A phase 2, open-label, non-randomized, single center study to explore diagnostic performance of [18F]fluoroestradiol (FES) positron emission tomography/computed tomography for the assessment of axillary lymph node metastasis in estrogen-positive breast cancer

Start Date15 Nov 2024

Sponsor / Collaborator

Asan Medical Center

NCT06260033

/ RecruitingPhase 2IIT

A Phase II Trial of Stereotactic Body Radiation Therapy and Fluoroestradiol Positron Emission Tomography in Patients With Oligoprogressive Estrogen Receptor Positive Metastatic Breast Cancer

This phase II trial tests how well stereotactic body radiation therapy (SBRT) works in treating patients with estrogen receptor positive (ER +) breast cancer that has spread from where it first started to other places in the body (metastatic) and has limited disease progression (oligoprogression). Currently, the standard of care for breast cancer patients with oligoprogressive disease is to change systemic therapy when progression occurs. Radiation therapy uses high energy x-rays, particles, or radioactive seeds to kill cancer cells and shrink tumors. SBRT is a type of external radiation therapy that uses special equipment to position a patient and precisely deliver radiation to tumors in the body (except the brain). The total dose of radiation is divided into smaller doses (fractions) given over several days. This type of radiation therapy helps spare normal tissue and has been shown to improve survival. SBRT may kill more tumor cells and allow patients with oligoprogressive ER + metastatic breast cancer to continue taking current systemic treatment.
This trial also tests how well ER targeted positron emission tomography (PET)/ computed tomography (CT) imaging, using FES, works in identifying progressive disease in patients with ER + metastatic breast cancer. FES, a radiolabeled substance, binds to estrogen receptors and gives off radiation that can be detected by a PET scan. The PET scan, an established imaging technique that utilizes small amounts of radioactivity attached to very minimal amounts of tracer, FES, forms an image that shows where tumor cells with estrogen receptors can be found in the body. CT images use x-rays to provide an exact outline of organs. FES PET/CT may improve identification of progressive disease in patients with ER + metastatic breast cancer.

Start Date23 Jul 2024

Sponsor / Collaborator

City of Hope National Medical Center

[+1]

NCT05659797

/ RecruitingEarly Phase 1IIT

Pilot Study Evaluating the Uptake of [18F]Fluoroestradiol (FES) BPET/DBT in Primary Breast Cancer to Measure the Localized Extent of Estrogen Receptor Positive Disease

Patients with newly diagnosed primary estrogen-receptor (ER) positive breast cancer, with at least one breast lesion that is 1.0 cm in diameter or greater, may be eligible for this study. Patients may participate in this study if they are at least 18 years of age. Up to 20 evaluable subjects will participate in a single imaging cohort. Study subjects will undergo imaging of the breast with a novel device combining dedicated Breast Positron Emission Tomography (BPET) and Digital Breast Tomosynthesis (DBT) following intravenous injection of [18F]-Fluoroestradiol (FES). This is an observational study; FES-BPET/DBT will not be used to direct treatment decisions. While patients and referring physicians will not be blinded to the FES-BPET/DBT results, treatment decisions are made by the treating physicians based upon standard clinical imaging.

Start Date02 Oct 2023

Sponsor / Collaborator

Abramson Cancer Center

100 Clinical Results associated with Fluoroestradiol F 18

100 Translational Medicine associated with Fluoroestradiol F 18

100 Patents (Medical) associated with Fluoroestradiol F 18

262

Literatures (Medical) associated with Fluoroestradiol F 18

01 Mar 2025·JOURNAL OF HAZARDOUS MATERIALS

Different contributions of crystalline and non-crystalline iron (hydr)oxides on the mobilization and thionation of diphenylarsinic acid in a flooded paddy soil

Article

Author: Yang, Ruyi ; Yan, Zhenqi ; Zhu, Meng ; Li, Yuan ; Yang, Lu ; Wei, Xiaobao

Iron reduction impacts the mobilization and thionation of diphenylarsinic acid (DPAA) in soil, but the contribution of crystalline and non-crystalline iron remains unknown. A paddy soil deficient in non-crystalline iron (P-Fe_o), crystalline and non-crystalline iron (P-Fe_d) were incubated with sulfate-plus-lactate, and the results were compared with paddy soil (P) in our previous study. For treatments without ferrous sulfide (FeS) precipitation, the solution-to-solid ratio (R_L/S) of DPAA increased slightly and dramatically with iron reduction, respectively, for P-Fe_o and P, suggesting that the reduction of non-crystalline iron contributes more to DPAA mobilization than crystalline iron. The R_L/S was > 0.667 and ≤ 0.667 for treatments without and with FeS, respectively, in P and P-Fe_o but not P-Fe_d, indicating that crystalline, rather than non-crystalline iron contributes more to DPAA sequestration through reduction and the subsequent FeS precipitation. The degree to which iron reduction facilitates DPAA mobilization or sequestration is likely determined by the composition and amount of iron in paddy soil, respectively. For treatments with FeS, the DPAA transformation rate was < 44 % and 74-86 %, respectively, in P-Fe_o and P-Fe_d after 90 days, with the maximum value comparable to those without FeS in P after 30 days. This suggests that the crystalline iron in P-Fe_o and the residual, small amount of non-crystalline iron in P-Fe_d could reduce DPAA thionation by forming FeS, and such effect seems to depend on both the composition and the amount of iron in paddy soil. The results would deepen our understanding of the "As-Fe-S" interactions in soil.

01 Dec 2024·ENVIRONMENTAL POLLUTION

Degradation of 2-(2H-benzotriazol-2-yl)-4,6-di-tert-pentylphenol (UV328) in soil by FeS activated persulfate: Kinetics, mechanism, and theoretical calculations

Article

Author: Wang, Zunyao ; Xu, Jianqiao ; Qu, Ruijuan ; Li, Xiaoyu ; Allam, Ahmed A ; Allam, Ahmed A. ; Bu, Yu ; Alfassam, Haifa E ; Bu, Yue ; Pan, Xiaoxue ; Rudayni, Hassan A ; Rudayni, Hassan A. ; Alfassam, Haifa E.

2-(2H-benzotriazol-2-yl)-4,6-di-tert-pentylphenol (UV328) is a commonly used benzotriazole ultraviolet stabilizers (BUVs) with bioaccumulative properties. Since it's stubbornly degraded in the environment, it poses significant environmental risks in soil. However, the removal of UV328 from soil is challenging, and existing treatment methods have low efficiency. This study focuses on UV328 in soil and proposes an efficient method for its removal using persulfate (PS) activated by iron sulfide (FeS). The research demonstrates that with FeS and PS dosages of 20 and 100 mM respectively, and a soil-to-water ratio of 5:1, 12 h-removal efficiency of UV328 with an initial concentration of 12 mg/kg reaches 93.0%. Furthermore, employing electron paramagnetic resonance spectroscopy and quenching experiments, key reactive oxygen species (ROSs) are identified. SO₄^•-, •OH, ¹O₂ and •O₂^- contribute 31.76%, 28.77%, 26.52% and 12.95%, respectively. Four main reaction pathways of amination, hydroxylation, sulfate substitution, and bond cleavage, are identified with 14 transformation products characterized. Calculated energy profiles based on density functional theory (DFT) identify the most susceptible reaction sites for different ROSs. Five different types of agricultural soils were selected to explore the impact of soil characteristics on UV328 removal. The degradation performance of natural mackinawite demonstrates the effectiveness and accessibility of raw materials. Toxicity assessments of transformation products confirm the environmental friendliness of this system. This study proposes an efficient degradation method for UV328-contaminated soil, providing scientific insights and theoretical guidance for addressing environmental removal of BUVs from soil.

01 Dec 2024·JOURNAL OF ENVIRONMENTAL MANAGEMENT

Synergistic degradation of refractory organic pollutant by underwater bubbling plasma combined with heterogeneous Fenton process

Article

Author: Kang, Yong ; Liu, Shuai

Excessive discharge of the refractory organic pollutants endangers the development of the society and economy, thus seeking an efficient wastewater abatement method is an urgent need. Herein, Iron (Ⅱ) sulfide (FeS) was employed as the heterogeneous catalyst and coupled with underwater bubbling plasma (UBP) for the elimination of the refractory organic pollutant, malachite green (MG). FeS catalyst was synthesized using the solvothermal method and subsequently characterized comprehensively, focusing on its microstructure, specific surface area, chemical bonds and elements valence states. The UBP system combined with FeS (UBP/FeS) exhibited the robust synergism with a maximum synergistic factor of 1.89. The MG degradation percentage and rate constant were up to 94.7% and 0.237 min^-1 within 12 min. The parameter experiments revealed that FeS dosage, pulse frequency, initial MG concentration and solution conductivity of 150 mg/L, 56 Hz, 5 mg/L and 21.8 μS/cm, respective, were more conducive for MG elimination. The MG removal efficiency reached 86.2% after five consecutive applications of FeS. Reactive substances including ·OH, ·O₂^-, e_aq, O₃ and H₂O₂ were confirmed to contribute to MG elimination. Additionally, the conversion circle between ≡ Fe(Ⅱ) and ≡ Fe(Ⅲ) promoted the catalytic conversion of H₂O₂ and O₃ into ∙OH. The comparison of UV-vis spectra and total organic carbon of MG solution before and after reaction revealed the superior degradation of MG in the UBP/FeS system. Hypotheses regarding to the decomposition pathways of MG were formulated based on the identified intermediates. The toxicity level of MG solution was lightened after reaction. The above results indicate that UBP/FeS has the advantages of quick degradation and high efficiency, representing a promising approach for refractory pollutants treatment.

News (Medical) associated with Fluoroestradiol F 18

27 Sep 2024

·www.biospace.com

GE HealthCare announces FDA approval of Flyrcado (flurpiridaz F 18) injection PET radiotracer for enhanced diagnosis of coronary artery disease

GE HealthCare’s FDA-approved flurpiridaz F 18 PET radiotracer, Flyrcado, delivers higher diagnostic efficacy in patients with known or suspected coronary artery disease (CAD), compared to SPECT MPI, the predominant procedure used in nuclear cardiology today With a half-life over ten times longer than currently approved cardiac PET radiotracers, Flyrcado brings the first practical opportunity to combine exercise stress testing with cardiac PET imaging for CAD Available as a unit dose - or ready-to-use, Flyrcado has the potential to expand clinician and patient access to PET myocardial perfusion imaging (MPI) ARLINGTON HEIGHTS, Ill.--(BUSINESS WIRE)--GE HealthCare (Nasdaq: GEHC) today announced that the U.S. Food and Drug Administration (FDA) has granted approval of Flyrcado™ (flurpiridaz F 18) injection, a first of its kind positron emission tomography myocardial perfusion imaging (PET MPI) agent, for the detection of coronary artery disease (CAD). Indicated for patients with known or suspected CAD, Flyrcado delivers higher diagnostic efficacy compared to single-photon emission computed tomography (SPECT) MPI, the predominant procedure used in nuclear cardiology today. Flyrcado, which can be manufactured in an offsite pharmacy and delivered as a ready-to-use unit dose, has the potential to expand clinician and patient access to PET MPI, including improving diagnostic accuracy in difficult-to-image patients such as those with a high body mass index (BMI) and women 1 . With a half-life of 109-minutes—significantly longer than existing PET MPI tracers—Flyrcado removes the need for on-site tracer production and generator maintenance and enables distribution to a wide network of hospitals and imaging centers. This longer half-life also means Flyrcado brings the first practical opportunity to combine exercise stress testing with cardiac PET imaging for CAD, enabling the most robust protocol for evaluating ischemia in patients. Furthermore, clinicians would have the ability to rescan a patient during the same imaging session in the event of technical difficulties, rather than rescheduling an additional scan. Dr. Jamshid Maddahi, MD, FACC, MASNC, principal investigator of the Flyrcado clinical trials, clinical professor of medicine (cardiology) and molecular and medical pharmacology (nuclear medicine) at UCLA School of Medicine and director of the Biomedical Imaging Institute, said, “Flyrcado is the most exciting development in the field of nuclear cardiology over the past few decades. Although PET MPI as a modality enables high diagnostic accuracy as compared to SPECT MPI 2 , only a minority of annual PET scans in the US are PET MPI because of limited access to the currently available PET tracers—which may be addressed with the introduction of Flyrcado. I am excited for this new radiotracer and its potential impact, as a game changer, for diagnosing the disease with the highest mortality rate in the world.” CAD is the most common form of heart disease and remains the leading cause of death for men and women in the U.S. 3 , with 695,000 deaths recorded in 2021 4 . During the multicenter international AURORA Phase III trial, flurpiridaz F 18 was compared with both invasive coronary angiography as a standard of truth to determine diagnostic efficacy in detecting CAD, as well as with SPECT MPI. Around six million MPI procedures are undertaken each year in the U.S. 5 to show blood flow through the heart muscle, and evaluate the presence, extent and degree of myocardial ischemia or infarction. Dr. Mouaz Al-Mallah, MD, MSc, MASNC, immediate Past President of the American Society of Nuclear Cardiology (ASNC) and Director of Cardiac PET at Houston Methodist Hospital, said “Given the desirable properties of flurpiridaz F 18, both in terms of myocardial uptake and fluorine-18 imaging characteristics, Flyrcado represents a favorable combination of imaging agent pharmacology and convenience to imaging institutions and patients. There are new frontiers for cardiac PET that this tracer can achieve; it can be ordered as a unit dose, and it offers the flexibility to perform exercise stress testing. We expect new imaging centers to be able to offer cardiac PET to their patients, making it more convenient to access PET MPI and providing a meaningful impact for clinicians and their patients.” Kevin O’Neill, CEO of the Pharmaceutical Diagnostics (PDx) segment of GE HealthCare, said, “As the first and only FDA-approved F 18 PET MPI radiotracer for CAD detection, Flyrcado can make a real difference to clinicians and their patients. This is another example of GE HealthCare’s commitment to innovating and investing to shape the future of molecular imaging, increasing diagnostic confidence and addressing unmet patient needs.” Flyrcado is one of three F 18 imaging agents in GE HealthCare’s portfolio of FDA-approved molecular imaging PET products, joining radiopharmaceutical PET imaging agents Cerianna™ (fluoroestradiol F 18) injection, used to detect estrogen receptor positive lesions as an adjunct to biopsy in patients with metastatic and recurrent breast cancer, and Vizamyl™ (flutemetamol F 18) injection which is a PET tracer for imaging of the brain to estimate beta amyloid neuritic plaque density in adult patients who are being evaluated for Alzheimer’s disease or other causes of cognitive decline. GE HealthCare acquired exclusive global commercialization rights for flurpiridaz F 18 from Lantheus in 2017 and has led the funding and development of the product through to approval. Lantheus collaborated on the development and will also collaborate on commercialization through a joint steering committee. Lantheus is entitled to royalties based on commercial sales milestones. Flyrcado will be available in initial U.S. markets in early 2025 with expanding availability thereafter. As a leading global medical technology and pharmaceutical diagnostics innovator, GE HealthCare provides both molecular imaging equipment and proprietary radiopharmaceuticals used across cardiology, neurology and oncology. The PDx segment is a global leader in imaging agents used to support over 120 million patient procedures per year globally, equivalent to four patient procedures every second. About GE HealthCare Technologies Inc. GE HealthCare is a leading global medical technology, pharmaceutical diagnostics, and digital solutions innovator, dedicated to providing integrated solutions, services, and data analytics to make hospitals more efficient, clinicians more effective, therapies more precise, and patients healthier and happier. Serving patients and providers for more than 125 years, GE HealthCare is advancing personalized, connected, and compassionate care, while simplifying the patient’s journey across the care pathway. Together our Imaging, Ultrasound, Patient Care Solutions, and Pharmaceutical Diagnostics businesses help improve patient care from diagnosis, to therapy, to monitoring. We are a $19.6 billion business with approximately 51,000 colleagues working to create a world where healthcare has no limits. Follow us on LinkedIn , X , Facebook , Instagram , and Insights for the latest news, or visit our website for more information. INDICATIONS AND USAGE OF FLYRCADO™: FLYRCADO™ (flurpiridaz F 18) injection, for intravenous use important safety information IMPORTANT SAFETY INFORMATION Indications and Usage FLYRCADO is a radioactive diagnostic drug indicated for positron emission tomography (PET) myocardial perfusion imaging (MPI) under rest or stress (pharmacologic or exercise) in adult patients with known or suspected coronary artery disease (CAD) to evaluate for myocardial ischemia and infarction. Contraindications None Warnings and Precautions Risk associated with exercise or pharmacologic stress: Patients evaluated with exercise or pharmacologic stress may experience serious adverse reactions such as myocardial infarction, arrhythmia, hypotension, bronchoconstriction, stroke, and seizure. Perform stress testing in the setting where cardiac resuscitation equipment and trained staff are readily available. When pharmacologic stress is selected as an alternative to exercise, perform the procedure in accordance with the pharmacologic stress agent’s prescribing information. Radiation risks: FLYRCADO contributes to a patient’s overall long-term cumulative radiation exposure. Long-term cumulative radiation exposure is associated with an increased risk of cancer. Ensure safe handling to minimize radiation exposure to patients and health care providers. Advise patients to hydrate before and after administration and to void. Adverse Reactions Most common adverse reactions occurring during FLYRCADO PET MPI under rest and stress (pharmacologic or exercise) (incidence ≥ 2%) are dyspnea, headache, angina pectoris, chest pain, fatigue, ST segment changes, flushing, nausea, abdominal pain, dizziness, and arrhythmia. Use in Specific Populations Pregnancy There are no data on use of flurpiridaz F 18 in pregnant women to evaluate for a drug-associated risk of major birth defects, miscarriage, or other adverse maternal or fetal outcomes. If considering FLYRCADO administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes based on the radiation dose from flurpiridaz F 18 and the gestational timing of exposure. FLYRCADO contains ethanol (a maximum daily dose of 337 mg anhydrous ethanol). If considering FLYRCADO administration to a pregnant woman, inform the patient about the potential for adverse pregnancy outcomes associated with ethanol exposure during pregnancy. Lactation Temporarily discontinue breastfeeding. A lactating woman should pump and discard breastmilk for at least 8 hours after FLYRCADO administration. Pediatric Use Safety and effectiveness of FLYRCADO in pediatric patients have not been established. To report SUSPECTED ADVERSE REACTIONS, contact GE HealthCare at 800-654-0118 (option 2 then option 1) or by email at GPV.drugsafety@gehealthcare.com or FDA at 800-FDA-1088 or For full prescribing information, click here . For important safety information, please click here . INDICATIONS AND USAGE OF CERIANNA™: INDICATIONS AND USAGE CERIANNA is indicated for use with positron emission tomography (PET) imaging for the detection of estrogen receptor (ER)-positive lesions as an adjunct to biopsy in patients with recurrent or metastatic breast cancer. Limitations of Use Tissue biopsy should be used to confirm recurrence of breast cancer and to verify ER status by pathology. CERIANNA is not useful for imaging other receptors, such as human epidermal growth factor receptor 2 (HER2) and the progesterone receptor (PR). CONTRAINDICATIONS None. ADVERSE REACTIONS In Clinical Trials (n=1207) the most common adverse reactions seen occurred at a rate < 1% were injection-site pain and dysgeusia. To report SUSPECTED ADVERSE REACTIONS, contact GE HealthCare Company at 800.654.0118 (option 2 then option 1) or by email at GPV.drugsafety@gehealthcare.com or FDA at 1-800-FDA-1088 or . For full Prescribing Information click here . INDICATIONS AND USAGE OF VIZAMYL™: PRODUCT INDICATIONS AND USE VIZAMYL™ (Flutemetamol F 18) injection is indicated for positron-emission tomography (PET) imaging of the brain to estimate β-amyloid neuritic plaque density in adult patients with cognitive impairment who are being evaluated for Alzheimer’s disease (AD) or other causes of cognitive decline. A negative scan indicates sparse to no neuritic plaques, inconsistent with a diagnosis of AD at the time of image acquisition. A negative scan result reduces the likelihood that a patient’s cognitive impairment is due to AD. A positive scan indicates moderate to frequent amyloid neuritic plaques. This amount of amyloid neuritic plaque has been shown to be present in patients with AD but may also be present in patients with other neurologic conditions as well as in older people with normal cognition. Vizamyl is an adjunct to other diagnostic evaluations. Limitations: A positive scan does not establish a diagnosis of AD or other cognitive disorder. The safety and effectiveness of Vizamyl have not been established for predicting the development of dementia or other neurologic conditions or for monitoring responses to therapies. Important Safety Information About VIZAMYL ™ (Flutemetamol F 18) injection CONTRAINDICATIONS • Known hypersensitivity to Vizamyl or any excipient, including polysorbate 80 ADVERSE REACTIONS • The most commonly reported adverse reactions in clinical trials were flushing (2%), increased blood pressure (2%), headache (1%), nausea and dizziness (1%) For full prescribing information, including additional important safety information, please click here . 1 Maddahi J, Agostini D, Bateman TM, Bax JJ, Beanlands RSB, BermanDS, Dorbala S, Garcia EV, Feldman J, Heller GV, Knuuti JM, Martinez-Clark P, Pelletier-Galarneau M, Shepple B, Tamaki N, Tranquart F, Udelson JE. Flurpiridaz F-18 PET Myocardial Perfusion Imaging in Patients with Suspected Coronary Artery Disease. J AmColl Cardiol. 2023; 82:1598–1610 2 Schindler, T. H., Bateman, T. M., Berman, D. S., Chareonthaitawee, P., De Blanche, L. E., Dilsizian, V., Dorbala, S., Gropler, R. J., Shaw, L., Soman, P., Winchester, D. E., Verberne, H., Ahuja, S., Beanlands, R. S., Di Carli, M. F., Murthy, V. L., Ruddy, T. D., & Schwartz, R. G. (2020). Appropriate use criteria for PET myocardial perfusion imaging. Journal of Nuclear Medicine, 61 (8), 1221-1265. 3 Friede A, O’Carroll PW, Thralls RB, Reid JA. CDC WONDER on the web. Proc AMIA Annu Fall Symp. 1996:408–412. 4 Tsao CW, Aday AW, Almarzooq ZI, et al. Heart disease and stroke statistics—2023 update: A report from the American Heart Association. Circulation. 2023;147: e93–e621. . 5 Miller, R. J. H., Bednarski, B. P., Pieszko, K., Kwiecinski, J., Williams, M. C., Shanbhag, A., Liang, J. X., Huang, C., Sharir, T., Hauser, M. T., Dorbala, S., Di Carli, M. F., Fish, M. B., Ruddy, T. D., Bateman, T. M., Einstein, A. J., Kaufmann, P. A., Miller, E. J., Sinusas, A. J., Acampa, W., Han, D., Dey, D., Berman, D. S., & Slomka, P. J. (2024). Clinical phenotypes among patients with normal cardiac perfusion using unsupervised learning: A retrospective observational study. EBioMedicine , 99, 104930. Contacts GE HealthCare Media Contact: Emmy Elguizaoui +1 (978) 243-7503 Emmy.Elguizaoui@gehealthcare.com

Phase 3Drug Approval

04 Jun 2024

·www.biospace.com

GE HealthCare Pharmaco-Economic Study Demonstrates Adding Breast Oncology PET Tracer to Standard Workup of Patients with Metastatic or Recurrent Breast Cancer May Yield Beneficial Clinical and Economic Outcomes, Potentially Saving $142M Over...

Adding a PET/CT scan with [18F]FES, a breast oncology PET tracer, may increase the accuracy of knowing the estrogen receptor (ER) status. This is notable when a tumor sample cannot be obtained, or the risk of a biopsy-related complication is high. Increased diagnostic accuracy may help clinicians select more effective treatments and decrease the rate of re-biopsies, resulting in the potential cost savings of $142M to the US healthcare system over a five-year period,1 according to a new study published in PLOS ONE. The study shows that adding a PET/CT scan with the [18F]FES tracer, commercially available in the US as Cerianna, to biopsy/immunohistochemistry (IHC) may increase the number of true positive and true negative ER status test results by up to eight percentage points2 compared to when biopsy/IHC is used alone. MARLBOROUGH, Mass.--(BUSINESS WIRE)-- GE HealthCare Pharmaco-Economic Study Demonstrates Adding Breast Oncology PET Tracer to Standard Workup of Patients with Metastatic or Recurrent Breast Cancer May Yield Beneficial Clinical and Economic Outcomes, Potentially Saving $142M Over Five Years in the US In a GE HealthCare sponsored pharmaco-economic study published in peer-reviewed journal PLOS ONE, the incidence, prevalence, diagnostic pathways, and treatments of different patients with metastatic or recurrent breast cancer were analyzed using a combination of widely accepted statistical modelling methods to estimate the clinical and associated economic impact of adding a PET/CT scan with [18F]FES, a breast oncology PET tracer, to the current standard diagnostic process. Breast cancer is the most diagnosed cancer worldwide, with approximately 2.3 million new cases appearing in 2020 alone.3 Correct identification of the receptor status in breast cancer is crucial to optimize treatment; however, the diagnostic standard of care which involves biopsy/IHC and imaging, can yield inconclusive results. [18F]FES can be a powerful tool, providing high diagnostic accuracy in detection of estrogen receptor (ER)-positive lesions. The study demonstrated that adding a PET/CT scan with [18F]FES to biopsy/IHC may increase the diagnostic accuracy of the ER status in all appropriate patients with metastatic or recurrent breast cancer. The clinical and economic benefits were especially pronounced in those situations where a tumor sample cannot be obtained, or the risk of a biopsy-related complication is high. Regina Young, Head of Global Market Access in the Pharmaceutical Diagnostics segment of GE HealthCare and lead author of the study said, “We found that if [18F]FES PET/CT was added to the standard diagnostic work up and in line with the Appropriate Use Criteria (AUC) for ER-targeted PET Imaging,4 the increase in diagnostic accuracy could improve the clinical outcomes. Additionally, results suggested a positive correlation between increased diagnostic accuracy, especially when multiple lesions are present,” said Young. "The increase in true ER-positive and ER-negative results may have beneficial clinical and economic outcomes primarily driven by the avoidance of repeated biopsies and futile treatments.” In 2023, FES PET imaging was added to the National Cancer Care Network (NCCN) Clinical Practice Guidelines in Oncology for ER-positive disease under certain circumstances during the systemic staging workup of patients with metastatic and recurrent breast cancer. This inclusion came after the Society of Nuclear Medicine and Molecular Imaging (SNMMI) published its AUC to guide referring and imaging physicians in appropriate use of ER-targeted PET imaging with 16α-18F-fluoro-17ß Fluoroestradiol. According to SNMMI, the inclusion of FES PET in its AUC is intended to help healthcare practitioners provide patients with the best care in a cost-effective manner. The AUC may also enable more efficient approval of FES use by payers.5 GE HealthCare’s Cerianna is the only FDA-approved FES PET imaging agent. Cerianna is indicated for use with PET imaging for the detection of ER-positive lesions as an adjunct to biopsy in patients with metastatic and recurrent breast cancer. Providing a whole-body view of ER-positive lesions, Cerianna may deliver a comprehensive assessment to assist in making an informed diagnosis and individualized treatment plan for the patient. GE HealthCare’s Pharmaceutical Diagnostics segment is a global leader in imaging agents used to support around 119 million procedures per year globally, equivalent to four patient procedures every second. Its Molecular Imaging portfolio combines established proprietary products across cardiology, neurology, and oncology, with an innovative pipeline, all aimed at enabling better-informed diagnosis and monitoring for improved therapy decision-making and clinical outcomes. About GE HealthCare Technologies Inc. GE HealthCare is a leading global medical technology, pharmaceutical diagnostics, and digital solutions innovator, dedicated to providing integrated solutions, services, and data analytics to make hospitals more efficient, clinicians more effective, therapies more precise, and patients healthier and happier. Serving patients and providers for more than 125 years, GE HealthCare is advancing personalized, connected, and compassionate care, while simplifying the patient’s journey across the care pathway. Together our Imaging, Ultrasound, Patient Care Solutions, and Pharmaceutical Diagnostics businesses help improve patient care from diagnosis, to therapy, to monitoring. We are a $19.6 billion business with approximately 51,000 colleagues working to create a world where healthcare has no limits. Follow us on LinkedIn, X (formerly Twitter), Facebook, Instagram, and Insights for the latest news, or visit our website for more information. NCCN makes no warranties of any kind whatsoever regarding their content, use or application and disclaims any responsibility for their application or use in any way. INDICATIONS AND USAGE: CERIANNA is indicated for use with positron emission tomography (PET) imaging for the detection of estrogen receptor (ER)-positive lesions as an adjunct to biopsy in patients with recurrent or metastatic breast cancer. Limitations of Use: Tissue biopsy should be used to confirm recurrence of breast cancer and to verify ER status by pathology. CERIANNA is not useful for imaging other receptors, such as human epidermal growth factor receptor 2 (HER2) and the progesterone receptor (PR). Important Safety Information CONTRAINDICATIONS None. WARNINGS AND PRECAUTIONS Risk of Misdiagnosis Inadequate Tumor Characterization and Other ER-Positive Pathology Breast cancer may be heterogeneous within patients and across time. CERIANNA images ER and is not useful for imaging other receptors such as HER2 and PR. The uptake of fluoroestradiol F 18 is not specific for breast cancer and may occur in a variety of ER-positive tumors that arise outside of the breast, including from the uterus and ovaries. Do not use CERIANNA in lieu of biopsy when biopsy is indicated in patients with recurrent or metastatic breast cancer. False Negative CERIANNA Scan A negative CERIANNA scan does not rule out ER-positive breast cancer. Pathology or clinical characteristics that suggest a patient may benefit from systemic hormone therapy should take precedence over a discordant negative CERIANNA scan. Radiation Risks Diagnostic radiopharmaceuticals, including CERIANNA, expose patients to radiation. Radiation exposure is associated with a dose-dependent increased risk of cancer. Ensure safe drug handling and patient preparation procedures (including adequate hydration and voiding) to protect patients and health care providers from unintentional radiation exposure. Pregnancy Status Assessment of pregnancy status is recommended in females of reproductive potential before administering CERIANNA. ADVERSE REACTIONS In Clinical Trials (n=1207) the most common adverse reactions seen occurred at a rate < 1% were injection-site pain and dysgeusia. USE IN SPECIFIC POPULATIONS Pregnancy Risk Summary All radiopharmaceuticals, including CERIANNA, have the potential to cause fetal harm depending on the fetal stage of development and the magnitude of radiation dose. Advise a pregnant woman of the potential risks of fetal exposure to radiation from administration of CERIANNA. There are no available data on CERIANNA use in pregnant women. No animal reproduction studies using fluoroestradiol F 18 have been conducted to evaluate its effect on female reproduction and embryo-fetal development. The estimated background risk of major birth defects and miscarriage for the indicated populations is unknown. All pregnancies have a background risk of birth defects, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2-4% and 15-20%, respectively. Lactation Risk Summary There are no data on the presence of fluoroestradiol F 18 in human milk, or its effects on the breastfed infant or milk production. Lactation studies have not been conducted in animals. Advise a lactating woman to avoid breastfeeding for 4 hours after CERIANNA administration in order to minimize radiation exposure to a breastfed infant. Pediatric Use The safety and effectiveness of CERIANNA in pediatric patients have not been established. Geriatric Use Clinical studies of fluoroestradiol F 18 injection did not reveal any difference in pharmacokinetics or biodistribution in patients aged 65 and over. DRUG INTERACTIONS Systemic Endocrine Therapies that Bind to ER Drugs that bind to the ER, including SERMs and SERDs, may compete with the binding of fluoroestradiol F18 and may reduce detection of ER-positive lesions with CERIANNA. Before administration of CERIANNA, discontinue drugs that bind to the ER, such as SERMs and SERDs, for at least 5 biological half-lives: (e.g. elacestrant for 11 days, tamoxifen for 8 weeks and fulvestrant for 28 weeks). To report SUSPECTED ADVERSE REACTIONS, contact GE HealthCare at 800 654 0118 (option 2 then option 1) or by email at GPV.drugsafety@gehealthcare.com or FDA at 800 FDA 1088 or 1 Munter-Young R, Fuentes-Alburo A, DiGregorio N, Neeser K, Gultyaev D (2024) Clinical and economic outcomes of adding [18F]FES PET/CT in estrogen receptor status identification in metastatic and recurrent breast cancer in the US. PLoS ONE 19(5): e0302486. 2 Munter-Young, Fuentes-Alburo, DiGregorio, Neeser, Gultyaev, 2024, Table 3 3 Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209–49. Epub 20210204. pmid:33538338. 4 Ulaner G, Mankoff D, Clark AS, Fowler AM, Linden HM, Peterson LM, Dehdashti F, Kurland BF, Mortimer J, Mouabbi J, Hyuk Moon D, de Vries EGE (2023) Summary: Appropriate Use Criteria for Estrogen Receptor-Targeted PET Imaging with 16α-F-Fluoro-17β-Fluoroestradiol. The Journal of Nuclear Medicine 64 (3) 351-354. 5 Ulaner G, Mankoff D, Clark AS, Fowler AM, Linden HM, Peterson LM, Dehdashti F, Kurland BF, Mortimer J, Mouabbi J, Hyuk Moon D, de Vries EGE (2023) Summary: Appropriate Use Criteria for Estrogen Receptor-Targeted PET Imaging with 16α-F-Fluoro-17β-Fluoroestradiol. The Journal of Nuclear Medicine 64 (3) 351-354. View source version on businesswire.com: Contacts GE HealthCare Media Contact: Emmy Elguizaoui +1 (978) 243-7503 Emmy.Elguizaoui@gehealthcare.com Source: GE HealthCare View this news release online at:

Radiation Therapy

07 Feb 2024

·www.fiercebiotech.com

GE HealthCare plots theranostics growth as it beats earnings estimates in first solo year

“In the next three years, we plan to significantly increase our current theranostics franchise through a combination of organic and inorganic expansions,” GE HealthCare President and CEO Peter Arduini said on the company's fourth-quarter earnings call. In its first full 12 months as an independent, public company, GE HealthCare posted an 8% boost in organic annual revenue—but the company said it doesn’t expect that trajectory to continue into its sophomore year. The imaging giant has set its 2024 expectations at 4% organic sales growth. On a call with investors for the company’s fourth-quarter earnings report this week, Chief Financial Officer Jay Saccaro attributed last year’s gains to recovering supply chains and pricing advantages. “And a lot of that came down to execution, in terms of translating backlog into sales—which was a testament to the work by many of our teams. So, as we look to 2024, we think roughly 4% is a solid number,” said Saccaro, who also described 2023’s 8% figure as the high end of the company’s previous full-year predictions and “in excess of our expectations for the fourth quarter.” In terms of total revenue, GE HealthCare brought in $19.6 billion during 2023—including $10.6 billion from its CT and MRI imaging systems, $3.5 billion from ultrasound devices, $3.1 billion in patient care and monitoring solutions and $2.3 billion from pharmaceutical diagnostics. That last portfolio, with its nuclear medicine and cancer-targeting imaging tracers, grew 18% year-over-year and 23% in the fourth quarter, driven by global expansions in diagnostic procedures and their need for imaging agents. “As novel therapies become more widely available, our tracers will play an increasingly important role—putting us at the center of this transformation of care that will help enable better patient outcomes across many pathways as functional imaging expands,” President and CEO Peter Arduini said on the investor call. “We see growth opportunities with our existing products—like Vizamyl for patients with suspected Alzheimer’s disease, as new therapies ramp up—and Cerianna for metastatic breast cancer, which are both used in conjunction with PET systems for diagnosis,” Arduini added. “And Flurpiridaz, a pipeline product for diagnosing and assessing coronary artery disease, is expected to significantly advance PET/CT imaging.” These injectable imaging tools are also expected to help set the stage as patient care turns more toward theranostic procedures, blurring the lines between discrete tests and treatments. “To give you some perspective, currently the overall theranostics market—which includes equipment, tracers and therapies—is about $9 billion and expected to grow to $40 billion by 2032,” Arduini said. “Today, theranostics are primarily used in thyroid, neuroendocrine and prostate tumors. However, a growing pipeline of drugs across the industry that includes breast, ovarian, pancreatic and lung cancers shows even more promise.” “In the next three years, we plan to significantly increase our current theranostics franchise through a combination of organic and inorganic expansions,” he said, highlighting GE HealthCare’s recently proposed acquisition of the AI developer MIM Software and its plans to integrate the latter’s imaging analysis programs for radiation oncology, molecular radiotherapy, urology and theranostics in particular. GE HealthCare’s first year also saw the company pay down $1 billion in debt while putting more than $1 billion into its R&D spend and launching more than 40 new products. “As a result of our investments, we estimate that we have gained global market share in equipment in 2023. And, once again, we topped the FDA’s list of AI-enabled device authorizations with 58, more than any other medtech company,” Arduini said, referring to the agency’s accounting. “Our backlog remains robust, led by an improved capital equipment landscape.” For the fourth quarter of 2023, the company posted $5.2 billion in sales for a 5% gain over the same period the year before. Net income, however, dropped to $403 million from $554 million, while the accounting for the full year fell to $1.6 billion, compared to 2022’s $1.9 billion. All told, the price of GE HealthCare’s stock on the Nasdaq jumped more than 12% following its earnings release, to more than $81 per share. The company completed its split from the General Electric mothership in January 2023.

Acquisition

100 Deals associated with Fluoroestradiol F 18

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KEGG	Wiki	ATC	Drug Bank
-	-	V09IX11	DB15690

R&D Status

10 top approved records.

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Indication	Country/Location	Organization	Date
Metastatic breast cancer	US	GE Healthcare, Inc.	20 May 2020
Breast Cancer	FR	Zionexa SAS	-

Clinical Result

Indication

Phase

Evaluation

View All Results

Study	Phase	Population	Analyzed Enrollment	Group	Results	Evaluation	Publication Date


NCT03703492 (CTgov)	Phase 2	Breast Cancer \| Noninfiltrating Intraductal Carcinoma	12	Gadobenate dimeglumine+(18F)FES	krznzcuteq(zphcmffwnj) = ukgzeiwmbf dwjlvghkgv (ckvktiqwbp, qyzugsxrlw - oivjtfjpek) View more	-	12 Feb 2025
NCT04692103 (CTgov)	Phase 2	Breast cancer recurrent \| Metastatic breast cancer	2	Computed Tomography+Fludeoxyglucose F-18+F-18 16 Alpha-Fluoroestradiol	aitoxwslfa(wuftiyywbi) = ezkmkcrcnb xlexznnqpz (rccgazjvqo, ajgtdnwpzw - zcxcnzvabw) View more	-	21 Feb 2023
NCT04382911 (CTgov)	Phase 2	Endometriosis	8	18F-fluoroestradiol	bufcgzmonc(sqkortwtsm) = pqgjcobgjh ckzhozibnr (xcakrbofds, brpnxorctv - pshfaxukii) View more	-	09 Feb 2023
NCT01720602 (Pubmed \| J Nucl Med) Manual	Phase 2	Metastatic human epidermal growth factor 2 positive carcinoma of breast ER positive \| HER2 negative	8	Vorinostat+18F-fluoroestradiol	vmggdzzako(wxtygzcdkb) = lfensrlnev rirolisccm (otmrqaiaoo )	Negative	01 Feb 2021
SNMMI2018	Not Applicable	Visible Lesion \| Breast Cancer	-	18F-FES8 F]fluoro-17β-estradiol (18F-FES PET/CT positive)	cwujhlsftf(zpdewloved) = kgrcwaeghc sddfnkncno (dlljjjroqf, 90.8 - 100) View more	-	23 May 2018
SNMMI2018	Not Applicable	Visible Lesion \| Breast Cancer	-	18F-FES8 F]fluoro-17β-estradiol (18F-FES PET/CT negative)	hsklteagii(msnigvxvtz) = mttywddack qpggoffyig (ylqnlprkxb, 90.8 - 100)	-	23 May 2018
SNMMI2017	Not Applicable	-	-	18F-FES	ymhwnjtgff(ojmvlleyuc) = gqsxgqzxir wrhamvjgfa (clwopvzbhu )	-	24 May 2017
SNMMI2015	Not Applicable	Uterine Fibroids	-	18 F-FES PET (Good responders)	jotxrezwgi(vumvpvgbbo) = tupdrvpprz pjiaouwxsn (lbdbecbswv )	Positive	15 May 2015
NCT01153672 (CTgov)	Not Applicable	Breast cancer recurrent \| Male Breast Neoplasms \| Metastatic breast cancer	8	positron emission tomography+vorinostat+letrozole+exemestane+F-18 16 alpha-fluoroestradiol+anastrozole	qqpgvbvinc(usihongmjj) = xcqpmjsryq tdmgruhzrw (umtutajimt, tpiujchakl - wszywxwxqt) View more	-	07 Nov 2014
NCT01720602 (CTgov)	Not Applicable	Breast cancer recurrent \| Male Breast Neoplasms \| Metastatic breast cancer	15	positron emission tomography+vorinostat+letrozole+fludeoxyglucose F 18+exemestane+F-18 16 alpha-fluoroestradiol+anastrozole	tqexuyiprk(ahxrjhuytt) = tnsjxkqpsv kgohhmgggg (vlxvbtevwp, vmjtkxjzux - bhdukacwfl) View more	-	06 Nov 2014

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