Potential new imaging agent in diagnosis, monitoring of prostate cancer

About 19 months ago we reported that a company called Progenics Pharmaceuticals had acquired all rights to a small, radiolabeled molecule known as [99mTc]MIP-1404, and that an international, multi-center Phase II trial was  investigating the clinical activity of [99mTc]MIP-1404 as a prostate cancer imaging agent.

A report on the ScienceDaily web site has now provided further information about the development of [99mTc]MIP-1404, which seems to be able to act as a superior imaging agent when compared to traditional bone scans.

Data from a Phase I trial, published by Vallabhajosula et al., indicate that [99mTc]MIP-1404

may be more sensitive to detecting skeletal or marrow invasion earlier than bone scans. 

and the authors state that

We also demonstrated that  [99mTc]MIP-1404 has favorable pharmacokinetics and biodistribution, which represents a breakthrough in imaging of prostate cancer for the following reasons:  [99mTc]MIP-1404 can image prostate cancer in lymph nodes, soft tissue and bone.

Data from the above-mentioned Phase II trial of [99mTc]MIP-1404 were also, most recently, presented at 27th annual meeting of the European Association of Nuclear Medicine, in Gothenburg, Sweden. This trial included about 100 men with high-risk prostate cancer, all of whom were scheduled for radical prostatectomy.

According to a media release issued by Progenics immediately following presentation of these data on October 20:

  • SPECT/CT imaging with  [99mTc]MIP-1404
    • Had a 94 percent sensitivity level in detecting and imaging cancer in the prostate gland of high-risk patients prior to prostatectomy
    • Was more sensitive than MRI in detecting primary prostate cancer (94 vs. 86 percent)
    • Was a good predictor of lymph node involvement at prostatectomy.
    • Identified 14 more patients with suspicious lymph node sites than MRI (a 19 percent better identification rate).
  • Uptake of [99mTc]MIP-1404 in the lobes of the prostate gland was highly correlated with Gleason score (p < 0.0001).
  • [99mTc]MIP-1404  in the primary tumor was significantly lower in treated patients (p < 0.0001), corresponding to a decrease in PSA over time observed in these treated patients.

Apparently Progenics Pharmaceuticals has plans to initiate a Phase III trial of [99mTc]MIP-1404 in the near future.

Every advance in the ability to identify the location of prostate cancer in high-risk patients is, obviously, potentially important, because it allows for better targeting of treatment to the cancer as opposed to just one organ or area of the body.

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