Implantable sensor for local Cherenkov-excited luminescence imaging of tumor pO2 during radiotherapy

Abstract. Significance: The necessity to use exogenous probes for optical oxygen measurements in radiotherapy poses challenges for clinical applications. Options for implantable probe biotechnology need to be improved to alleviate toxicity concerns in human use and facilitate translation to clinical trial use. Aim: To develop an implantable oxygen sensor containing a phosphorescent oxygen probe such that the overall administered dose of the probe would be below the Federal Drug Administration (FDA)-prescribed microdose level, and the sensor would provide local high-intensity signal for longitudinal measurements of tissue pO2. Approach: PtG4, an oxygen quenched dendritic molecule, was mixed into an agarose matrix at 100  μM concentration, allowing for local injection into tumors at the total dose of 10 nmol per animal, forming a gel at the site of injection. Cherenkov-excited luminescence imaging (CELI) was used to acquire the phosphorescence and provide intratumoral pO2. Results: Although PtG4 does not form covalent bonds with agarose and gradually leaches out into the surrounding tissue, its retention time within the gel was sufficiently long to demonstrate the capability to measure intratumoral pO2 with the implantable gel sensors. The sensor’s performance was first evaluated in vitro in tissue simulation phantoms, and then the sensor was used to measure changes in oxygen in MDA-MB-231 tumors during hypofractionated radiotherapy. Conclusions: Our study demonstrates that implantable oxygen sensors in combination with CELI present a promising approach for quantifying oxygen changes during the course of radiation therapy and thus for evaluating the tumor response to radiation. By improving the design of the gel–probe composition in order to prevent leaching of the probe into the tissue, biosensors can be created that should allow longitudinal oxygen measurements in tumors by means of CELI while using FDA-compliant microdose levels of the probe and thus lowering toxicity concerns.

[1]  B. Palcic,et al.  Survival measurements at low doses: oxygen enhancement ratio. , 1982, British Journal of Cancer.

[2]  B Palcic,et al.  Reduced oxygen enhancement ratio at low doses of ionizing radiation. , 1984, Radiation research.

[3]  J. Vanderkooi,et al.  An optical method for measurement of dioxygen concentration based upon quenching of phosphorescence. , 1987, The Journal of biological chemistry.

[4]  S M Evans,et al.  Interlaboratory variation in oxygen tension measurement by Eppendorf “Histograph” and comparison with hypoxic marker , 1997, Journal of surgical oncology.

[5]  A. Giaccia,et al.  The unique physiology of solid tumors: opportunities (and problems) for cancer therapy. , 1998, Cancer research.

[6]  Louis B Harrison,et al.  Impact of tumor hypoxia and anemia on radiation therapy outcomes. , 2002, The oncologist.

[7]  Bert Vogelstein,et al.  Overcoming the hypoxic barrier to radiation therapy with anaerobic bacteria , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[8]  John E. Moulder,et al.  Tumor hypoxia: its impact on cancer therapy , 2004, Cancer and Metastasis Reviews.

[9]  Lester J. Peters,et al.  Utility of FMISO PET in advanced head and neck cancer treated with chemoradiation incorporating a hypoxia-targeting chemotherapy agent , 2005, European Journal of Nuclear Medicine and Molecular Imaging.

[10]  D. Mankoff,et al.  Hypoxia imaging-directed radiation treatment planning , 2006, European Journal of Nuclear Medicine and Molecular Imaging.

[11]  M. Schwaiger,et al.  Hypoxia imaging with FAZA-PET and theoretical considerations with regard to dose painting for individualization of radiotherapy in patients with head and neck cancer. , 2007, International journal of radiation oncology, biology, physics.

[12]  H. Greenberg,et al.  American College of Clinical Pharmacology Position Statement on the Use of Microdosing in the Drug Development Process , 2007, Journal of clinical pharmacology.

[13]  J. Schellens,et al.  The impact of FDA and EMEA guidelines on drug development in relation to Phase 0 trials , 2007, British Journal of Cancer.

[14]  Mark W. Dewhirst,et al.  Hypoxia and radiotherapy: opportunities for improved outcomes in cancer treatment , 2007, Cancer and Metastasis Reviews.

[15]  P. Vaupel,et al.  Hypoxia in cancer: significance and impact on clinical outcome , 2007, Cancer and Metastasis Reviews.

[16]  Jens Overgaard,et al.  Resolution in PET hypoxia imaging: Voxel size matters , 2008, Acta oncologica.

[17]  P. Usha Rani,et al.  Phase 0 - Microdosing strategy in clinical trials , 2008, Indian journal of pharmacology.

[18]  D. Boas,et al.  Dendritic phosphorescent probes for oxygen imaging in biological systems. , 2009, ACS Applied Materials and Interfaces.

[19]  Alexander I. Karagodov,et al.  Two new "protected" oxyphors for biological oximetry: properties and application in tumor imaging. , 2011, Analytical chemistry.

[20]  Wade P. Smith,et al.  Hypoxia imaging with [F-18] FMISO-PET in head and neck cancer: potential for guiding intensity modulated radiation therapy in overcoming hypoxia-induced treatment resistance. , 2011, Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology.

[21]  J. Petersen,et al.  Imaging hypoxia to improve radiotherapy outcome , 2012, Nature Reviews Clinical Oncology.

[22]  Sergei A. Vinogradov,et al.  Cherenkov excited phosphorescence-based pO2 estimation during multi-beam radiation therapy: phantom and simulation studies , 2014, Physics in medicine and biology.

[23]  Albert C. Koong,et al.  Papaverine and its derivatives radiosensitize solid tumors by inhibiting mitochondrial metabolism , 2018, Proceedings of the National Academy of Sciences.

[24]  Jennifer R. Shell,et al.  Maps of in vivo oxygen pressure with submillimetre resolution and nanomolar sensitivity enabled by Cherenkov-excited luminescence scanned imaging , 2018, Nature Biomedical Engineering.

[25]  Robert Lesurf,et al.  Molecular landmarks of tumor hypoxia across cancer types , 2019, Nature Genetics.

[26]  Mengyu Jia,et al.  Tissue pO2 distributions in xenograft tumors dynamically imaged by Cherenkov-excited phosphorescence during fractionated radiation therapy , 2020, Nature Communications.