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Theranostics 2017; 7(17):4322-4339. doi:10.7150/thno.21848 This issue Cite

Review

Past, Present, and Future: Development of Theranostic Agents Targeting Carbonic Anhydrase IX

Joseph Lau¹, Kuo-Shyan Lin^{1, 2✉}, François Bénard^{1, 2✉}

1. Department of Molecular Oncology, BC Cancer Agency, Vancouver, BC, Canada;
2. Department of Radiology, University of British Columbia, Vancouver, BC, Canada.

✉ Corresponding authors: Dr. François Bénard, Department of Molecular Oncology, BC Cancer Agency, 675 West 10th Avenue, Vancouver BC, Canada E-mail: fbenardca Phone: 1-604-675-8206 Fax: 1-604-675-8218 Dr. Kuo-Shyan Lin, Department of Molecular Oncology, BC Cancer Agency, 675 West 10th Avenue, Vancouver BC, Canada E-mail: klinca Phone: 1-604-675-8208 Fax: 1-604-675-8218 More

Abstract

Theranostics is the integration of diagnostic information with pharmaceuticals to increase effectiveness and safety of cancer treatments. Nuclear medicine provides a non-invasive means to visualize drug target expression across primary and metastatic sites, and assess pharmacokinetics and efficacy of companion therapeutic agents. This is significant given the increasing recognition of the importance of clonal heterogeneity in treatment response and resistance. Carbonic anhydrase IX (CA-IX) has been advocated as an attractive diagnostic and therapeutic biomarker for targeting hypoxia in solid malignancies. CA-IX confers cancer cell survival under low oxygen tension, and is associated with increased propensity for metastasis. As such, CA-IX is overexpressed in a broad spectrum of cancers. Different classes of antigen recognition molecules targeting CA-IX including monoclonal antibodies, peptides, small molecule inhibitors, and antibody mimetics have been radiolabeled for imaging and therapeutic applications. cG250, a chimeric monoclonal antibody, has been labeled with an assortment of radionuclides (¹²⁴I, ¹¹¹In, ⁸⁹Zr, ¹³¹I, ⁹⁰Y, and ¹⁷⁷Lu) and is the most extensively investigated CA-IX radiopharmaceutical. In recent years, there have been tremendous advancements made by the research community in developing alternatives to cG250. Although still in preclinical settings, several small molecule inhibitors and antibody mimetics hold great promise in improving the management of aggressive and resistant cancers.

Keywords: Nuclear medicine, theranostics, carbonic anhydrase IX, hypoxia, cancer.

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