Patent Application
20100172836
1. Field of the Invention The present invention relates generally to synthesis methods for 18F-radiolabeled brain imaging agents and more specifically to methods of synthesizing 18F-radiolabeled styrylpyridine and its tosylate precursor and to stable pharmaceutical compositions comprising 18F-radiolabeled brain imaging agents.
2. Description of Related Art
Alzheimer's Disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, irreversible memory loss, disorientation, and language impairment. AD affects 10% of the population aged greater than 65 and at least 50% of the population aged greater than 85 years. AD has been reported in patients as young as 40-50 years of age, but because the presence of the disease is difficult to detect without histopathological examination of brain tissue, the time of onset in living subjects is unknown.
Currently, the only means of definitively diagnosing AD is through examination of brain tissue, typically performed at postmortem autopsy. During the autopsy, medical examiners inspect the brain tissue for excess neuritic plaques (NPs) composed of amyloid-βpeptide deposits and neurofibrillary tangles (NFTs) formed of filaments of highly phosphorylated tau proteins, as these features distinguish the pathogenesis of AD. The amyloid deposits are formed by aggregation of amyloid peptides, followed by further combination with other aggregates and/or amyloid peptides. The fibrillar aggregates of amyloid peptides, Aβ1-40 and Aβ1-42, are the major peptide metabolites derived from amyloid precursor protein that are found in NPs and cerebrovascular amyloid deposits in AD patients.
Parkinson's Disease (PD) is a progressive neurodegenerative disease characterized by resting tremors, bradykinesia, muscular rigidity, and postural instability. PD typically develops after the age of 60, though 15% of diagnosed patients are under the age of 50. Family history of PD is an etiological factor for 5-10% of patients diagnosed with the disease, yet only 1% of cases have been shown to be clearly familial. It is estimated that 1.5 million Americans are currently living with PD.
Dementia with Lewy Bodies (DLB) is a progressive brain disease having symptoms that fluctuate between various degrees of manifestation. These symptoms include progressive dementia, Parkinsonian movement difficulties, hallucinations, and increased sensitivity to neuroleptic drugs. As with AD, advanced age is considered to be the greatest risk factor for DLB, with average onset usually between the ages of 50-85. Further, 20% of all dementia cases are caused by DLB and over 50% of PD patients develop “Parkinson's Disease Dementia” (PDD), a type of DLB. It is possible for DLB to occur alone, or in conjunction with other brain abnormalities, including those involved in AD and PD, as mentioned above. At present, a conclusive diagnosis of DLB is only possible after postmortem autopsy.
PD and DLB share an etiology of dopamine deficiency that is correlated with the death of dopaminergic neurons in the substantia nigra. The cause of dopaminergic neuronal death in PD is uncertain, although it appears that aggregates of α-synuclein in the brain may be associated with dopaminergic neuronal losses in the striatum. It is also recognized that in DLB, abnormal protein deposits containing α-synuclein, referred to as “Lewy bodies”, are the cause of the death of dopaminergic neurons. Lewy bodies occur mostly in the substantia nigra and locus ceruleus sections of the brain stem, and also in the subcortical and cortical regions of the brain. Because of this particular localization in the brain, Lewy bodies may interfere with the production of acetylcholine, causing disruption of perception and thought process and impacting behavior. Lewy bodies are considered to be a type of neuritic plaque (NP) because they are comprised of aggregates of α-synuclein protein deposits.
The etiology of neurodegeneration can also involve a mixture of pathologies including a component of microvascular, or perfusion, deficits in the brain. For example, a disorder commonly referred to as “mixed dementia” often comprises both perfusion deficits and amyloid plaque pathology. The term “mixed dementia” possesses various meanings, but the term is commonly used to refer to the coexistence of AD and vascular dementia (VaD), in particular where the VaD is caused by numerous micro-thrombi in the vascular system of the brain. Though little is currently known about the true prevalence of mixed dementia, this form of neurodegeneration is clinically important because the combination of AD and VaD may have a greater impact on the brain than either condition independently. Mixed dementia is traditionally very difficult to diagnose. Symptoms are similar to those of AD or VaD or a combination of the two.
The occurrence of amyloid deposits in the brain may be characteristic of numerous other conditions including, but not limited to, Mediterranean fever, Muckle-Wells syndrome, idiopathic myeloma, amyloid polyneuropathy, amyloid cardiomyopathy, systemic neuritic amyloidosis, amyloid polyneuropathy, hereditary cerebral hemorrhage with amyloidosis, Down's syndrome, Scrapie, Creutzfeldt-Jacob disease, Kuru, Gerstamnn-Straussler-Scheinker syndrome, medullary carcinoma of the thyroid, isolated atrial amyloid, β2-microglobulin amyloid in dialysis patients, inclusion body myositis, β2-amyloid deposits in muscle wasting disease, and islets of Langerhans diabetes Type II insulinoma.
Because of the role of the presence of neuritic plaques (NPs) in the diagnosis of neurodegenerative disease, there has been interest in developing radiolabeled ligands that bind to and allow imaging of such abnormalities using current methodologies. Some common imaging agents include [11C]PIB, [11C] 4-N-methylamino-4′-hydroxy-stilbene (SB-13), [18F]FDDNP and [123I]IMPY.
[18F]AV-45 (“18F-AV-45”), ((E)-4-(2-(6-(2-(2-(2-[18F]fluoroethoxy)ethoxy)ethoxy)pyridine-3-yl)vinyl)-N-methylbenzenamine, is a radiopharmaceutical for Positron Emission Tomography (PET) imaging of amyloid aggregates in the brain (see, for example, Choi, S R, et al., J Nucl Med, 50(11), 1887-1894, 2009). 18F-AV-45 contains the F-18 radioisotope which, due to its 110 minute radioactive decay half life, may be manufactured in a centralized location and shipped within a 4 to 8 hour radius to imaging centers that perform the PET brain imaging. This production and distribution scheme for 18F-AV-45, and for other F-18 radiolabeled amyloid imaging compounds, requires that the radiopharmaceutical be produced on the same day on which the PET scan is performed because of the radioactive decay of the F-18 isotope. Therefore, several requirements result: first, the radioactive 18F-AV-45 must be produced in a short period of time from a stable intermediate compound (referred to as the “precursor”); second, the 18F-AV-45 radiopharmaceutical must be produced in reasonable (e.g., >10%) radiochemical yield starting from the precursor reacting with F-18 fluoride ion; and third, the 18F-AV-45 must be in a solution medium which provides adequate solubility of both the radiopharmaceutical as well as its non-radioactive counterpart (19F-AV-45, which is always present at some low level due to stable F-19 in the manufacturing environment), as well as stabilization properties to inhibit the radiolytic breakdown of the compound.
Ethanol is generally recognized as a suitable aid for solubilization of lipophilic drugs, including radiopharmaceutical drugs (see, for example, Lemaire C., et al., J Label Compd and Radiopharm, 42, 63-75, 1999). Ascorbic acid or ascorbate salts have been utilized previously as aids in inhibiting radiolysis of radiopharmaceuticals (see, for example, Tofe A J, et al., J. Nucl Med, 17, 820-825, 1976; Knapp F F, et al., Anticancer Res 17, 1783-1795, 1997; Liu S, et al., Bioconj Chem, 14, 1052-1056, 2003), including F-18 radiopharmaceuticals, see, for example, Firnau G, et al., J Nucl Med, 25, 1228-1233, 1984). However, the use of ascorbate salts in an aqueous-ethanol solution as a preferred medium for both solubilization and stabilization of an F-18 brain imaging radiopharmaceutical, such as 18F-AV-45, is new.
The use of a precursor containing a tosylate group for reaction with F-18 fluoride in the production of F-18-containing radiopharmaceuticals has been previously described (see, for example, Zhang W, et al., Nucl Med Biol 34, 89-97, 2007). However, an efficient synthetic process for producing larger (i.e., >10 gm) quantities of the tosylate precursor (referred to as “AV-105” herein) has not been described previously. Each of the publications cited herein are hereby incorporated by reference in their respective entireties to the extent such references are not inconsistent with the explicit teachings of this specification.
Embodiments of the invention are directed to a radiopharmaceutical composition for positron emission tomography (PET) imaging of neurodegenerative diseases of the brain comprising an effective amount of an 18F-radiolabeled compound, about 1.0% to about 20% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) of ascorbic acid or a salt thereof. In various embodiments, the 18F-radiolabeled compound is capable of binding to a pathologic target in the brain of a patient. The pathologic target may include an abnormal concentration of a native or pathologically-altered protein, peptide or oligonucleotide; β-amyloid; α-synuclein; or vesicular monoamine transporter 2 (VMAT2).
According to some aspects of the invention, the 18F-radiolabeled compound is a styrylpyridine derivative. In various aspects, the 18F-radiolabeled compound is ((E)-4-(2-(6-(2-(2-(2-[18F]fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methylbenzenamine) (18F-AV-45). In some embodiments, the 18F-AV-45 is produced from a tosylate precursor. In other aspects, the 18F-radiolabeled compound in the radiopharmaceutical composition is (2R,3R,11bR)-9-(3-[18F]Fluoropropoxy)-3-isopropyl-10-methoxy-11b-methyl-2,3,4,6,7,11b-hexahydro-1H-pyrido[2,1-a]isoquinolin-2-ol (“18F-AV-133”). In still other aspects, the 18F-radiolabeled compound is a derivative of dihydrotetrabenazine (DTBZ).
The radiopharmaceutical composition of some embodiments includes an ethyl alcohol concentration in the range of about 1.0% to about 15.0% (v/v). Other embodiments include a concentration of ascorbic acid or salt thereof in the range of about 0.1% to about 1.0% (w/v). The pH of the radiopharmaceutical composition can range from about 4.5 to about 8.0. In preferred embodiments, the purity of the radiopharmaceutical composition is greater than or equal to about 90% when measured at least about 4 hours post end-of-synthesis (EOS).
The radiopharmaceutical composition can be used in the diagnosis of neurodegenerative disease such as, for example, dementia, cognitive impairment, Alzheimer's Disease (AD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Vascular Dementia (VaD) and combinations thereof.
Other embodiments of the invention are directed to a radiopharmaceutical composition for positron emission tomography (PET) imaging of the brain comprising an effective amount of an 18F-radiolabeled compound, at least about 1.0% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) of an ascorbate salt, wherein the 18F-radiolabeled compound decomposes less than about 10% from the end-of-synthesis to about 12 hours after the end-of-synthesis.
In another aspect of the invention, a method is provided for diagnosing a neurodegenerative disease in a patient comprising the steps of administering a radiopharmaceutical composition capable of binding to a target associated with a neurodegenerative disease to a patient, wherein said radiopharmaceutical composition includes an effective amount of 18F-radiolabeled compound, at least about 1.0% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) sodium ascorbate; imaging at least a portion of the patient's brain including a region wherein the target is expected to be positioned; and detecting the target. The imaging step may be performed using positron emission tomography (PET) imaging, PET with concurrent computed tomography imaging (PET/CT), PET with concurrent magnetic resonance imaging (PET/MRI) or a combination thereof.
In yet another embodiment of the invention, a method is provided for producing an 18F-radiolabeled composition capable of binding to β-amyloid including the steps of synthesizing a tosylate precursor; performing nucleophilic 18F fluorination of the tosylate precursor in a dimethylsulfoxide (DMSO) solution to provide an 18F radiopharmaceutical; and formulating the 18F radiopharmaceutical in an aqueous-ethyl alcohol solution containing ascorbic acid or a salt thereof; wherein the ethyl alcohol is present at a minimum concentration of about 1.0% (v/v) and the minimum concentration of the ascorbic acid or salt thereof is about 0.1% (w/v) in the final 18F-radiolabeled pharmaceutical composition.
In another embodiment, a method of producing the tosylate precursor of 18F-AV-45,(E)-2-(2-(2-(5-(4-(tert-butoxycarbonyl(methyl)amino)styryl)pyridin-2-yloxy)ethoxy)ethoxy)ethyl 4-methylbenzenesulfonate (“AV-105”), is provided. This method includes the steps of (i) preparing a mono Boc-protected vinylaniline compound; (ii) converting the vinylaniline compound to a methyl, t-butyl carbamate derivative; (iii) reacting 2-halo 5-iodopyridine with triethyleneglycol; (iv) reacting the methyl, t-butyl carbamate derivative of step (ii) with the resultant compound of step (iii) to produce (E)-tert-Butyl 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyl)carbamate; and (v) reacting the (E)-tert-Butyl 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyl)carbamate with tosyl chloride to form AV-105.
In still another aspect of the invention, a method of producing a radiopharmaceutical composition is provided including reacting the AV-105 tosylate precursor with an 18F-fluoride ion in dimethylsulfoxide (DMSO) solution or other high-boiling point aprotic solvent to produce ((E)-4-(2-(6-(2-(2-(2-[18F]-fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methylbenzenamine) (18F-AV-45); isolating the 18F-AV-45; and purifying the 18F-AV-45. The method of producing the radiopharmaceutical composition may further include the step of formulating the 18F-AV-45 in a solution containing about 1.0% to about 15% (v/v) of ethyl alcohol and about 0.1% to about 1.0% (w/v) of an ascorbate salt. In particular embodiments of the invention, the ascorbate salt is sodium ascorbate and the concentration is about 0.5% (w/v).
The above summary is not intended to describe each illustrated embodiment or every implementation of the present invention.
For a better understanding of the disclosure, reference should be made to the following figures, in which:
This invention is not limited to the particular compositions or methodologies described, as these may vary. In addition, the terminology used in the description describes particular versions or embodiments only and is not intended to limit the scope of the invention. Unless defined otherwise, all technical and scientific terms used herein have the same meanings as commonly understood by one of ordinary skill in the art. In case of conflict; the patent specification, including definitions, will prevail.
As used herein; the singular forms “a”, “an” and “the” include plural reference unless the context clearly dictates otherwise.
As used herein, the term “about” means plus or minus 10% of the numerical value of the number unless otherwise described.
“Administering” when used in conjunction with an diagnostic agent, such as, for example, a radiopharmaceutical, means to administer directly into or onto a target tissue or to administer the radiopharmaceutical systemically to a patient whereby the diagnostic agent is used to image the tissue or a pathology associated with the tissue to which it is targeted. “Administering” a composition may be accomplished by injection, infusion, or by either method in combination with other known techniques.
The terms “comprise”, “contain”, “have” and “include” and their conjugates, as used herein, mean “including, but not necessarily limited to.”
An “effective amount” or “therapeutically effective amount”, as used herein, refers to the amount of positron-emitting radiopharmaceutical that results in a sufficient gamma radiation signal to adequately image the biological target of interest in the brain of an individual with a suspected neurodegenerative disease.
The term “end-of synthesis” or “EOS”, as used herein, means end-of-radiosynthesis. This is the timepoint at which the radiosynthesis process, including any purification steps required for isolation of the radiopharmaceutical, are completed.
The term “high-boiling point aprotic solvent”, as used herein, is defined as an aprotic solvent having a boiling point of at least about 140° C. at one (1) atm.
The terms “pathology” or “pathologic”, as used herein, refer to an altered biological process that may be, for example, associated with aberrant production of proteins, peptides, RNA, and other substances associated with a disease process.
As used herein, the terms “patient” and “subject” refer to any living organism to which the compounds described herein are administered and whose brain activity is to be measured in conjunction with performing the analysis methods of the invention. Patients and/or subjects may include, but are not limited to, any non-human mammal, primate or human. Such patients and/or subjects may or may not be exhibiting signs, symptoms or pathology of one or more particular diseased states.
The term “target” when used in conjunction with a diagnostic agent, such as the radiopharmaceutical of the present invention, refers to tissue or other material associated with pathology to which localization of the radiopharmaceutical or diagnostic agent is desired. Targets may include, but are not limited to, diseased cells, pathogens, infectious material or other undesirable material in a patient, such as abnormal proteins, peptides, RNA or DNA or normally-expressed receptors that are altered in a disease process.
Generally speaking, as used herein, the term “tissue” refers to any aggregation of similarly specialized cells that are united in the performance of a particular function.
Various embodiments of the invention provide a method for the synthesis of an 18F-radiolabeled imaging agent from a tosylate precursor and a pharmaceutical composition of a stable drug product comprising such 18F-radiolabeled imaging agent.
Certain embodiments of the invention are directed to a radiopharmaceutical composition comprising an effective amount of an 18F-radiolabeled compound, such as an 18F-radiolabeled styrylpyridine or an 18F-labeled dihydrotetrabenazine (DTBZ) derivative, in a solution containing about 1.0% to about 30% (w/v) of ethyl alcohol, and at least about 0.1% (w/v) sodium ascorbate. Other embodiments of the invention are directed to a radiopharmaceutical composition comprising an effective amount of an 18F-radiolabeled compound in a solution for intravenous injection containing about 1.0% to about 20% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) sodium ascorbate with a pH of between approximately 4.5 and 8.0. This radiopharmaceutical composition is a clear solution, without insoluble matter, which is stable for at least 6 hours following production at concentrations up to 100 mCi/mL (37 to 3700 MBq/mL) or more of the F-18 radiopharmaceutical.
The parenteral radiopharmaceutical composition of embodiments of the invention may contain a F-18 radiolabeled compound which is capable of binding to a pathologic target in a brain of a patient such as, for example, an abnormal concentration of a native or pathologically-altered protein, peptide or oligonucleotide, β-amyloid, α-synuclein, or to a normally-expressed endogenous target that is impaired in the presence of certain degenerative disorders such as the vesicular monoamine transporter (VMAT2) in Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), or diabetes.
Various embodiments of the invention provide radiopharmaceutical compositions having characteristics including: a high affinity and selectivity for the target, low molecular weight (<400 g/mol), medium lipophilicity (log P in the range of 1-3) to ensure high initial brain uptake with rapid clearance, functional groups in the molecule for introduction of positron emitting radionuclides such as, for example, 11C or 18F, high stability in the brain as well as no brain uptake of peripherally generated metabolites of the tracer compound, and high availability of the tracer compound for clinical centers.
Use of the 18F-labeled imaging agents of the invention provides many logistic advantages due to the relatively large half life of 18F (t1/2=110 min) as compared to other radioisotopes such as, for example, 11C (t1/2=20 min). The relatively longer half-life of 18F is advantageous in that more time is provided for clearance of non-specifically bound tracer with less loss of signal strength due to radioactive decay.
In certain embodiments of the invention, the 18F-radiolabeled compound in the radiopharmaceutical composition comprises an 18F-radiolabeled compound, which is capable of binding to amyloid aggregates for use in positron emission tomography (PET) imaging of the brain. In various aspects, the 18F-radiolabeled compound is ((E)-4-(2-(6-(2-(2-(2-[18F]fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methylbenzenamine) (“18F-AV-45”). In some embodiments, the 18F-AV-45 is produced from a tosylate precursor. In other embodiments of the invention, the 18F-radiolabeled compound is a derivative of dihydrotetrabenazine (DTBZ). In still other aspects, the 18F-radiolabeled compound in the radiopharmaceutical composition is (2R,3R,11bR)-9-(3-[18F]-Fluoropropoxy)-3-isopropyl-10-methoxy-11b-methyl-2,3,4,6,7,11b-hexahydro-1H-pyrido[2,1-a]isoquinolin-2-ol (“18F-AV-133”).
In yet another embodiment of the invention, a radiopharmaceutical composition is provided comprising an effective amount of an 18F-radiolabeled compound, at least about 1.0% (w/v) of ethyl alcohol, and at least about 0.1% (w/v) ascorbate salt (e.g., sodium ascorbate), wherein the radiopharmaceutical composition retains a radiochemical purity of the desired radiopharmaceutical of ≧90% over a period of at least 4 hours after radiosynthesis, and more preferably over a period of up to 8 hours after radiosynthesis.
The radiopharmaceutical composition of certain embodiments includes ethyl alcohol in a concentration range of about 1.0% to about 15.0% (v/v) and ascorbate salt (e.g., sodium ascorbate or other salt of ascorbic acid) in a concentration range of about 0.1% to about 1.0% (w/v). In certain embodiments of the invention, sodium ascorbate is used at a concentration of 0.5% (w/v). The pH of the composition can range from about 4.5 to about 8.0. In some embodiments, the purity of the radiopharmaceutical is at least 90% when measured at least about 2 hours post end-of-synthesis (EOS). In preferred embodiments, the purity of the radiopharmaceutical composition is at least 90% when measured at least about 4 hours post EOS.
In yet another embodiment of the invention, a method is provided for producing an 18F-radiolabeled composition capable of binding to β-amyloid including synthesizing a tosylate precursor; performing nucleophilic 18F fluorination of the tosylate precursor; formulating the 18F fluorinated tosylate precursor in an aqueous solution; adding ethyl alcohol to achieve a minimum concentration of about 1.0% (w/v) in the final 18F-radiolabeled styrylpyridine composition; and adding sodium ascorbate to achieve a minimum concentration of about 0.1% (w/v) in the final 18F-radiolabeled styrylpyridine composition.
In another embodiment, a method of producing the tosylate precursor of 18F-AV-45, (E)-2-(2-(2-(5-(4-(tert-butoxycarbonyl(methyl)amino)styryl)pyridin-2-yloxy)ethoxy)ethoxy)ethyl 4-methylbenzenesulfonate (“AV-105”), is provided. This method includes the steps of (i) preparing a mono Boc-protected vinylaniline compound; (ii) converting the vinylaniline compound from (i) to an N-methyl, t-butyl carbamate (i.e., N-methyl, N-Boc) derivative; (iii) reacting 2-halo 5-iodopyridine (in some embodiments halo=chloro or bromo); with triethyleneglycol (iv) reacting the N-methyl, N-Boc derivative of step (ii) with the resultant compound of step (iii) to produce (E)-tert-Butyl 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyl)carbamate; and (v) reacting the (E)-tert-Butyl 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyl)carbamate with tosyl chloride to form AV-105.
In another aspect of the invention, a method of producing a radiopharmaceutical composition is provided including reacting the AV-105 tosylate precursor with an 18F-fluoride ion in DMSO or other high boiling aprotic solvent to produce ((E)-4-(2-(6-(2-(2-(2-[18F]fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methylbenzenamine) (“18F-AV-45”); isolating the 18F-AV-45; and purifying the 18F-AV-45. The method of producing the radiopharmaceutical composition may further include the step of formulating the 18F-AV-45 in a solution containing about 1.0% to about 15% (v/v) of ethyl alcohol and about 0.1% to about 1.0% or more (w/v) of sodium ascorbate or other ascorbate salt. In particular embodiments of the invention, the sodium ascorbate concentration is 0.5% (w/v).
In yet another embodiments of the invention, a radiopharmaceutical composition is provided comprising an effective amount of an 18F-radiolabeled compound, at least about 1.0% (v/v) of ethyl alcohol, and at least about 0.1% (w/v) sodium ascorbate, wherein the radiopharmaceutical composition decomposes at a rate measured in vitro that substantially corresponds to the following: (a) from about 0.01 to about 5% of the total decomposition after about 2 hours of measurement; (b) from about 0.01 to about 10% of the total decomposition after about 10 hours of measurement; (c) from about 0.01 to about 20% of the total decomposition after about 15 hours of measurement; and (d) not more than about 25% of the total decomposition after about 24 hours of measurement.
In certain embodiments, the invention involves synthesis methods for an 18F-radiolabeled styrylpyridine tosylate precursor, AV-105 (shown in
An alternative synthesis method for AV-105 is illustrated in
The radiosynthesis of one embodiment of the invention using a primary alkyl tosylate to produce β-amyloid binding radiopharmaceutical 18F-AV-45 is shown in
In another aspect of the invention, a method is provided for detecting a neurodegenerative disease in a patient including administering a radiopharmaceutical composition capable of binding to a target associated with a neurodegenerative disease comprising an effective amount of an 18F-radiolabeled amyloid imaging compound, such as 18F-AV-45, or an alternative F-18 labeled amyloid binding radiopharmaceutical, with about 1.0% to 15% (v/v) of ethyl alcohol, and about 0.1% to 1% (w/v) of sodium ascorbate to the patient; imaging a portion of the patient comprising a region of the patient wherein the target is expected to be positioned; and detecting the target. The region of the patient may include at least a portion of the brain.
The radiopharmaceutical composition can be used in the diagnosis of neurodegenerative disease such as, for example, dementia, cognitive impairment, Alzheimer's Disease (AD), Parkinson's Disease (PD), Dementia with Lewy Bodies (DLB), Vascular Dementia (VaD), and combinations thereof.
The 18F-radiolabeled pharmaceutical composition of embodiments of the present invention may be administered by any method known in the art. For example, in a particular aspect, the radiopharmaceutical composition may be administrated by injection. In particular, methods of administration may include, but are not limited to, intravascular injection, intravenous injection, intraperitoneal injection, subcutaneous injection, and intramuscular injection. The 18F-radiolabeled pharmaceutical composition may also be administered in unit dosage form, e.g., as an intravenous administration. In some embodiments, the radiopharmaceutical composition may be prepared in a unit dose syringe containing an appropriate quantity of the radiopharmaceutical.
The 18F-radiolabeled pharmaceuticals of various embodiments of the invention may be imaged using any suitable technique known in the art including Positron Emission Tomography (PET), Single Photon Emission Computed Tomography (SPECT), PET with concurrent computed tomography imaging (PET/CT), PET with concurrent magnetic resonance imaging (PET/MRI) or a combination thereof.
The 18F-radiopharmaceutical compositions of embodiments of the invention possess both high radiochemical purity and high radiosynthetic yield. The shelf-lives of the 18F-radiolabeled pharmaceuticals may vary among embodiments and may depend upon various aspects of the procedure. Generally, the shelf-lives of the 18F-radiolabeled pharmaceuticals are greater 8 hours after production when formulated in the compositions described herein. Certain embodiments of the invention further provide a formulation of the 18F-labeled compound that is both safe for administration to humans and stable to radiolysis or other chemical degradation over the time period (e.g., up to 8-10 hours) of shipment to hospitals or other imaging centers. For example, in one embodiment, an 18F-AV-45 radiopharmaceutical composition comprising ethyl alcohol and sodium ascorbate maintains stability (greater than 90% RCP) for up to 20 hours post-production.
In order that the invention disclosed herein may be more efficiently understood, the following examples are provided. These examples are for illustrative purposes only and are not to be construed as limiting the invention in any manner.
The synthetic route for the scale-up synthesis of tosylate precursor (E)-2-(2-(2-(5-(4-(tert-butoxycarbonyl(methyl)amino)styryl)pyridin-2-yloxy)ethoxy)ethoxy)ethyl 4-methylbenzenesulfonate (“AV-105”) of ((E)-4-(2-(6-(2-(2-(2-[18F]fluoroethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)-N-methylbenzenamine) (“18F-AV-45”) in accordance with one embodiment of the invention is shown in
Vinylaniline (3.75 g, 31.4 mmol) and di-tert-butyl dicarbonate (7.55 g, 34.6 mmol) were stirred vigorously in water (23 mL) at room temperature for two hours. Precipitates were filtered, and the remaining filter cake was redissolved in ethyl acetate (50 mL). The organic layer was washed with water (50 mL) and brine (50 mL), dried over anhydrous sodium sulfate, filtered, and concentrated under reduced pressure to obtain crude Mono-Boc-protected vinylaniline 5 (6.75 g, 98%) as a pinkish solid, which may be used in the next step without further purification.
Under a nitrogen atmosphere, sodium hydride (1.11 g 46.2 mmol) was added into anhydrous DMF (80 mL), and the suspension was cooled to 0° C. using an ice bath. Mono-Boc-protected vinylaniline 10 (6.75 g, 30.8 mmol) dissolved in anhydrous DMF (30 mL) was added within 30 minutes through an additional funnel. The reaction mixture was allowed to warm to room temperature, and methyl iodide (8.75 g, 61.6 mmol) was added within 30 minutes using a syringe. After stirring at room temperature for another 1.5 hours, the mixture was poured onto ice (200 g) and extracted with ethyl acetate (200 mL). The organic layer was separated from the aqueous layer, washed with water (100 mL) and brine (50 mL), dried over anhydrous sodium sulfate, filtered, and concentrated under reduced pressure to obtain crude product 11 (6.3 g, 88%) as a reddish oil.
Potassium tert-butoxide (869 mg, 7.7 mmol) was added in portions to a solution of 2-bromo-5-iodopyridine (2 g, 7.04 mmol) and triethylene glycol (4.23 g, 28.1 mmol) in tetrahydrofuran (THF) (40 mL). The reaction mixture was then refluxed for 20 h. The reaction mixture was concentrated under reduced pressure to remove the THF solvent. The concentrate was diluted with water (100 mL) and extracted with ethyl acetate (50 mL×2). The combined organic layers were washed with water (50 mL) then brine (50 mL), dried over anhydrous sodium sulfate, filtered, and concentrated under reduced pressure to obtain the mono-alkylated product 2-(2-(2-(5-Iodopyridin-2-yloxy)ethoxy)ethoxy)ethanol 13 (2.2 g, 88%) as a light yellowish oil that solidified after sitting overnight at ambient temperature.
The coupling partners ten-Butyl methyl(4-vinylphenyl)carbamate 11 (1.29 g, 5.55 mmol) and 2-(2-(2-(5-Iodopyridin-2-yloxy)ethoxy)ethoxy)ethanol 13 (1.96 g, 5.55 mmol), together with palladium acetate (62.3 mg, 0.278 mmol), tetrabutylammonium bromide (5.53 g, 16.65 mmol), and potassium carbonate (3.83 g, 27.75 mmol) were added to anhydrous DMF (80 mL). The reaction mixture was degassed with N2 for 5 minutes and heated at 100° C. overnight. The volume of the reaction was reduced 50% under vacuum, and the mixture was partitioned between ethyl acetate (200 mL) and water (400 mL). The aqueous layer was separated and extracted with additional ethyl acetate (150 mL). The organic layers were combined, washed with water (100 mL) and brine (100 mL), dried over anhydrous sodium sulfate, and concentrated under reduced pressure. The residue was purified by Biotage medium pressure flash column chromatography (45% ethyl acetate in hexanes; 65% ethyl acetate in hexanes) to give (E)-tert-Butyl 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyl)carbamate 14 (1.4 g, 55%).
The (E)-tert-Butyl 4-(2-(6-(2-(2-(2-hydroxyethoxy)ethoxy)ethoxy)pyridin-3-yl)vinyl)phenyl(methyl)carbamate 14 (1.3 g, 2.83 mmol) was dissolved in DCM (50 mL) followed by the addition of toluenesulfonyl chloride (1.08 g, 5.68 mmol), triethylamine (0.86 g, 8.49 mmol), and DMAP (24 mg, 0.2 mmol). The mixture was stirred at room temperature for 6 hours. Water (50 mL) was added. The organic layer was separated, washed with brine, dried over anhydrous sodium sulfate, concentrated under reduced pressure, and purified by Biotage medium pressure flash column chromatography (start from 30% ethyl acetate in hexane and way up to 40% ethyl acetate in hexane) to obtain compound AV-105 (1.5 g, 86%) as a clear, light yellow oil, which eventually solidified after a few days under vacuum.
[18F]fluoride activity was trapped on an anion exchange cartridge and eluted to the reaction vessel using aqueous K.2.2.2-K2CO3 solution (potassium carbonate and Kryptofix) and CH3CN. The eluted activity was dried under vacuum. The [18F]fluoride was further dried by addition of CH3CN to the reactor vessel, and the water-CH3CN azeotrope was evaporated with heating. AV-105 (1.5 mg in 2.0 mL of DMSO) was added to the reactor vessel. The vessel mixture was heated to 110-120° C. for the 18F-radiolabeling reaction. A solution of 3M HCl was added to the vessel, and the resulting mixture was heated to 120° C. for 5 minutes to remove the N-Boc-group. After cooling, a solution of 1M NaOH solution was added for neutralization. The solution was loaded onto a reverse phase cartridge. The isolated crude 18F-AV-45 on the cartridge was washed with about 4 mL of water for injection (WFI) containing 5% w/v sodium ascorbate. The 18F-AV-45 was then eluted using 1.5 mL of CH3CN into a reservoir containing 2 mL of WFI containing 5% w/v sodium ascorbate and 1 mL of high performance liquid chromatography (HPLC) solvent. The 18F-AV-45 was then loaded onto a semi-preparative HPLC column and subjected to purification. The HPLC fraction containing the purified 18F-AV-45 was collected in a reservoir containing 20 mL of WFI containing 0.5% w/v sodium ascorbate. The diluted solution was passed through a SEP-PAK® C-18 cartridge and the trapped 18F-AV-45 was washed with 15 mL of WFI containing 0.5% w/v sodium ascorbate. The 18F-AV-45 was eluted off the SEP-PAK® Light C-18 cartridge using 1 mL of EtOH (USP) into 9 mL of 0.9% Sodium Chloride Injection (sterile, USP) containing 0.5% w/v sodium ascorbate (USP). This solution was then dispensed through a 0.22 μm sterilizing filter into a 10 or 30 mL sterile pre-crimped septum-sealed container. The 18F-AV-45 drug product may be diluted with Sodium Chloride Injection (0.9%, USP, sterile) containing NMT 10% v/v EtOH (USP) and 0.5% w/v sodium ascorbate (USP).
The 18F-AV-45 radiopharmaceutical formulation/composition was evaluated for the solubility of the non-radioactive 19F-AV-45, which is also formed in quantities of 1-5 μg/mL during the radiosynthesis of 18F-AV-45 due to the presence of small quantities of 19F-fluoride from tubing, valves and other sources in the radiosynthesis system. In the absence of ethanol in the composition, particulate matter may be observed due to the low solubility of 19F-AV-45. The addition of 10% ethanol to the radiopharmaceutical composition was, therefore, evaluated to determine if the solubility of 19F-AV-45 was sufficient to avoid the potential of precipitate formation. The solubility limit of AV-45 in the drug product composition (10% (v/v) EtOH and 0.5% (w/v) sodium ascorbate in 0.9% aqueous sodium chloride) was determined to be 17 μg/mL at ambient temperature. A visible precipitate was noticeable in solutions with concentrations ≧22 μg/mL. Samples prepared at concentrations ≦20 μg/mL were evaluated by HPLC analysis following centrifugation. Samples with ≦20 μg/mL were also tested after storage for one week at ambient temperature. There was no change in concentration after one week of storage at ambient temperature.
The 18F-AV-45 radiopharmaceutical compositions of embodiments of the invention are remarkably stable to radiolysis or chemical degradation. Sodium ascorbate is used to minimize radiolysis during the purification of 18F-AV-45 and in the final drug product solution to increase stability and shelf life. Ethanol at 1-10% (v/v) in aqueous solution aids in the solubilization of 18F-AV-45. To demonstrate the stabilization of 18F-AV-45 in the final drug product, research compositions were manufactured with and without sodium ascorbate. The compositions were analyzed at end-of-synthesis (EOS) using reverse HPLC, equipped with both an ultra violet (UV) detector and radiochemical detector. The radiochemical purity of 18F-AV-45 was monitored by HPLC with radiometric detection and the purity of 19F-AV-45 was monitored by HPLC UV detection in the drug product by Area Percent Normalization. The area percent values for both radiochemical and ultraviolet analysis are shown in Tables 1 and 2.
At EOS, the radiochemical purity of the 18F-AV-45 composition prepared without sodium ascorbate was 84% and decomposed further such that at 2 hours the purity was 80%. The purity of the 18F-AV-45 composition manufactured with sodium ascorbate was significantly higher. At EOS, the purity was 96% with negligible decomposition at 2 hours post EOS (purity of 95%).
18F-AV-45 Injection at End of Synthesis (EOS).
Sodium ascorbate had a similar stabilizing affect on 19F-AV-45 and minimized the formation of non-radioactive impurities detected by UV, as shown in Table 2.
Table 3 shows extended stability of the 18F-AV-45 radiopharmaceutical in approximately 10% (v/v) of ethanol in normal saline containing 0.5% (w/v) of sodium ascorbate. As noted, the radiochemical purity of the 18F compound is maintained for up to approximately 20 hours after production.
An additional study was performed to demonstrate the stability of the 18F-AV-45 radiopharmaceutical in 10% (v/v) of ethanol in normal saline containing 0.5% (w/v) of sodium ascorbate when stored in a FLUROTEC®. The stability of the drug product was evaluated on three separate manufacturing lots of 18F-AV-45. Vials were stored upright and inverted at ambient and 40° C. temperatures, and upright at 50° C. Drug product was sampled at the specified intervals over a 12 hour testing period and evaluated for radiochemical purity and strength. The constant RCP over 12 hours and <5% drift of the drug product strength at all temperatures tested demonstrates the stability of the drug substance in the drug product as well as the minimal interaction of the drug substance with the vial stopper.
Although the present invention has been described in considerable detail with reference to certain preferred aspects thereof, other versions are possible. Therefore, the spirit and scope of the appended claims should not be limited to the description and the preferred versions contained within this specification.
This application claims priority under 35 U.S.C. §119(e) to U.S. Provisional Patent Application Ser. No. 61/141,885, filed Dec. 31, 2008, the disclosure of which is incorporated by reference in its entirety.
| Number | Date | Country | |
|---|---|---|---|
| 61141885 | Dec 2008 | US |
