A Theranostic Approach to Imaging and Treating Melanoma with (203)Pb/(212)Pb-Labeled Antibody Targeting Melanin

SIMPLE SUMMARY: Metastatic melanoma is a deadly disease that claims thousands of lives each year despite the introduction of several new drugs into the clinic over the past decade, inspiring the need for novel therapeutics. We investigate targeting melanin pigment, which causes melanoma, with protein molecules called antibodies, which carry a radioactive payload to visualize or treat melanoma tumors. In this study, we imaged and treated melanoma in mice using a c8C3 antibody to melanin and two radioisotopes of lead—Lead-203 for imaging and Lead-212 for therapy. Imaging with Lead-203-bound antibodies allowed for visualization of the tumors in mice, while treatment with Lead-212-bound antibodies slowed down the growth of these aggressive tumors. The treatment was not toxic to mice. We concluded that the melanin-targeting Lead-203/Lead-212-bound c8C3 antibody is a promising agent for imaging and therapy of metastatic melanoma (so-called theranostic), which warrants further investigation. ABSTRACT: Metastatic melanoma is a deadly disease that claims thousands of lives each year despite the introduction of several immunotherapeutic agents into the clinic over the past decade, inspiring the development of novel therapeutics and the exploration of combination therapies. Our investigations target melanin pigment with melanin-specific radiolabeled antibodies as a strategy to treat metastatic melanoma. In this study, a theranostic approach was applied by first labeling a chimeric antibody targeting melanin, c8C3, with the SPECT radionuclide (203)Pb for microSPECT/CT imaging of C57Bl6 mice bearing B16-F10 melanoma tumors. Imaging was followed by radioimmunotherapy (RIT), whereby the c8C3 antibody is radiolabeled with a (212)Pb/(212)Bi “in vivo generator”, which emits cytotoxic alpha particles. Using microSPECT/CT, we collected sequential images of B16-F10 murine tumors to investigate antibody biodistribution. Treatment with the (212)Pb/(212)Bi-labeled c8C3 antibody demonstrated a dose-response in tumor growth rate in the 5–10 µCi dose range when compared to the untreated and radiolabeled control antibody and a significant prolongation in survival. No hematologic or systemic toxicity of the treatment was observed. However, administration of higher doses resulted in a biphasic tumor dose response, with the efficacy of treatment decreasing when the administered doses exceeded 10 µCi. These results underline the need for more pre-clinical investigation of targeting melanin with (212)Pb-labeled antibodies before the clinical utility of such an approach can be assessed.