(MT1-MMP knock-out cells with low MT1-MMP expression, Figures S7–S14) indicate favorable specificity
(Figure B). The saturation
binding assay revealed a Bmax (cpm) value of 63,216 for
HT1080 WT cells, while uptake on HT1080 KO control cells could not
be saturated due to very low MT1-MMP expression.
Figure 3
(A) Immunoreactivity
of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
in HT1080 WT cells; (B) saturation binding plot to determine binding
affinity (Kd) of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
in HT1080 WT cells.
(A) Immunoreactivity
of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
in HT1080 WT cells; (B) saturation binding plot to determine binding
affinity (Kd) of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
in HT1080 WT cells.
Ex Vivo MT1-MMP Staining
Immunohistochemistry,
fluorescence, and digital autoradiography images of adjacent murine
tumor sections incubated with [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
were co-registered in order to assess the specificity of the dual-modal
tracer for MT1-MMP (Figure ). Excellent co-localization of both fluorescence (IRDye800CW)
and radioactive (89Zr) signals can be observed with regions
of elevated MT1-MMP expression on immunohistochemistry (IHC) images
(Figure ; brown),
whereas regions without MT1-MMP show low, diffuse signal in both imaging
modalities. Adjacent sections incubated with the non-specific control,
[89Zr]Zr-DFO-IgG-IRDye800CW, showed no co-localization
of fluorescence or radioactivity with MT1-MMP.
Figure 4
Representative immunohistochemistry
(brown: MT1-MMP, blue: nucleus)
with additional magnification, fluorescence, and digital autoradiography
images of adjacent murine tumor sections stained with [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW or [89Zr]Zr-DFO-IgG-IRDye800CW.
Representative immunohistochemistry
(brown: MT1-MMP, blue: nucleus)
with additional magnification, fluorescence, and digital autoradiography
images of adjacent murine tumor sections stained with [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW or [89Zr]Zr-DFO-IgG-IRDye800CW.
In Vivo Evaluation
To assess the ability
of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW to visualize MT1-MMP
expression in vivo, we developed a clinically relevant
murine model of MT1-MMP positive and MT1-MMP negative dedifferentiated
chondrosarcoma by orthotopic intrafemoral injection with either HT1080
WT or HT1080 KO cells, respectively. Using this model, intrafemoral
tumors were scanned for fluorescence and radioisotope-generated Cerenkov
luminescence at 24, 48, and 72 h following intravenous (IV) administration
of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW or [89Zr]Zr-DFO-IgG-IRDye800CW. Cerenkov luminescence imaging was used
as a rapid, simple, and cost-effective alternative to PET for semiquantitative in vivo evaluation of the RICs.[25] HT1080 WT tumor-bearing mice that received the MT1-MMP-specific
RIC showed higher fluorescence and Cerenkov signal at the tumor site
compared to control groups at all time points (Figures A,B, S4). Moreover,
images from both modalities showed a reduction in background signal
at a rate that is typical of an intact IgG, leading to an enhancement
of tumor contrast over 72 h.
Figure 5
Representative IVIS images showing mice bearing
either HT1080 WT
or KO tumours (right femur in supine position; red dashed circle)
acquired at 24, 48, and 72 h p.i. of either [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
(MT1) or [89Zr]Zr-DFO-IgG-IRDye800CW (IgG). Mice were imaged
for (A) fluorescence (Ex = 745 nm, Em = 800 nm) and (B) Cerenkov luminescence (open
filter).
Representative IVIS images showing mice bearing
either HT1080 WT
or KO tumours (right femur in supine position; red dashed circle)
acquired at 24, 48, and 72 h p.i. of either [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
(MT1) or [89Zr]Zr-DFO-IgG-IRDye800CW (IgG). Mice were imaged
for (A) fluorescence (Ex = 745 nm, Em = 800 nm) and (B) Cerenkov luminescence (open
filter).After the 72 h imaging timepoint, selected organs
were excised
and imaged for both Cerenkov luminescence and fluorescence (Figures , S5). Fluorescence intensity was significantly higher in HT1080
WT inoculated femurs of mice administered [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
compared to controls (P < 0.05). Moreover, fluorescence
signal was negligible in all other organs, which serves to highlight
the potential utility of this RIC in FGS applications. Cerenkov images
were consistent with these observations but were not quantified due
to high tissue photon attenuation.[26]
Figure 6
Representative
fluorescence (top) and Cerenkov (bottom) images,
respectively, showing the radiant efficiency and radiance of inoculated
femurs (left) and contralateral thigh muscle (right) for all groups.
Representative
fluorescence (top) and Cerenkov (bottom) images,
respectively, showing the radiant efficiency and radiance of inoculated
femurs (left) and contralateral thigh muscle (right) for all groups.The biodistribution of the RIC was assessed by
gamma counting at
72 h p.i. (Table ).
Uptake of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW in HT1080
WT (high MT1-MMP) inoculated femurs (17.64 ± 3.84 %IA/g) was
significantly higher compared to that in the HT1080 KO control group
(7.09 ± 2.62 [P < 0.01]) and higher than
uptake of the non-specific IgG control in both HT1080 WT and KO groups
(6.65 ± 1.64 %IA/g [P < 0.01] and 5.82 ±
1.84 %IA/g [P < 0.001], respectively) (Figure ; left). This uptake
value is comparable to previously reported values obtained using the
related agent 89Zr-DFO-LEM2/15 in a mouse model of glioma
based on U251 xenografts (17.7 ± 2.6 and 14.3 ± 2.0 %IA/g
at day 2 and 4 p.i., respectively)[20] and
higher than that observed in mice bearing CAPAN-2 xenografts (6.29
± 0.64 %IA/g at day 3 p.i).[27] Similarly,
inoculated femur-to-blood (Figure ; middle) and inoculated femur-to-muscle (Figure ; right) uptake ratios
for [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW in HT1080 WT femurs
(T/B: 1.31 ± 0.14; T/M: 13.89 ± 1.33) were significantly
higher than that in control groups. Although the extent of muscle
invasion varied in this model, increased uptake of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
was also observed in the thigh muscle immediately adjacent to femurs
inoculated with HT1080 WT cells (Table , Figure S6). [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW also accumulated highly in the
spleen (27.90 ± 3.98 %IA/g), and overall, splenic uptake of the
anti-MT1-MMP probe was significantly higher than that of the IgG (P < 0.001), suggesting that uptake is partly mediated
by MT1-MMP. Indeed, MT1-MMP is highly expressed in spleen;[28] however, it is also worth noting that high splenic
uptake is often encountered in immunoPET studies involving immunodeficient
mouse models due to antibody/Fc receptor interactions.[29] No other statistically significant differences
were apparent for any other organ, and the overall biodistribution
profile is typical of an 89Zr-labeled antibody in mice
at 3 days p.i.[30]
Table 1
Ex vivo Biodistribution
Data (%IA/g ± S.D.) for the [89Zr]Zr-DFO- and IRDye800CW-Labeled
anti-MT1-MMP and IgG RICs in NSG Mice Bearing Either HT1080 WT (High
MT1-MMP) or HT1080 KO (Low MT1-MMP) Orthotopic Tumors
organ
[89Zr]Zr-DFO-MT1-MMP-IRDye800CW + HT1080
WT
[89Zr]Zr-DFO-MT1-MMP-IRDye800CW + HT1080 KO
[89Zr]Zr-DFO-IgG-IRDye800CW
+ HT1080 WT
[89Zr]Zr-DFO-IgG-IRDye800CW + HT1080
KO
blood
13.77 ± 4.30
14.24 ± 2.23
18.22 ± 2.13
19.11 ± 2.78
inoculated femur
17.64 ± 3.84
7.91 ± 2.62
6.65 ± 1.64
5.82 ± 1.85
invaded thigh muscle
19.28 ± 14.02
10.55 ± 11.83
7.21 ± 5.68
3.37 ± 2.96
contralateral femur
7.57 ± 2.79
6.00 ± 4.50
4.65 ± 0.89
4.11 ± 0.27
contralateral thigh muscle
1.28 ± 0.32
1.31 ± 0.14
1.38 ± 0.20
1.68 ± 0.34
lung
10.36 ± 1.16
8.29 ± 1.58
10.00 ± 3.06
8.17 ± 1.34
liver
12.89 ± 1.31
10.80 ± 1.43
9.51 ± 0.83
7.97 ± 1.34
heart
4.68 ± 1.44
5.46 ± 2.29
5.36 ± 0.49
4.68 ± 0.91
spleen
27.90 ± 3.98
26.29 ± 11.03
13.10 ± 3.37
9.30 ± 2.01
stomach
1.133 ± 0.33
0.68 ± 0.26
1.09 ± 0.38
0.98 ± 0.31
small intestine
1.99 ± 0.43
1.76 ± 0.19
1.83 ± 0.24
1.71 ± 0.42
large intestine
2.05 ± 0.38
1.90 ± 0.33
2.06 ± 0.64
1.74 ± 0.11
pancreas
3.11 ± 1.47
2.43 ± 0.95
2.97 ± 0.51
2.32 ± 0.34
kidneys
8.42 ± 1.62
7.67 ± 0.89
6.22 ± 0.68
5.24 ± 0.98
skin
3.78 ± 1.39
5.09 ± 2.21
3.28 ± 1.73
4.23 ± 2.81
fat
3.74 ± 1.48
4.80 ± 1.87
3.07 ± 2.92
3.30 ± 2.56
Figure 7
Biodistribution data
collected 72 h after the administration of
[89Zr]Zr-DFO-MT1-MMP-IRDye800CW or [89Zr]Zr-DFO-IgG-IRDye800CW
in mice bearing HT1080 WT (high MT1-MMP) or HT1080 KO (low MT1-MMP)
tumors. (A) Uptake (%IA/g) in the inoculated femur for all groups;
(B) inoculated femur-to-blood ratios; (C) inoculated femur-to-muscle
ratios. Each group contained at least 3 animals. *P < 0.05. **P < 0.01. ***P < 0.001. ****P < 0.0001. Error bars represent
standard deviation.
Biodistribution data
collected 72 h after the administration of
[89Zr]Zr-DFO-MT1-MMP-IRDye800CW or [89Zr]Zr-DFO-IgG-IRDye800CW
in mice bearing HT1080 WT (high MT1-MMP) or HT1080 KO (low MT1-MMP)
tumors. (A) Uptake (%IA/g) in the inoculated femur for all groups;
(B) inoculated femur-to-blood ratios; (C) inoculated femur-to-muscle
ratios. Each group contained at least 3 animals. *P < 0.05. **P < 0.01. ***P < 0.001. ****P < 0.0001. Error bars represent
standard deviation.
Conclusions
This study provides data to support [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
as a promising dual-modal imaging agent for pre-operative surgical
planning and intraoperative FGS in sarcoma. Favorable MT1-MMP binding
specificity has been demonstrated in both in vitro experiments and a novel in vivo mouse model of
dedifferentiated chondrosarcoma. The development of anti-MT1-MMP RICs
could overcome a major challenge in FGS of sarcoma that stems from
the use of probes that lack specificity for molecular biomarkers of
sarcoma, leading to improved resection margins and better patient
outcomes. With a view to clinical translation, future work will evaluate
the in vivo stability, toxicity, and dosimetry of
the RIC and involve direct comparisons with other imaging agents including
ICG and [18F]FDG. In addition, humanization of the anti-MT1-MMP
antibody will be necessary to reduce the likelihood of adverse immunogenic
reactions in patients. Lastly, the development of a good manufacturing
practice compliant production method will be required for human administration
and evaluation in early phase clinical trials to assess the feasibility,
safety profile, and optimal dosing of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
for pre-operative PET imaging and FGS in patients with bone and soft
tissue sarcomas.
Experimental Procedures
General Methods
All reagents were purchased from Thermo
Fisher Scientific unless otherwise stated and used without further
purification. Water was deionized using a Select Fusion ultrapure
water deionization system (Suez) and had a resistance of >18.2
MΩ
cm–1 at 25 °C. Protein concentration measurements
were obtained using a NanoDrop One Microvolume UV–vis spectrophotometer
(NanoDrop Technologies, Inc.). Mass spectrometry measurements were
performed using a Thermo RSLC coupled to Bruker maXis. Radioactivity
measurements were obtained using a CRC-25 Dose Calibrator (Capintec,
Inc.) or a Wizard 2480 Gamma Counter (PerkinElmer). RIC synthesis
and serum stability studies were monitored by instant thin-layer chromatography
using glass microfiber chromatography paper (iTLC-SA, Agilent). Radio-iTLC
strips were measured by autoradiography (Amersham Typhoon Bioimager,
GE) and analyzed using ImageQuant software (GE Healthcare). All experiments
were performed in accordance with the United Kingdom Human Tissue
Act (2004) regulations. Appropriate informed consent for the use of
human tumor specimen slides and paraffin embedded blocks was obtained
and approved by the Newcastle and North Tyneside 1 Research Ethics
Committee (REC reference number: 17/NE/0361).
Site-Specific Antibody Modification
Preparation of the Azide-modified mAb
Azide-modified
anti-MT1-MMP (MSX LEM-2/15.8, Millipore) or IgG (mouse IgG1 Isotype Control, Bio-techne, Catalog # MAB002) was prepared using
the SiteClick Antibody Azido Modification Kit from Thermo Fisher using
a slightly modified procedure. Briefly, a purified aliquot of anti-MT1-MMP
or IgG (300 μg) was incubated with β-1,4-galactosidase
(10 μL) at 37 °C for 6 h at 450 rpm in a reaction volume
of 60 μL. A solution containing UDP-GalNAz (220 μg), GalT
(Y289L) enzyme (80 μL), SiteClick buffer additive (25 μL),
20× tris buffer (12.5 μL, pH 7), and deionized water (75
μL) was then added to the antibody solution. The resulting mixture
was incubated at 30 °C for 16 h at 450 rpm. The azide-modified
antibody was then isolated from the mixture using pre-rinsed 30 kDa
molecular weight cutoff 0.5 mL centrifugal filters (Amicon) at 12,000
× g for 10 min, followed by three washes and
adjustment to 1 mg/mL using 50 mM Tris buffer (pH 7.0). To the azide-modified
antibody solution, the following were added: (i) 15 M equivalents
of DFO-DBCO (Macrocyclics) from a 2 mM stock solution in dimethyl
sulfoxide and (ii) 15 M equivalents of IRDye800CW-DBCO (Li-Cor) from
a 2 mM stock solution in PBS, concurrently. The reaction mixture was
incubated at 25 °C for 16 h at 450 rpm. The site-specifically
labeled antibodies were then purified by centrifugal filtration as
previously described.
Degree of Labeling Determination by UV Spectroscopy
IRDye800CW degree of labeling (DOLIRDye800CW) was determined
by measuring the absorbance of the antibody conjugates at 280 and
774 nm.where and .CF = correction factor (A280/A774), εmax = molar attenuation coefficient at Amax, ε1% = percent molar attenuation coefficient for
a 10 mg/mL IgG solution.
LC ESI-qTOF MS
Immunoconjugate samples in PBS (∼5
μL, 0.7–1.0 mg/mL) were reduced by the addition of the
required volume of DTT (100 mM) to yield a 10 mM DTT concentration
in each sample. The samples were incubated at 60 °C for 30 min
prior to MS analysis. Protein samples were analyzed using a Thermo
RSLC coupled to a Bruker maXis. The equivalent of 1–5 μM
(1–5 pmol/μL) protein was injected onto the system per
run. The loading pump was used at high flow to run linear chromatography
gradients. The buffer system comprised Buffer A: 0.1% (v/v) formic
acid and Buffer B: 99.9% acetonitrile, 0.1% (v/v) formic acid. Chromatographic
separations were achieved using a Fortis C8 column, 100 mm ×
2.1 mm, 3 μM particle size, 45 °C at a flow rate of 150
μL/min. Proteins were loaded onto the column and desalted online
for 1 min, with eluent diverted to waste. A valve switch directed
flow to the mass spectrometer. Proteins were then eluted from the
column using a linear gradient from 3% to 70% Buffer B over 12 min.
Total run time was 17 min. The eluent was directed into a Bruker maXis
4G, operated in a positive mode. Source conditions had a dry temperature
of 200 °C, dry gas 6 L/min, Nebuliser gas 2.5 L/min, capillary
4500 v, and end plate offset 500 v. Data were acquired in an MS scan
mode between 800 and 5000 m/z. Resolution
of the instrument was 70,000 at m/z 922. Data files were assessed in Bruker Data Analysis software.
The charge state ruler was used to crudely assess and deconvolute
spectra. For more accurate deconvolution, .xy files were exported
and analyzed using UniDec software.[31]
SDS-PAGE
Anti-MT1-MMP immunoconjugates were analyzed
using reduced sodium dodecyl sulfate-polyacrylamide gel electrophoresis
(SDS-PAGE). Samples were prepared by adding sample buffer (2.5 μL,
NuPAGE 4× LDS sample buffer), dithiothreitol (1 μL, NuPAGE
10× Sample Reducing Agent), and deionized water (5.5 μL)
to each of the antibody samples (1 μL, 1 mg/mL). The resulting
solutions were incubated at 70 °C for 10 min at 450 rpm. Protein
samples and molecular weight standards (ThermoScientific PageRuler
Unstained Broad Range Protein Ladder) were then loaded on to a 10-well
protein gel (4–12% Bis-Tris) and run for 1 h at 200 V in NuPAGE
MOPS SDS running buffer. Once complete, the gel was washed three times
in water (200 mL, 5 min) before staining using Coomassie Fluor Orange
protein stain (50 mL) for 1 h. Destaining was achieved by washing
in acetic acid (1 M) for 5 min before finally washing again in water.
The gel was scanned using a Typhoon Bioimager for Coomassie Fluor
Orange (Cy3, λex = 532 nm) and IRDye800 (Cy7, λex = 785 nm).
Zirconium-89 Radiolabeling and Purification
In brief,
an aliquot containing approximately 17 MBq of zirconium-89 in oxalic
acid (1 M, PerkinElmer) was adjusted to pH 7 by the addition of sodium
carbonate (1 M). The resulting solution was added to a solution of
DFO-anti-MT1-MMP-IRDye800CW or DFO-IgG-IRDye800CW in PBS (95–101
μL, 2.3–2.4 mg/mL). The reaction mixture was incubated
at room temperature for 1 h at 450 rpm, and the radiolabeling efficiency
was determined by radio-iTLC using EDTA (50 mM, pH 5.5) as the mobile
phase. RICs were purified from the crude reaction mixture by size
exclusion chromatography using Sephadex-G50 resin (Sigma-Aldrich),
eluting with 100 μL fractions of PBS (pH 7.4) as the eluent.
The radiochemical purity of isolated RICs was determined by radio-iTLC
as previously described.
Serum Stability Studies
[89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
(27 μL, 0.1 mg/mL, 0.2 MBq) was added to human serum (500 μL,
Sigma-Aldrich, Cat# H4522), mouse serum (500 μL, Sigma-Aldrich,
Cat# M5905), or PBS (500 μL, 1×, pH 7.4) and incubated
at 450 rpm for 7 days at either 37 °C or 25 °C in triplicate.
RIC stability was assessed at 24 h intervals by radio-iTLC as previously
described.
Cell Lines
HT1080 WT (high MT1-MMP, obtained from ATCC)
and KO (low MT1-MMP) cell lines were authenticated before use and
found to be a 100% match to a HT1080 profile located on the ATCC database
(authenticated by NorthGene Limited, Newcastle). Details of creation
of the HT1080 MT1-MMP KO cells and validation of the gene and protein
knock-down are provided in the Supporting Information Cells were cultured in an RPMI 1640 cell culture medium (Sigma-Aldrich,
Cat#: R8758, with l-glutamine and sodium bicarbonate), supplemented
with 10% fetal bovine serum (FBS, Gibco), 100 units/mL penicillin,
and 10 μg/mL streptomycin (Gibco), in a humidified 5% CO2 environment at 37 °C. Cells were harvested and passaged
using Trypsin–EDTA solution (Gibco) with a subcultivation ratio
of 1:15 every 3–4 days. The cumulative length of the culture
was <6 months following retrieval from liquid nitrogen storage.
Cells were tested for the absence of mycoplasma at regular intervals.
In Vitro Assays
The immunoreactivity
of [89Zr]Zr-DFO-anti-MT1-MMP was determined on HT1080 WT
cells by linear extrapolation to an infinite antigen excess according
to methods described by Lindmo et al.(32) Data were background-corrected, and the ratio
of the total-to-bound activity was plotted against the inverse of
the normalized cell concentration for the linear regression analysis.
To determine the binding affinity of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
to MT1-MMP, aliquots of 2 × 105 HT1080 WT and HT1080
KO cells were seeded onto 24-well plates in 500 μL of growth
medium and allowed to adhere overnight. Cells were then incubated
with increasing amounts (2–100 nM) of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW
for 2 h at 4 °C. The supernatant was removed, and cells were
washed twice with PBS (500 μL). Cells were lysed by incubation
with 0.1 M NaOH for 30 min 89Zr activity in the cell-associated
fractions was measured with an automated gamma counter. Binding affinity
(dissociation constant [Kd]) was estimated
by nonlinear regression analysis with a 1-site total binding model.
IHC Staining for MT1-MMP
Sections of murine sarcoma
tissue were cut from formalin-fixed paraffin-embedded tissue blocks
at a thickness of 3 μm and mounted onto Superfrost microscope
slides. Sections were deparaffinized in xylene and rehydrated through
a graded series of alcohol to deionized water. Controlled antigen
retrieval was induced with citrate buffer (pH 6.0) for 40 min at 100
°C. Before RIC incubation, tissue sections were blocked with
4% BSA/PBS (1 mL) for 2 h at 25 °C. A 1:50 dilution of [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW or [89Zr]Zr-DFO-IgG-IRDye800CW
in 4% BSA/PBS (1 mL) was added to tissue sections and incubated at
4 °C overnight, followed by washing with PBS (5 × 1 mL,
5 min). Fluorescence and autoradiography images of the resulting sections
were obtained using an Amersham Typhoon Bioimager and co-registered
to images of adjacent tissue sections that had been stained with 3,3′-diaminobenzidine
to visualize MT1-MMP expression and a hematoxylin counterstain.
In Vivo Studies
All mouse studies
were carried out in accordance with UK Animals (Scientific Procedures)
Act, 1986, under project license P74687DB5 following approval from
Newcastle University Animal Ethical Review Body (AWERB). NOD SCID
gamma (NSG; NOD.Cg-Prkdcscid Il2rg tm1Wjl/SzJ) mice from an in-house
colony (females, n = 14, aged 15–18 weeks
on the date of RIC injection) were housed in specific pathogen free
conditions in individually ventilated cages with sterile bedding, ad libitum water, and diet (irradiated no. 3 breeding diet,
SDS) in a facility with a 10-h dark cycle and controlled temperature
and humidity. Mice were examined and checked daily and weighed weekly
to ensure good health. Mice were injected intrafemorally with 20 μL
of media containing 5000 of either HT1080 wild-type (WT, MT1-MMP positive, n = 7) or HT1080 CRISPR-Cas9 knockout (KO, MT1-MMP negative, n = 7) cells. During the procedure, mice were anesthetized
by isoflurane inhalation and provided with analgesia (subcutaneous
carprofen, 5 mg/kg). Cell lines expressed luciferase (Supporting Information Experimental Methods)
to allow monitoring of tumor growth by bioluminescent imaging (BLI)
weekly. For imaging, mice were injected interperitoneally with 150
mg/kg D-luciferin (in vivo Glo, Promega) and anesthetized
with isoflurane prior to measurement of total flux using an IVIS Spectrum
(Caliper Life Sciences).
IVIS Imaging
Two to three weeks after intrafemoral
inoculation and confirmation of HT1080 cell tumor growth by BLI, mice
were transferred to non-florescent bedding for 1 day and administered
either [89Zr]Zr-DFO-anti-MT1-MMP-IRDye800CW (n = 3 for WT tumors, n = 4 for KO tumors) or [89Zr]Zr-DFO-IgG-IRDye800CW (n = 4 for WT tumors, n = 3 for KO tumors) via the lateral tail
vein with doses of 0.8–1.4 MBq (17–24 μg) in 100
μL of PBS. Mice were imaged under isoflurane anesthesia for
fluorescence (excitation and emission filters: 745/800 nm) and Cerenkov
luminescence (open filter) using an IVIS Spectrum (PerkinElmer) at
24, 48, and 72 h p.i. After the final imaging session, mice were euthanized
by cervical dislocation and organs of interest were removed. The samples
were immediately rinsed with water, dried, and then scanned with the
IVIS as previously described. IVIS images were analyzed using Living
Image version 4.7.2 software (PerkinElmer) by drawing regions of interest
(ROIs) in defined areas/organs.
Ex Vivo Biodistribution
After imaging,
selected organs, tissues, and blood were transferred into pre-weighed
counting tubes. After weighing the filled counting tubes, the activity
in each sample was measured with a gamma counter. Counts per minute
were converted into activity units (MBq) using a calibration curve
generated from known standards. These values were decay-corrected
to the time of injection and normalized to the injected activity.
The percentage of the injected activity per gram (%IA/g) of each sample
was calculated. Tissues of interest were then flash-frozen with dry
ice and stored at −80 °C until required for further processing.
Statistical Analysis
All statistical and regression
analyses were performed using GraphPad Prism v9 (GraphPad Software,
San Diego, CA, USA). A confidence interval of 95% (P < 0.05) was considered statistically significant. One-way ANOVA
followed by Tukey’s post hoc test was used to compare multiple
groups. All data were obtained in at least triplicate, and results
were reported and graphed as mean ± standard deviation, unless
stated otherwise.
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