Improved Diagnostic Tool for Clear Cell Renal Cell Carcinoma - EMJ

Improved Diagnostic Tool for Clear Cell Renal Cell Carcinoma

A NEW study has demonstrated the diagnostic superiority of [68Ga]Ga-NYM046 PET/CT over the conventional [18F]FDG PET/CT in detecting clear cell renal cell carcinoma (ccRCC), a predominant form of kidney cancer. This advancement could pave the way for earlier and more precise diagnosis, which is crucial for improving patient outcomes.

The study assessed the performance of [68Ga]Ga-NYM046 in preclinical and clinical settings. Using OS-RC-2 xenograft tumour models in mice, the compound displayed significant tumour accumulation, with uptake values of 7.21±2.39 at one hour post-injection. This high uptake was also seen in kidneys and stomach tissue.

In a clinical setting, 12 ccRCC patients underwent both [68Ga]Ga-NYM046 and [18F]FDG PET/CT scans. The new tracer demonstrated enhanced efficacy, detecting all nine primary tumours compared to just one identified by [18F]FDG PET/CT. Similarly, it identified 95 of 96 involved lymph nodes and 137 of 147 distant metastases, surpassing the traditional tracer in accuracy.

The study revealed that the SUVmax (a marker of tracer uptake) for primary tumours was significantly higher for [68Ga]Ga-NYM046 (median 13.5 vs 2.4, p=0.008). Interestingly, [18F]FDG PET/CT showed higher uptake in involved lymph nodes, but both tracers performed equally well in identifying distant metastases. Additionally, a strong correlation (R²=0.8274) was noted between [68Ga]Ga-NYM046 uptake and the expression of carbonic anhydrase IX (CAIX), a protein commonly overexpressed in ccRCC tumours.

CAIX plays a pivotal role in tumour aggressiveness and is minimally expressed in normal tissues, making it an ideal target for diagnostic imaging. Previous imaging agents targeting CAIX faced challenges such as poor tumour penetration, but NYM046—a small molecule—addresses these limitations with improved pharmacokinetics and patient convenience.

These findings suggest that [68Ga]Ga-NYM046 PET/CT is a promising tool for detecting primary ccRCC lesions and monitoring metastases, potentially improving early diagnosis and treatment strategies for patients.

 

Reference

Lou K et al. Value of [68Ga]Ga-NYM046 PET/CT, in Comparison with 18F-FDG PET/CT, for Diagnosis of Clear Cell Renal Cell Carcinoma. J Nuc Med. 2024;DOI:10.2967/jnumed.124.267527.

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