×
![]()
The cholecystokinin-2 receptor (CCK2R) is expressed on various cancer types including small cell lung cancer (SCLC) [1, 2]. Recently, radiolabelled CCK2R-targeting peptides have shown promising results in medullary thyroid carcinoma [3, 4]. We used the minigastrin analogue DOTA-DGlu-Ala-Tyr-Gly-Trp-(N-Me)Nle-Asp-1-Nal-NH2 radiolabelled with gallium-68 ([68Ga]Ga-DOTA-MGS5) in a 40 year-old patient with extensive disease (ED)-SCLC who also underwent [18F]FDG (08/2023) and [68Ga]Ga-DOTA-TOC (01/2024) PET/CT. [68Ga]Ga-DOTA-MGS5 PET/CT was performed to evaluate the potential therapeutic option with [177Lu]Lu-DOTA-MGS5.
Anzeige
[18F]FDG PET/CT (a) concentrated in the cervical and mediastinal lymph nodes, the lung tumour and the cervical vertebrae. Inhomogeneous uptake was detected in the mediastinal tumour mass (b) and in the right adrenal gland (d). All lesions were confirmed by contrast-enhanced CT (c,e).
[68Ga]Ga-DOTA-MGS5 PET/CT (12/2023), beyond high tracer uptake in all FDG-avid lesions (f), identified additional abnormal foci in left subpleural lesions (g,h), the right mammary region, both adrenal glands (i,j), gastric curvature and the right pelvis. Bone involvement was seen in the left ileum, right VII rib, and cervical vertebrae. These newly detected lesions were not present in the [18F]FDG PET/CT suggesting disease progression. Due to the time interval between [18F]FDG and [68Ga]Ga-DOTA-MGS5 PET/CT scans no direct lesion comparison was performed.
Somatostatin receptor expression as detected by [68Ga]Ga-DOTA-TOC PET/CT (k) was faint in all lesions, also in those clearly visible by low-dose CT (l-o).
Considering the poor prognosis of ED SCLC (5-year survival-rate 10–15% [5]), this case suggests that CCK2R-targeting may provide a new theranostic tool in ED-SCLC patients.
Anzeige
Declarations
Ethics approval
All procedures performed in this study were in accordance with the ethical standards of the institutional and/or national research committee. Written informed consent was given by the patient prior to the exams together with the permission for anonymized publication of the related medical data. [68Ga]Ga-DOTA-MGS5 was used on a named patient basis and prepared according to the Austrian Medicinal Products Act (AMG §8 and §62).
Competing interests
The Medical University of Innsbruck has filed a patent application for minigastrin analogues with “Improved pharmacokinetics and cholecystokinin-2 receptor (CCK2R) targeting for diagnosis and therapy”. All other authors have nothing to disclose.
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.