18B. Targeting the SSR2A receptor with [68]Ga-SATO in NBL patients

Neuroblastoma is a relatively common malignancy in paediatric patients, with a median age at diagnosis of 18.8 months. Approximately 90% of NBL tumor cells express the Norepinephrine Receptor (NET) which takes up Meta-Iodo Benzyl Guanidine (MIBG) and is used for Theranostic purposes. Unfortunately, both current clinical standards; imaging with M123IBG and therapy with M131IBG have several disadvantages. As an alternative, somatostatin receptor (SSTR) targeted imaging and therapy might have several benefits over MIBG. Approximately 85% of recurrent or refractory high risk neuroblastoma patients have positive SSTR2a staining at histopathology. In low-, intermediate- and high (non-refractory) risk patients, SSTR2a expression is even higher.1 In NBL tumours with MYNC-amplification, SSTR expression is present, but to a lesser degree than in non-MYNC amplified NBL tumors.1 Besides MYNC-amplification, in high risk NBL patients (INSS stage 3 or 4) SSTR expression was an independent predictor for overall survival, potentially identifying a subgroup of high risk NBL patients with a poorer survival.1 Experience exists with a SSTR subtype 2a agonist (i.e. 68Ga-DOTATOC). However, from a physiological perspective a SSTR antagonist (i.e. 68Ga-Satoreotide trizoxetan, abbreviated to 68Ga-SATO), targeting both activated as non-activated SSTR2a, seems better than a SSTR2a agonist.

This study aims to understand a)the effectiveness of 68Ga-SATO in patients compared to the standard M¹²³IBG scanning and whole body MRI, b) It will assess the diagnostic accuracy and safety of the new imaging radiopharmaceutical, SSTR-antagonist 68Ga-SATO compared to current clinical standard.

The study will address ancilliary problems: c) assessment of the radiation absorbed dose for whole body and organs using dynamic qualitative PET scanning and d) patient burden of this scan protocol.

Study population: Paediatric patients, 0-18 years of age, with (clinical suspicion of) neuroblastoma, who are referred for conventional M¹²³IBG imaging.

Necessary skills for this position:

• Medical degree