Single crystal X-ray diffraction show that Zr(IV) forms an octa-coordinated complex with 4 bidentate hydroxamates whose solution structures were investigated utilizing density functional theory at the level of B3LYP/DGDZVP. Stability constants obtained by potentiometry were in accordance with the tendency observed when radiolabeling with 89Zr.

(211)At is a promising radionuclide for α-particle therapy of cancers. Its physical characteristics make this radionuclide particularly interesting to consider when bound to cancer-targeting biomolecules for the treatment of microscopic tumors. (211)At is produced by cyclotron irradiation of (209)Bi with α-particles accelerated at ~28 MeV and can be obtained in high radionuclidic purity after isolation from the target. Its chemistry resembles iodine, but there is also a tendency to behave as a metalloid. However, the chemical behavior of astatine has not yet been clearly established, primarily due to the lack of any stable isotopes of this element, which precludes the use of conventional analytical techniques for its characterization. There are also only a limited number of research centers that have been able to produce this element in sufficient amounts to carry out extensive investigations. Despite these difficulties, chemical reactions typically used with iodine can be performed, and a number of biomolecules of interest have been labeled with (211)At. However, most of these compounds exhibit unacceptable instability in vivo due to the weakness of the astatine-biomolecule bond. Nonetheless, several compounds have shown high potential for the treatment of cancers in vitro and in several animal models, thus providing a promising basis that has allowed initiation of the first two clinical studies.

Metals of interest for biomedical applications often need to be stably complexed and associated with a targeting agent before use. While the basics of the complexation of most transition metals have been thoroughly studied in that end, ZrIV has been somewhat neglected. Yet, this metal has received a growing attention in recent years, especially in nuclear medicine with the use of 89Zr, a β+-emitter with near ideal characteristics for cancer imaging. However, the best chelating agent known for this radionuclide is the tris-hydroxamate desferrioxamine B (DFB), whose ZrIV complex exhibits non-optimal stability resulting in the progressive release of 89Zr in vivo. Based on a recent report demonstrating the higher thermodynamic stability of the tetrahydroxamate complexes of ZrIV compared to the tris-hydroxamate complexes analogue to DFB, we designed a series of tetrahydroxamic acids of varying geometries for improved complexation of this metal. Three macrocycles differing by their cavity size (28 to 36-membered rings) were synthesized using a ring closing metathesis strategy, as well as their acyclic analogues. A solution study with 89Zr showed the complexation to be more effective with increasing size of cavity. Evaluation of the kinetic inertness of these new complexes in EDTA solution showed significantly improved stabilities of the larger chelates compared to 89Zr-DFB, whereas the smaller complexes exhibited insufficient stabilities. These results were rationalized by a quantum chemical study. The lower stability of the smaller chelates was attributed to the ring strain, whereas the better stability of the larger cyclic complexes was explained by the macrocyclic effect and structural rigidity. Overall, these new chelating agents open new perspectives for the safe and efficient use of 89Zr in nuclear imaging, with the best ones providing dramatically improved stabilities compared to the reference DFB.

Among all existing radionuclides, only a few are of interest for therapeutic applications and more specifically for targeted alpha therapy (TAT). From this selection, actinium-225, astatine-211, bismuth-212, bismuth-213, lead-212, radium-223, terbium-149 and thorium-227 are considered as the most suitable. Despite common general features, they all have their own physical characteristics that make them singular and so promising for TAT. These radionuclides were largely studied over the last two decades, leading to a better knowledge of their production process and chemical behavior, allowing for an increasing number of biological evaluations. The aim of this review is to summarize the main properties of these eight chosen radionuclides. An overview from their availability to the resulting clinical studies, by way of chemical design and preclinical studies is discussed.

Aryliodonium salts have become precursors of choice for the synthesis of 18F-labelled tracers for nuclear imaging. However little is known on the reactivity of these precursors with heavy halogenides, i.e. radioiodide and astatide at the radiotracer scale. Herein, we report the first comparative study of radiohalogenation of aryliodonium salts with [125I]-iodide and [211At]-astatide. Initial experiments on a model compound highlight a higher reactivity of astatide compared to iodide that could not be anticipated from the trends previously observed within the halogen series. Kinetic studies indicate a significant difference in activation energy (Ea = 23.5 and 17.1 kcal/mol with 125I− and 211At−, respectively). Quantum chemical calculations support the hypothesis of a monomeric iodonium-astatide intermediate whereas radio-iodination occurs in a dimeric environment. The good to excellent regioselectivity of halogenation and high yields achieved with diversely substituted aryliodonium salts indicates that this class of compounds is a promising alternative to the stannane chemistry currently used for radiohalogen labeling of tracers in nuclear medicine.

Cu-ATSM appears superior in terms of imaging performance, calling for industrial and clinical development of this innovative radiopharmaceutical.

Recent advances in molecular characterization of tumors have allowed identification of new molecular targets on tumor cells or biomarkers. In medical practice, the identification of these biomarkers slowly but surely becomes a prerequisite before any treatment decision, leading to the concept of personalized medicine. Immuno-positron emission tomography (PET) fits perfectly with this approach. Indeed, monoclonal antibodies (mAbs) labelled with radionuclides represent promising probes for theranostic approaches, offering a non-invasive solution to assess in vivo target expression and distribution. Immuno-PET can potentially provide useful information for patient risk stratification, diagnosis, selection of targeted therapies, evaluation of response to therapy, prediction of adverse effects or for titrating doses for radioimmunotherapy. This paper reviews some aspects and recent developments in labelling methods, biological targets, and clinical data of some novel PET radiopharmaceuticals.

This paper reviews some aspects and recent developments in the use of antibodies to target radionuclides for tumor imaging and therapy. While radiolabeled antibodies have been considered for many years in this context, only a few have reached the level of routine clinical use. However, alternative radionuclides, with more appropriate physical properties, such as lutetium-177 or copper-67, as well as alpha-emitting radionuclides, including astatine-211, bismuth-213, actinium-225, and others are currently reviving hopes in cancer treatments, both in hematological diseases and solid tumors. At the same time, PET imaging, with short-lived radionuclides, such as gallium-68, fluorine-18 or copper-64, or long half-life ones, particularly iodine-124 and zirconium-89 now offers new perspectives in immuno-specific phenotype tumor imaging. New antibody analogues and pretargeting strategies have also considerably improved the performances of tumor immunotargeting and completely renewed the interest in these approaches for imaging and therapy by providing theranostics, companion diagnostics and news tools to make personalized medicine a reality.