<p>Tumour targeted radiotherapy is an appealing approach for treatment of disseminated tumour cells. A targeting agent that specifically binds to a structure on tumour cells is then used to transport therapeutically relevant radionuclides. The epidermal growth factor receptor, EGFR, is overexpressed on tumour cells in several malignancies, e.g. highly malignant gliomas. In this thesis, three types of radiolabelled EGF-conjugates, aimed for targeting to EGFR-expressing tumour cells, were developed and studied: EGF-dextran labelled with ¹²⁵I, EGF labelled with ²¹¹At, and two EGF-chelates, DTPA-EGF and Bz-DTPA-EGF, labelled with the radioactive metals ¹¹¹In and ¹⁷⁷Lu. </p><p>The targeting properties of radioiodinated EGF-dextran were first studied in cultured glioma cells. Radioiodine coupled to the dextran part of EGF-dextran was retained in cells appreciably longer than radioiodine coupled to EGF. This can give about 100 times increased radiation dose to tumour cells.</p><p>Targeting with ²¹¹At-EGF was investigated in combination with the tyrosine kinase inhibitor gefitinib (Iressa™, ZD1839). The uptake of ²¹¹At-EGF in EGFR-expressing tumour cells increased with increasing gefitinib concentrations. This was the case for both gefitinib-resistant and gefitinib-sensitive cell lines. The effect of the combined treatment on cell survival, however, differed between the cell lines in an unexpected way. In gefitinib resistant cells, combined treatment decreased cell survival approximately 3.5 times relative to ²¹¹At-EGF treatment alone. In gefitinib sensitive cells, however, combined treatment increased the cell survival (i.e. a protective effect).</p><p>The EGF-chelates studied ([¹¹¹In]DTPA-EGF, [¹¹¹In]Bz-DTPA-EGF and [¹⁷⁷Lu]Bz-DTPA-EGF) all bound specifically with high affinity (K_d≈2 nM) to EGFR on cultured glioma cells. They were internalised after binding, and the cellular retention of radionuclides was high (60% remained after 45 h). A biodistribution study in mice showed that liver and kidneys accumulated a majority of the radioactivity. The EGF-chelates bound EGFR specifically also <i>in vivo</i>. A tumour-to-blood ratio of 25 was achieved in a preliminary study.</p>

Tumour targeted radiotherapy is an appealing approach for treatment of disseminated tumour cells. A targeting agent that specifically binds to a structure on tumour cells is then used to transport therapeutically relevant radionuclides. The epidermal growth factor receptor, EGFR, is overexpressed on tumour cells in several malignancies, e.g. highly malignant gliomas. In this thesis, three types of radiolabelled EGF-conjugates, aimed for targeting to EGFR-expressing tumour cells, were developed and studied: EGF-dextran labelled with 125I, EGF labelled with 211At, and two EGF-chelates, DTPA-EGF and Bz-DTPA-EGF, labelled with the radioactive metals 111In and 177Lu. The targeting properties of radioiodinated EGF-dextran were first studied in cultured glioma cells. Radioiodine coupled to the dextran part of EGF-dextran was retained in cells appreciably longer than radioiodine coupled to EGF. This can give about 100 times increased radiation dose to tumour cells. Targeting with 211At-EGF was investigated in combination with the tyrosine kinase inhibitor gefitinib (Iressa™, ZD1839). The uptake of 211At-EGF in EGFR-expressing tumour cells increased with increasing gefitinib concentrations. This was the case for both gefitinib-resistant and gefitinib-sensitive cell lines. The effect of the combined treatment on cell survival, however, differed between the cell lines in an unexpected way. In gefitinib resistant cells, combined treatment decreased cell survival approximately 3.5 times relative to 211At-EGF treatment alone. In gefitinib sensitive cells, however, combined treatment increased the cell survival (i.e. a protective effect). The EGF-chelates studied ([111In]DTPA-EGF, [111In]Bz-DTPA-EGF and [177Lu]Bz-DTPA-EGF) all bound specifically with high affinity (Kd≈2 nM) to EGFR on cultured glioma cells. They were internalised after binding, and the cellular retention of radionuclides was high (60% remained after 45 h). A biodistribution study in mice showed that liver and kidneys accumulated a majority of the radioactivity. The EGF-chelates bound EGFR specifically also in vivo. A tumour-to-blood ratio of 25 was achieved in a preliminary study.

L'inhibidor de carboxipeptidasa de patata (PCI) és un antagonista de l'EGF. Un dels problemes del PCI, però, és la baixa afinitat per l'EGFR en comparació amb el lligand natural. En aquest treball s'han dissenyat nous bloquejadors de la via ErbB partint de l'estructura de l'EGF per tal d'augmentar l'afinitat d'unió. S'ha determinat que les variants tenen reduïda la capacitat d'activació del receptor però segueixen promovent la proliferació cel·lular. Tot i així, s'ha obtingut una variant, l'EGF Truncat, que tot i no estar correctament plegada, és la que ofereix uns millors. També s'ha dut a terme un tractament combinat entre el PCI i un inhibidor de tirosin quinases d'aquesta mateixa via, l'Iressa. Els resultats han posat de manifest que hi ha un antagonisme entre els dos tractaments. Aquesta és la primera vegada que s'associa de forma directa un tipus de tractament amb una resistència associada a l'activació de la producció autocrina de lligands, i representa un avenç molt important en la recerca oncològica. / Potato carboxypeptidase inhibitor (PCI) is an EGF antagonist. One of the main problems of PCI is its low affinity for EGFR in comparison to the natural ligand. In this study, blockers of the ErbB pathway have been designed taking as a model the EGF structure, in order to increase binding affinity. It has been observed that the variants have less ability to activate the receptor but they still promote cell proliferation. Nevertheless, the variant called Truncated EGF, although being unfolded, is the one that shows best perspectives.A combined treatment using PCI and a tyrosine kinase inhibitor of the same pathway, Iressa, has also been carried out. Results have shown that there is an antagonism between both treatments. This is the first time that a treatment is associated to resistance involving autocrine loop activation of ligands, and it represents a very important finding in the oncologic research.