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. 2022 Apr-Jun;14(2):4-15.
doi: 10.32607/actanaturae.11611.

The Evolution of Targeted Radionuclide Diagnosis of HER2-Positive Breast Cancer

O D Bragina  1   2 , S M Deyev  2   3 , V I Chernov  1   2 , V M Tolmachev  2   4
Affiliations

The Evolution of Targeted Radionuclide Diagnosis of HER2-Positive Breast Cancer

O D Bragina et al. Acta Naturae. 2022 Apr-Jun.

Abstract

This review examines the evolution of the radionuclide diagnosis of HER2-positive breast cancer using various compounds as a targeting module in clinical practice: from full-length antibodies to a new group of small synthetic proteins called alternative scaffold proteins. This topic is of especial relevance today in view of the problems attendant to the detection of breast cancer with HER2/neu overexpression, which, in most cases, introduce errors in the treatment of patients. The results of clinical studies of radiopharmaceuticals based on affibody molecules, ADAPTs, and DARPins for SPECT and PET have demonstrated good tolerability of the compounds, their rapid excretion from the body, and the possibility to differentiate tumor sites depending on the HER2/neu status. This indicates that targeted radionuclide diagnosis holds promise and the need to continue research in this direction.

Keywords: HER2/neu; alternative scaffold proteins; breast cancer; monoclonal antibody; radionuclide diagnostics.

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Figures

Fig. 1
Fig. 1
Schematic representation of several alternative scaffold proteins
Fig. 2
Fig. 2
A patient with HER2-negative primary breast cancer. FDG-PET/CT detected metastases in the left lobe of the liver, peritoneal lymph nodes, and the bladder neck. The study using 68Ga-ABY-025 revealed its high additional accumulation level in hepatic metastasis and low level or no accumulation at other sites. According to IHC, the HER2/neu metastasis status is positive in the liver and negative at other sites
Fig. 3
Fig. 3
Anterior projection of planar scintigraphy of breast cancer patients with positive (HER+) and negative (HER-) expression of HER2/neu 2 h after injection of 250, 500, and 1,000 μg of 99mTc-ADAPT6 (arrows indicate a breast tumor)
Fig. 4
Fig. 4
Anterior projection of planar scintigraphy of breast cancer patients with positive (HER+) and negative (HER-) expression of HER2/neu 4 h after injection of 1,000; 2,000, and 3,000 μg of 99mTc-DARPinG3 (arrows indicate a breast tumor)
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