Delving into the Latest Updates on 11C-methionine with Synapse

Overview

Basic Info

Drug Type

Small molecule drug

Synonyms-

Target-

Action

enhancers

Mechanism

PET imaging(Positron-emission tomography enhancers)

Therapeutic Areas

NeoplasmsNervous System DiseasesOther Diseases

Active Indication

Familial EpendymomaRhabdomyosarcomaCraniopharyngioma

Inactive Indication-

Originator Organization

St. Jude Children's Research Hospital, Inc.

Active Organization

St. Jude Children's Research Hospital, Inc.

Inactive Organization-

License Organization-

Drug Highest PhasePhase 2

First Approval Date-

Regulation-

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Glioblastoma multiforme (GBM) is the most common primary brain cancer. The treatment of GBM consists of a combination of surgery and subsequent oncological therapy, i.e. radiotherapy, chemotherapy, or combination of both at te same time. If post-operative oncological therapy involves irradiation, magnetic resonance imaging (MRI) is planned. Unfortunately, in some cases, a very early worsening (progression) or return (recurrence) of the disease is observed several weeks after the surgery, i.e. rapid early progression (REP). Radiotherapy planning is based on this MRI in all patients. However, a subset of patients with REP have a less favorable prognosis with this treatment management. The investigators therefore assume that these patients need a more thorough examination to form a precise radiotherapy plan. The project focuses on this group of patients with a less favorable prognosis (with a more aggressive disease). Patients who develop REP within approximately 6 weeks after surgery will have PET/CT (positron emission tomography in combination with computed tomography) examinations using the radiopharmaceutical 11C-methionine in addition to standard practice. PET is one of the most modern methods of molecular imaging, a non-invasive in vivo method that allows physicians to study processes in the human body using radiolabeled radiopharmaceuticals. 11C-methionine is an example of a radiolabeled (carbon 11) amino acid - a source of energy for tumor cells and a building material for new proteins. This radiopharmaceutical is commonly used in the diagnosis of brain tumors and in the evaluation of response to treatment. For patients who undergo this examination, the radiotherapy planning will be adjusted based on it. The purpose of clinical trial is to improve the prospects of patients with REP.

Start Date01 May 2020

Sponsor / Collaborator

Masaryk Memorial Cancer Institute

JPRN-UMIN000037036

/ RecruitingNot ApplicableIIT

Study to investigate growth style of brain tumor using 11C-methionine PET - Study to investigate growth style of brain tumor using 11C-methionine PET

Start Date12 Jun 2019

Sponsor / Collaborator-

100 Clinical Results associated with 11C-methionine

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100 Translational Medicine associated with 11C-methionine

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100 Patents (Medical) associated with 11C-methionine

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31

Literatures (Medical) associated with 11C-methionine

01 Jun 2024·Cancer biotherapy & radiopharmaceuticals

Evaluating the Diagnostic Efficacy of ^99mTc-Methionine Single-Photon Emission Computed Tomography–Computed Tomography: A Head-to-Head Comparison with ¹¹C-Methionine Positron Emission Tomography–Magnetic Resonance Imaging in Glioma Patients

Article

Author: Saini, Jitender ; Sitani, Keerti ; Sadashiva, Nishanth ; Basavaraja, Harish ; Beniwal, Manish ; Mishra, Anil Kumar ; Mangalore, Sandhya ; Rajan, Archith ; Nagaraj, Chandana ; Kumar, Aishwarya ; Santosh, Vani ; Kumar, Pardeep ; Hazari, Puja Panwar

Background: Amino acid positron emission tomography (PET) imaging plays a significant role in the diagnosis of gliomas and in differentiating tumor recurrence from necrosis. In this study, the authors evaluated the diagnostic efficacy of [^99mTc]Tc-methionine single-photon emission computed tomography-computed tomography (SPECT-CT) in comparison with [¹¹C]methionine PET-magnetic resonance imaging (MRI) in delineating tumors. Methods: Thirty-one (primary: 16 and postoperative: 15) patients of confirmed (either MRI or histopathological proven) glioma underwent both [^99mTc]Tc-methionine SPECT-CT and [¹¹C]methionine PET-MRI. A comparative analysis was performed between SPECT, PET, and MR images to calculate the concordance between the modalities and to evaluate the diagnostic efficacy of the [^99mTc]Tc-methionine SPECT. Results: [^99mTc]Tc-methionine SPECT showed comparable uptake in the tumor lesions in comparison to [¹¹C]methionine PET. A significant and strong positive correlation was observed between the volume of tumor (Vt) in PET and Vt MR (p < 0.004). Likewise, a significant and strong positive correlation was found between Vt SPECT and Vt MR. [^99mTc]-methionine has a sensitivity and specificity of 91% and 75%, respectively, compared with 82% and 100% for [¹¹C]methionine in postoperative cases to differentiate the tumor recurrence from necrosis. The sensitivity and specificity of [^99mTc]Tc-methionine was 92% and 100%, respectively, compared with 92% and 67% for [¹¹C]methionine in primary tumors. Conclusion: [^99mTc]Tc-methionine SPECT-CT is as equally good as [¹¹C]methionine for diagnosing and differentiating it from necrosis especially in high-grade glioma.

01 Aug 2023·Journal of neuro-oncology

T2-FLAIR mismatch sign correlates with ¹¹C-methionine uptake in lower-grade diffuse gliomas.

Article

Author: Nariai, Tadashi ; Ebiko, Yusuke ; Maehara, Taketoshi ; Tamura, Kaoru ; Hara, Shoko ; Ishii, Kenji ; Tanaka, Yoji ; Inaji, Motoki

PURPOSE:

The T2-FLAIR mismatch sign is recognized as an imaging finding highly suggestive of IDH-mutant astrocytomas. This study was designed to determine whether the T2-FLAIR mismatch sign correlates with uptake of ¹¹C-methionine in lower-grade gliomas.

METHODS:

We included 78 histopathologically verified lower-grade gliomas (grade 2: 31 cases, grade 3: 47 cases) in this study. 78 patients underwent ¹¹C-methionine positron emission tomography (MET-PET) scans and magnetic resonance (MR) imaging scans prior to histological diagnosis. The tumor-to-normal ratio (T/N) of ¹¹C-methionine uptake was calculated by dividing the maximum standardized uptake value (SUV) for the tumor by the mean SUV of the normal brain. MR imaging scans were evaluated for the presence of the T2-FLAIR mismatch sign by three independent reviewers. We compared molecular status, the T2-FLAIR mismatch sign and ¹¹C-methionine uptake among patients with different lower-grade glioma molecular types.

RESULTS:

The 78 lower-grade gliomas were assigned to one of three molecular groups: Group A (IDH-mutant and 1p/19q non-codeleted, n = 22), Group O (IDH-mutant and 1p/19q codeleted, n = 20), and Group W (IDH wildtype, n = 36). T2-FLAIR mismatch was found in 16 cases (20.5%) that were comprised of 8 (36.4%), 0 (0%), 8 (22.2%) cases in the molecular group A, O and W, respectively. The median T/N ratio of MET-PET in tumors with T2-FLAIR mismatch was 1.50, which was significantly lower than that of tumors without T2-FLAIR mismatch (1.83, p < 0.001, Mann-Whitney U test). In the Groups A and W (excluding Group O), the median T/N ratio on MET-PET in groups A and W (but not group O) with T2-FLAIR mismatch was 1.50, which was significantly lower than that of tumors without T2-FLAIR mismatch (1.81, p = 0.002, Mann-Whitney U test).

CONCLUSION:

The T2-FLAIR mismatch sign correlated with lower ¹¹C-methionine uptake in lower grade gliomas.

01 Jun 2023·EJNMMI physics

Development of a bespoke phantom to optimize molecular PET imaging of pituitary tumors.

Article

Author: Santarius, Thomas ; Marsden, Daniel ; MacFarlane, James ; Harper, Ines ; Gillett, Daniel ; Koulouri, Olympia ; van der Meulen, Merel ; Bird, Nick ; Aloj, Luigi ; Cheow, Heok ; Heard, Sarah ; Crawford, Rosy ; Mendichovszky, Iosif A ; Mannion, Richard ; Bashari, Waiel ; Ballout, Safia ; Gillett, Bethany ; Powlson, Andrew S ; Gurnell, Mark ; Kolias, Angelos

BACKGROUND:

Image optimization is a key step in clinical nuclear medicine, and phantoms play an essential role in this process. However, most phantoms do not accurately reflect the complexity of human anatomy, and this presents a particular challenge when imaging endocrine glands to detect small (often subcentimeter) tumors. To address this, we developed a novel phantom for optimization of positron emission tomography (PET) imaging of the human pituitary gland. Using radioactive 3D printing, phantoms were created which mimicked the distribution of ¹¹C-methionine in normal pituitary tissue and in a small tumor embedded in the gland (i.e., with no inactive boundary, thereby reproducing the in vivo situation). In addition, an anatomical phantom, replicating key surrounding structures [based on computed tomography (CT) images from an actual patient], was created using material extrusion 3D printing with specialized filaments that approximated the attenuation properties of bone and soft tissue.

RESULTS:

The phantom enabled us to replicate pituitary glands harboring tumors of varying sizes (2, 4 and 6 mm diameters) and differing radioactive concentrations (2 ×, 5 × and 8 × the normal gland). The anatomical phantom successfully approximated the attenuation properties of surrounding bone and soft tissue. Two iterative reconstruction algorithms [ordered subset expectation maximization (OSEM); Bayesian penalized likelihood (BPL)] with a range of reconstruction parameters (e.g., 3, 5, 7 and 9 OSEM iterations with 24 subsets; BPL regularization parameter (β) from 50 to 1000) were tested. Images were analyzed quantitatively and qualitatively by eight expert readers. Quantitatively, signal was the highest using BPL with β = 50; noise was the lowest using BPL with β = 1000; contrast was the highest using BPL with β = 100. The qualitative review found that accuracy and confidence were the highest when using BPL with β = 400.

CONCLUSIONS:

The development of a bespoke phantom has allowed the identification of optimal parameters for molecular pituitary imaging: BPL reconstruction with TOF, PSF correction and a β value of 400; in addition, for small (< 4 mm) tumors with low contrast (2:1 or 5:1), sensitivity may be improved using a β value of 100. Together, these findings should increase tumor detection and confidence in reporting scans.

100 Deals associated with 11C-methionine

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R&D Status

10 top R&D records.

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Indication	Highest Phase	Country/Location	Organization	Date
Familial Ependymoma	Phase 2	United States	St. Jude Children's Research Hospital, Inc.	07 May 2014
Rhabdomyosarcoma	Phase 2	United States	St. Jude Children's Research Hospital, Inc.	04 Dec 2013
Craniopharyngioma	Phase 2	United States	St. Jude Children's Research Hospital, Inc.	22 Aug 2011

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Clinical Result

Indication

Phase

Evaluation

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Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT05608395 (P13.01.A, EANO2024)	Phase 2	Glioblastoma IDHwt \| IDHmt \| WHO grade IV	31	11C-METHIONIN (Standard RT planning)	qjykxzbqin(zubvsafwyx) = presented in 7 patients et least 1cm beyond MRI volume rfrijuwhza (klxihqufot )	Negative	17 Oct 2024
EUCTR2020-000640-64-CZ (P15.16.A, EANO2023)	Phase 2	Glioblastoma IDHwt \| IDHmt	67	11C-METHIONIN (Stupp protocol)	rsnlndbbmf(nncjnwdbfc) = outuzttbdh vygbsdqzrd (nqqfmozixq ) View more	Positive	08 Sep 2023
				11C-METHIONIN (Perry protocol)	rsnlndbbmf(nncjnwdbfc) = hhyhqnoaxf vygbsdqzrd (nqqfmozixq ) View more
EANM2022	Not Applicable	Glioma	21	[99mTc] methionine	gyisxdhhox(hwifczlkjg) = nseqhnprjw ehhjqgmefs (pzhwdyzhvs ) View more	-	22 Sep 2022
				[11C] methionine	gyisxdhhox(hwifczlkjg) = htdtkflgms ehhjqgmefs (pzhwdyzhvs ) View more
SNMMI2022	Not Applicable	Multiple Myeloma	-	11C-Methionine (MM patients)	onzkbnegfy(tmpocpnzas) = hmramssyrp xnlmhecbvf (zwjhdebjkx, 6.6)	-	08 Aug 2022
				11C-Methionine (Controls)	onzkbnegfy(tmpocpnzas) = hesperkjvw xnlmhecbvf (zwjhdebjkx, 0.8)
EANM2021	Not Applicable	Glioma IDH-mutant \| IDH-wildtype	201	11 C-methionine (PET-positive patients)	lvzbudduim(mhilvgldyw) = tzvrjuojni dpqrjzwbzx (ymrolyukib )	-	24 Sep 2021
				11 C-methionine (PET-negative patients)	lvzbudduim(mhilvgldyw) = ewzybcsgzr dpqrjzwbzx (ymrolyukib )
EANM2020	Not Applicable	Visible Lesion 11C-Methionine \| perfusion weighted imaging (PWI)	10	11C-Methionine (Perfusion Weighted Imaging (PWI))	nebzxidlnj(agrxgrmwmo) = mean DICE index between PET and Gd-VOIs of the lesions was moderate (0.58 ± 0.15) ksibxpomxi (flubybzkyr ) View more	-	18 Sep 2020
ASTRO2019	Not Applicable	Glioblastoma	-	(11)C-Methionine (11C-methionine (MET)-PET)	zxbgiqiyqb(ucfmisxvpg) = khmgtsekar vhpysdmxgt (bgmhbiwwzk, 0 - 43.8)	-	01 Sep 2019
SNMMI2018	Not Applicable	Radiation Injuries \| Brain Cancer	-	11C-methionine (Brain Tumor Recurrence)	bptzhuskkg(nqdvebcgbc) = jqboeknsua wsjvgevqug (lfhelahosi, 0.15)	-	23 May 2018
				11C-methionine (Radiation Necrosis)	bptzhuskkg(nqdvebcgbc) = wlyygwhuky wsjvgevqug (lfhelahosi, 0.22)
11 C-Methionine PET Examination (SNMMI2018)	Not Applicable	Glioma isocitrate dehydrogenase 1-R132H mutational status (IDH1-R132H)	160	11 C-Methionine (Male patients)	sljmabvjcq(gmxsmnkqqa) = zzuhnqjaby hegfhatgbr (fimowutwyd )	-	23 May 2018
				11 C-Methionine (Female patients)	sljmabvjcq(gmxsmnkqqa) = hlvfgtbalk hegfhatgbr (fimowutwyd )
EANM2017	Not Applicable	Hyperparathyroidism, Primary	-	99m Tc-MIBI	uyjbgemndv(tlpnsqvcxn) = agodqohlpw owwgawtzyv (ejvgwipyya ) View more	-	11 Sep 2017