Special Considerations for Tracers Based on Proteins or Protein Fragments

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Special Considerations for Tracers Based on Proteins or Protein Fragments 10 June, 2017 Serge K. Lyashchenko, Pharm.D. Assistant Attending, Memorial Hospital, Memorial Sloan Kettering Cancer Center Assistant Professor of Radiochemistry and Radiopharmacy, Weill Cornell Medical College, Cornell University

Disclosures Serge K. Lyashchenko declares no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria.

Why Radiolabeled Proteins? q Biomolecule q highly specific q less toxic q clinical need q Radionuclide q PET q SPECT q Therapy q Chelator q TETA q DOTA q DFO q Linkage q Peptide q Thiourea q Thio-maleimide Zeglis, et al. Dalton Transactions2011, 40: 6168-6195.

Presentation Overview Manufacturing Considerations and Experiences: Protein conjugation Radiolabeling Dispensing Regulatory considerations Q&A

Conjugation Process Buffer exchange to appropriate buffer Incubation Purification buffer exchange Quality control Vialing and storage

Buffer Exchange Process Tangential Flow Filtration Considerations Easy-to-use Minimal manipulation Conjugations of up to 2gm of material are possible Single-use sterile, apyrogenic assemblies are available Emulsifiers in the formulation may be a problem

Conjugated Proteins Unique QC Specifications Protein concentration (UV spectrophotometry) Number of chelates (radioisotopic dilution)

Protein Concentration Determination Determination of protein amount post initial buffer exchange Determination of conjugated protein yield Calculations are based on Beer-Lambert Law Absorbance = extinction coefficient x concentration x travel distance Accurate response when using 0.2-1.0 mg/ml protein concentration Dilution may be required Chen Y, Methods Mol Biol.2013;1045:267-73. doi: 10.1007/978-1-62703-541-5_16

Why Number Of Chelate Sites is Important? Not enough chelates may result in suboptimal radionuclide incorporation efficiency Too many chelates may change protein behavior in-vivo Radioisotopic dilution method Does not provide information on chelator distribution within protein species Assumes minimal effect of the radioactive isotope species Lewis, MR, et al, Cancer Biother Radiopharm 2001 Dec;16(6):483-94

Protein Conjugation Experiences How much chelator to use? As little as possible to allow sufficient radionuclide incorporation Storage (<-60⁰C) Stability testing (depends on individual IND)

Radionuclide Availability Diagnostic 89 Zr (78.4hours) 124 I (100.4 hours) 86 Y (14.74 hours) 64 Cu (12.69 hours) 43 Sc (3.89hours) 44 Sc (3.97 hours) Therapeutic Beta 177 Lu (6.65days) 131 I (8.02 days) 90 Y (2.66days) 67 Cu (2.57days) 47 Sc (3.35 days) Alpha 225 Ac (9.95days) 213 Bi (45.6minutes) 212 Pb (10.64 hours) 211 At (7.21hours)

Radionuclide Related Experiences Dose calibrator radioactivity measurement Dial setting 89 Zr 465 to 517 Dial setting 124 I 570 to 494 (487), with copper dipper Radiopharmaceutical vs. radiochemical raw material testing Beattie, BJ, et al, (2014) PLoS ONE, 9 (9), art. no. e0106868

Radiolabeling and Quality Control

Radiolabeling Considerations Desalting Gel Purification Considerations Quick and easy-to-use Volume and protein mass limitations Manual process

Radiolabeled Proteins Key QC Specifications Radionuclide incorporation (radiochemical purity by radio- TLC) Protein integrity (radiochemical purity by SEC-HPLC) Immunoreactivity (antigen binding assay)

Radiochemical Purity by (r-tlc) Measures amount of unincorporated radionuclide

Radiolabeled Protein Integrity (Radiochemical Purity by SEC-HPLC)

Radiochemical Purity by SEC-HPLC Factors affecting results Column Radioactivity detector Formulation

Immunoreactivity Ability of antibody to bind to the antigen Serves as a measure of efficacy Factors Affecting Immunoreactivity Incorporation of chelator Radionuclide incorporation Site of incorporation Conjugation and radiolabeling conditions Autoradiolysis Radiolabeled protein specific activity

Immunoreactivity Assay (RIA)

Cell Based RadioimmunoAssay Conc. CPM CPM CPM Avg CPM Avg - Blank 500 6885 6885 6885 6885 6885 400 6800 6800 6800 6800 6800 300 6600 6600 6600 6600 6600 250 6400 6400 6400 6400 6400 200 5525 5525 5525 5525 5525 150 4675 4675 4675 4675 4675 50 2800 2800 2800 2800 2800 5 (Blank) 0 0 0 0 0 STD 8500 8500 8500 8500 Conc. NIC T/B 500 1 1.23 400 1.25 1.25 300 1.666667 1.29 250 2 1.33 Y-Intercept 1.003 200 2.5 1.54 IR (%) 99.7 150 3.333333 1.82 50 10 3.04 Bound/Total 1 0.8 0.6 0.4 0.2 0 0 200 400 600 Cell Concentration [B/T] Total/Bound 4.00 3.00 2.00 1.00 0.00 89Zr-MAb y = 0.2056x + 1.0031 R² = 0.9884 0 2 4 6 8 10 12 Normalized Cell Concentration Lindmo T, et al. J Immunol Meth 1984

Radioimmunoassay Considerations Lindmo Limitations Reported calculated IRF value by itself is insufficient for evaluation purposes The method is prone to overestimation of true immunoreactivity Results may not be valid when the calculated theoretical value varies by more than 10% from the obtained experimental value Experimental Factors Incubation time Protein mass Operator technique when separating the bound fraction from the unbound Sample dilution Gamma counter operation Degree of antigen expression on antigen expressing cells Mattes MJ. Int J Cancer 1995

Formulation Considerations Radioprotection Stabilization Compatibility with intended route of administration Volume ph Osmolality Chemical Composition https://www.mskcc.org/pdf/cancer-care/patient-education/about-yourommaya-reservoir-placement-surgery

Patient Unit Dose Preparation Systemic administration requires the addition of the cold protein Final protein mass may exceed microdose limits Separate administration is preferred Special regulatory consideration is required if the cold protein will not be marketed separately as a pharmaceutical

Additional Regulatory Considerations Which material to use for toxicology batches Protein Chelated protein Chelated protein labeled with non-radioactive isotope Radiotherapeutic toxicology challenge Stability testing program

Comparison to Traditional PET Similarities Stability limitations Autoradiolysis Radioactive decay Post-release testing Distribution QC represents entire batch of the final drug product Limited personnel and resources at smaller facilities Differences Drug substance mass plays a significant role Longer radioactive half-life Cleaning Radioactive waste storage Various radionuclides used Equipment (shielding) Radiotherapeutics

Summary and Conclusion Radiolabeling process should be designed to preserve the protein integrity and efficacy as much as possible Radiolabeled proteins require special evaluation of efficacy of the radiolabeled portion of the protein As the field develops and expands, the unique nature of radiolabeled biologic compounds must be taken into account when implementing new regulations and guidance associated with radiopharmaceutical preparation

Special Thanks MSK RMIP Core

Thank you