COMPOUNDS AND METHODS OF USE

Field of Invention

The present invention relates to compounds for human or animal administration and to methods of use thereof. In particular, the present invention relates to compounds suitable for the preparation of agents for use in imaging that uses radionuclides (i.e. , endoradiology or nuclear medical imaging) and/or radiotherapy. Examples of such imaging techniques are single-photon emission computed tomography (SPECT) scintigraphy and positron emission tomography (PET). Examples of radionuclides used in radiotherapy include a-particle emitters, b-particle emitters and Auger electron emitters. Furthermore, the present invention relates to kits and imaging/radiotherapy agents for use in nuclear medical imaging and/or radiotherapy.

Background

Radiolabelled compounds are useful in both molecular imaging and radiotherapy, and several of these have been described in the prior art.

WO2012/022676 describes radiolabelled cMet binding peptides suitable for PET imaging in vivo. The cMet binding peptides are labelled with the radioisotope ¹⁸ F. Also described are pharmaceutical compositions, methods of preparation of the agents and compositions, and methods of in vivo imaging using the compositions, especially for use in the

management of cancer.

WO2012/119937 describes technetium imaging agents comprising radiolabelled cMet binding peptides suitable for SPECT or PET imaging in vivo. The cMet binding peptides are labelled via chelator conjugates.

Also described are pharmaceutical compositions, methods of preparation of the agents and compositions, and methods of in vivo imaging using the compositions, especially for use in the diagnosis of cancer.

W02005/030266 discloses cMet as a preferred biological target for contrast agents for optical imaging, specifically for colorectal cancer (CRC) diagnosis. W02005/030266 discloses optical imaging agents which comprise a vector, which has affinity to the abnormally expressed target, a linker moiety and one or more reporter moieties detectable in optical imaging.

W02004/078778 discloses polypeptides or multimeric peptide constructs which bind cMet or a complex comprising cMet and HGF.

W02004/078778 discloses that the peptides can be labelled with a detectable label for in vitro and in vivo applications, or with a drug for therapeutic applications.

Arulappu et al. (Nucl. Med. 2016, 57, 765-770) discloses a ¹⁸ F PET agent developed for cancer imaging of head and neck carcinomas. The agent is based on a 26-amino acid peptide with two internal disulphide bridges, specifically binding to cMet receptor. The lysine residue on the peptide is labelled with ¹⁸ F.

Flowever, the synthesis of agents such as this, where the radionuclide is introduced covalently is complex, yields are low and purification steps are required to afford the imaging agent in sufficient purity. In addition, such syntheses require the use of prosthetic groups such as p- ¹⁸ F

benzaldehyde as a starting material, which needs to be prepared from ¹⁸ F -fluoride. Therefore, similarly to the vast majority of ¹⁸ F based PET agents, the preparation requires skilled radiochemists and dedicated equipment such as specific robots and cassettes and shielded“hot” cells. As such, specialist sites are required to implement the synthesis of this particular type of ¹⁸ F PET imaging agent.

Due to the problems associated with preparing agents with covalently bound ¹⁸ F, the use of alternative radionuclides that can be bound by chelating agents has emerged. For example, ⁶⁷ Ga for SPECT imaging and ⁶⁸ Ga for PET imaging has become more prevalent, as has the use of AI ¹⁸ F salts. Whilst examples of imaging agents comprising a targeting moiety conjugated to a chelator (capable of chelating radioactive isotopes) exist, it would be of benefit to have an imaging and/or radiotherapeutic agent that can target cell-surface cMet overexpression with high affinity binding, favourable kinetic profile, specific uptake and/or rapid systemic clearance, as this would enable diagnostic imaging soon (perhaps as early as 1 hour) after administration and/or would enable more targeted radiotherapy (which reduces toxicity caused by off-target exposure).

Therefore, it is an object of the present invention to obviate or mitigate at least some of the disadvantages of the prior art.

A further object of the invention is to provide a radioimaging and/or radiotherapeutic agent for use in targeting sites of cMet overexpression and/or associated conditions.

Disclosure of Invention

According to the first aspect of the invention there is provided a compound suitable for the preparation of an agent for use in imaging and/or radiotherapy, the compound having Formula I: wherein:

Z ¹ is attached to the N-terminus of cMBP, and is H or Q;

Z ² is attached to the C-terminus of cMBP, and is OH, OB ^c or Q; wherein B ^c is a biocompatible cation;

cMBP is a cMet binding cyclic peptide of 17 to 30 amino acids, which comprises the amino acid sequence (SEQ-1 ):

Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b - T yr-Xaa ⁴ -Xaa ⁵ -Xaa ⁶ ;

wherein: Xaa ¹ is Asn, His or Tyr;

Xaa ² is Gly, Ser, Thr or Asn;

Xaa ³ is Thr or Arg;

Xaa ⁴ is Ala, Asp, Glu, Gly or Ser;

Xaa ⁵ is Ser or Thr;

Xaa ⁶ is Asp or Glu;

and Cys ^a_d are each cysteine residues such that residues a and b as well as c and d are cyclised to form two separate disulphide bonds;

each occurrence of Q is independently at least one of:

a metabolism inhibiting group (M ^IG ), which is a biocompatible group that inhibits or suppresses in vivo metabolism of the peptide, a tumour retention group (T ^RG ), which is a biocompatible group that enhances retention in tumour cells or the like in vivo, and a biodistribution enhancement group (D ^EG ), which is a biocompatible group that enhances biodistribution and/or prolongs blood retention in vivo ;

L is a synthetic linker group of formula -(A) _m - wherein each A is independently -CR2-, -CR=CR- -CºC-, -CR2CO2-, -CO2CR2-, -

NRCO-, -CONR-, -NR(C=0)NR- -NR(C=S)NR- -SO2NR-, -NRSO2- , -CR2OCR2-, -CR2SCR2-, CR2NRCR2-, a C4-8 cycloheteroalkylene group, a C ₄ -8 cycloalkylene group, a C5- ₁₂ arylene group, a C3- ₁₂ heteroarylene group, an amino acid, a sugar or a monodisperse polyethyleneglycol (PEG) building block;

each R is independently chosen from H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 alkoxyalkyl or C1-4 hydroxyalkyl;

m is an integer of value 1 to 20;

n is an integer of value 0 or 1 ;

IM is a chelating agent suitable for complexing a radioactive moiety.

The compound may comprise the radioactive moiety.

The Z ¹ group substitutes the amine group of the last amino acid residue. Thus, when Z ¹ is H, the amino terminus of the cMBP terminates in a free NH2 group of the last amino acid residue. The Z ² group substitutes the carbonyl group of the last amino acid residue. Thus, when Z ² is OH, the carboxy terminus of the cMBP terminates in the free CO2H group of the last amino acid residue, and when Z ² is OB ^c that terminal carboxy group is ionised as a C0 ₂ B ^C group.

By the term "metabolism inhibiting group" (M ^IG ) is meant a biocompatible group which inhibits or suppresses in vivo metabolism of the cMBP peptide at either the amino terminus (Z ¹ ) or carboxy terminus (Z ² ). Such groups are well known to those skilled in the art and are suitably chosen from, for the peptide amine terminus: N-acylated groups -NH(C=0)R ^G where the acyl group -(C=0)R ^G has R ^G chosen from: C1-6 alkyl, C3-10 aryl groups or comprises a polyethyleneglycol (PEG) building block. Suitable PEG groups are described for the linker group (L), below. Such PEG groups may be the biomodifiers of Formula IA or IB. Such amino terminus M ^IG groups may be acetyl, benzyloxycarbonyl or trifluoroacetyl, typically acetyl.

Suitable metabolism inhibiting groups for the peptide carboxyl terminus include: carboxamide, tert-butyl ester, benzyl ester, cyclohexyl ester, amino alcohol or a polyethyleneglycol (PEG) building block. A suitable M group for the carboxy terminal amino acid residue of the cMBP peptide is where the terminal amine of the amino acid residue is N-alkylated with a C1-4 alkyl group, optionally a methyl group. Such M ^IG groups may be carboxamide or PEG, and typically are carboxamide.

Formula I denotes that the -(L) _n [IM] moiety can be attached at any suitable position of Z ¹ , Z ² or cMBP. For Z ¹ or Z ² , the -(L) _n [IM] moiety may either be attached to the M ^IG group when either of Z ¹ /Z ² is a M ^IG . When Z ¹ is FI or Z ² is OH, attachment of the -(L) _n [IM] moiety at the Z ¹ or Z ² position gives compounds of formulae [IM]-(L) _n -[cMBP]-Z ² or Z ¹ -[cMBP]-(L) _n -[IM] respectively. Inhibition of metabolism of the cMBP at either peptide terminus may also be achieved by attachment of the -(L) _n [IM] moiety in this way, but -(L) _n [IM] is outside the definition of M ^IG herein.

The -(L)n- moiety of Formula I may be attached at any suitable position of the IM. The -(L) _n - moiety either takes the place of an existing substituent of the IM, or is covalently attached to the existing substituent of the IM.

The -(L)n- moiety is optionally attached via a carboxyalkyl substituent of the IM.

By the term "tumour retention group" (T ^RG ) is meant a biocompatible group which that enhances or improves retention of the compound in tumour cells or the like in vivo. Such groups can be moieties that add to the overall size of the compound and are suitably chosen from, for the peptide amine terminus or the peptide carboxyl terminus: polyamines, polylysines, PEG (monodisperse), albumin, fatty linear carbon chains, sugars

(glycosylation).

By the term "biodistribution enhancement group" (D ^EG ) is meant a biocompatible group which enhances biodistribution or prolongs blood retention (enhancing or improving the pharmacokinetics) of the compound in vivo. Such groups are suitably chosen from, for the peptide amine terminus or the peptide carboxyl terminus: polyamines, polylysines, PEG (monodisperse), albumin, fatty linear carbon chains, sugars

(glycosylation), and most suitably are PEG (monodisperse).

By the term "cMet binding cyclic peptide" (cMBP) is meant a peptide which binds to the hepatocyte growth factor (HGF) high affinity receptor, also known as cMet (c-Met or hepatocyte growth factor receptor). Suitable cMBP peptides have an apparent Kd for cMet of cMet/HGF complex of less than about 10 mM. The cMBP peptides comprise proline residues, and it is known that such residues can exhibit cis/trans isomerisation of the backbone amide bond. The cMBP peptides described herein include any such isomers.

By the term "biocompatible cation" (B ^c ) is meant a positively charged counterion which forms a salt with an ionised, negatively charged group, where said positively charged counterion is also non-toxic and hence suitable for administration to the mammalian body, especially the human body. Examples of suitable biocompatible cations include: the alkaline metals sodium or potassium; the alkaline earth metals calcium and magnesium; and the ammonium ion. Typical biocompatible cations are sodium and potassium, typically sodium.

By the term "amino acid" is meant an L- or D-amino acid, amino acid analogue (e.g., naphthylalanine) or amino acid mimetic which may be naturally occurring or of purely synthetic origin, and may be optically pure, i.e. a single enantiomer and hence chiral, or a mixture of enantiomers. Conventional 3-letter or single letter abbreviations for amino acids are used herein. The amino acids used may be optically pure. By the term "amino acid mimetic" is meant synthetic analogues of naturally occurring amino acids which are isosteres, i.e. have been designed to mimic the steric and electronic structure of the natural compound. Such isosteres are well known to those skilled in the art and include but are not limited to depsipeptides, retro-inverso peptides, thioamides, cycloalkanes or 1 ,5- disubstituted tetrazoles [see M. Goodman, Biopolymers, 24, 137, (1985)]. By the term "peptide" is meant a compound comprising two or more amino acids, as defined above, linked by a peptide bond (i.e. an amide bond linking the amine of one amino acid to the carboxyl of another). The term "peptide mimetic" or "mimetic" refers to biologically active compounds that mimic the biological activity of a peptide or a protein but are no longer peptidic in chemical nature, that is, they no longer contain any peptide bonds (that is, amide bonds between amino acids). Here, the term peptide mimetic is used in a broader sense to include molecules that are no longer completely peptidic in nature, such as pseudo-peptides, semi peptides and peptoids. By the term "chelating agent" (IM) is meant a substance whose certain atoms can form several bonds to a single metal ion or metal ion salt. A chelating agent is a multidentate ligand often consisting in a macrocycle rich in electron giving elements such as nitrogen or oxygen.

One of the roles of the linker group -(A) _m ,- of Formula I may be to distance the IM from the active site of the cMBP peptide. This is particularly important when the compound is relatively bulky, so that interaction with the target protein is not impaired. This can be achieved by a combination of flexibility (e.g. simple alkyl chains), so that the bulky group has the freedom to position itself away from the active site and/or rigidity such as a cycloalkyl or aryl spacer which orientate the IM away from the active site. The nature of the linker group can also be used to modify the

biodistribution of the compound. Thus, e.g., the introduction of ether groups in the linker will help to modify plasma protein binding. When - (A)rrr comprises a polyethyleneglycol (PEG) building block or a peptide chain of 1 to 10 amino acid residues, the linker group may function to modify the pharmacokinetics and blood clearance rates of the compound in vivo. Such "biomodifier" linker groups may alter the rate of the clearance of the compound from background tissue, such as muscle or liver, and/or from the blood, thus giving a better diagnostic image due to less background interference. A biomodifier linker group may also be used to favour a particular route of excretion, e.g., via the kidneys as opposed to via the liver.

By the term "sugar" is meant a mono-, di- or tri- saccharide. Suitable sugars include: glucose, galactose, maltose, mannose, and lactose.

Optionally, the sugar may be functionalised to permit facile coupling to amino acids. Thus, e.g., a glucosamine derivative of an amino acid can be conjugated to other amino acids via peptide bonds. The glucosamine derivative of asparagine (commercially available from NovaBiochem) is one example of this:

The molecular weight of the imaging agent is suitably up to 8,000 Daltons. Optionally, the molecular weight is in the range 2,800 to 6,000 Daltons, typically 3,000 to 4,500 Daltons, with 3,200 to 4,000 Daltons being most typical.

Imaging agents of the present invention may have both peptide termini protected by M ^IG groups, i.e. optionally both Z ¹ and Z ² are M ^IG , which will usually be different. As noted above, either of Z ¹ /Z ² may optionally equate to -(L)n[IM] Having both peptide termini protected in this way is important for in vivo imaging applications, since otherwise rapid metabolism would be expected with consequent loss of selective binding affinity for cMet. When both Z ¹ and Z ² are M ^IG , optionally Z ¹ is acetyl and Z ² is a primary amide. Z ¹ may be acetyl and Z ² may be a primary amide and the -(L) _n [IM] moiety may be attached to the epsilon amine side chain of a lysine residue of cMBP. cMBP peptides of the present invention may have a KD for binding of cMet to cMet/HGF complex of less than about 10 nM (based on fluorescence polarisation assay measurements), most typically in the range 1 to 5 nM, with less than 3nM being the ideal. The peptide sequence (SEQ-1 ): Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b -Tyr-Xaa ⁴ -

Xaa ⁵ -Xaa ⁶

(SEQ-1 )

of the cMBP of Formula I is a 17-mer peptide sequence, which is primarily responsible for the selective binding to cMet. When the cMBP peptide of the present invention comprises more than 17 amino acid residues, the remaining amino acids can be any amino acid apart from cysteine.

Additional, unprotected cysteine residues could cause unwanted scrambling of the defined Cys ^a -Cys ^b and Cys ^c -Cys ^d disulfide bridges. The additional peptides preferably comprise at least one amino acid residue with a side chain suitable for facile conjugation of the -(L) _n [IM] moiety. Suitable such residues include Asp or Glu residues for conjugation with amine-functionalised -(L) _n [IM] groups, or a Lys residue for conjugation with a carboxy- or active ester- functionalised -(L) _n [IM] group. The amino acid residues for conjugation of -(L) _n [IM] are suitably located away from the 17- mer binding region of the cMBP peptide (SEQ-1 ), and are optionally located at the C- or N- terminus. Optionally, the amino acid residue for conjugation is a Lys residue.

Substitution of the tryptophan residue of SEQ-1 was evaluated with the known amino acid substitutes phenylalanine and napthylalanine. Loss of cMet affinity was, however, found suggesting that the tryptophan residue is important for activity. Optionally the cMBP peptide further comprises a N-terminal serine residue, giving the 18-mer (SEQ-2):

Ser-Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b -Tyr-

Xaa ⁴ -Xaa ⁵ -Xaa ⁶ .

(SEQ-2) In addition to SEQ-1 , or SEQ-2, the cMBP may further comprise either:

(i) an Asp or Glu residue, or an analogue thereof, within 4 amino acid residues of either the C- or N- peptide terminus of the cMBP peptide, and -(L) _n [IM] is functionalised with an amine group which is conjugated to the carboxyl side chain of said Asp or Glu residue, or analogue thereof, to give an amide bond; or

(ii) a Lys residue, or an analogue thereof, within 4 amino acid residues of either the C- or N- peptide terminus of the cMBP peptide, and - (L)n[IM] is functionalised with a carboxyl group which is conjugated to the epsilon amine side chain of said Lys residue, or analogue thereof, to give an amide bond.

In addition to SEQ-1 , or SEQ-2, the cMBP may further comprise a Lys residue, or an analogue thereof, within 4 amino acid residues of either the C- or N- peptide terminus of the cMBP peptide, and -(L) _n [IM] is

functionalised with a carboxyl group which is conjugated to the epsilon amine side chain of said Lys residue, or analogue thereof, to give an amide bond.

Analogues of Asp and/or Glu may include one or more or 2- aminobutanedioic acid, 2-aminohexanedioic acid, 2-aminoheptanedioic acid, 2-aminooctanedioic acid, 2-aminononanedioic acid, 2- aminodecanedioic acid, 2-aminoundecanedioic acid, and 2- aminododecanedioic acid.

Analogues of Lys may include one or more of 2,3-diaminopropanoic acid, 2,4-diaminobutanoic acid, 2,5-diaminopentanoic acid, 2,7- diaminoheptanoic acid, 2,8-diaminooctanoic acid, 2,9-diaminononanoic acid, 2,10-diaminodecanoic acid, 2,11 -diaminoundecanoic acid, 2,12- diaminododecanoic acid.

When a synthetic linker group (L) is present, it may comprise terminal functional groups which facilitate conjugation to [IM] and Z ¹ -[cMBP]-Z ² . When L comprises a peptide chain of 1 to 10 amino acid residues, the amino acid residues may be independently chosen from histidine, glycine, lysine, arginine, aspartic acid, glutamic acid or serine, optionally may be independently chosen from glycine, lysine, arginine, aspartic acid, glutamic acid or serine. Optionally, L may comprise a peptide chain of 1 to 5 amino acids. Optionally, L may comprise a peptide chain of 2 amino acids. Optionally, L may comprise a peptide chain of 3 amino acids. The amino acid residues may be independently chosen from histidine, glycine, lysine, arginine, aspartic acid, glutamic acid or serine, optionally may be independently chosen from glycine, lysine, arginine, aspartic acid, glutamic acid or serine. The amino acid residues may be glycine.

In the synthetic linker group of formula -(A) _m -, each A may be an amino acid and m may be an integer of value 1 to 5. Optionally, each A may be an amino acid and m may be 2. Optionally, each A may be an amino acid and m may be 3. The amino acid may be independently chosen from histidine, glycine, lysine, arginine, aspartic acid, glutamic acid or serine, optionally may be independently chosen from glycine, lysine, arginine, aspartic acid, glutamic acid or serine. The, or each, amino acid may be glycine.

When L comprises a PEG moiety, it may comprise units derived from oligomerisation of the monodisperse PEG-like structures of Formulae IA (17-amino-5-oxo-6-aza-3, 9, 12, 15-tetraoxaheptadecanoic acid) or IB:

(Formula IA) wherein p is an integer from 1 to 10. Alternatively, a PEG-like structure based on a propionic acid derivative of Formula IB can be used:

(Formula IB) where p is as defined for Formula IA and q is an integer from 3 to 15. In Formula IB, p may be 1 or 2, and q may be 5 to 12.

L may comprise a peptide chain of 1 to 10 amino acid residues and a PEG moiety. In the synthetic linker group of formula -(A) _m -, each A may independently be an amino acid or a monodisperse polyethyleneglycol (PEG) building block. Optionally, each A may independently be an amino acid m may be an integer of value 1 to 5, optionally 3, optionally 2.

When the linker group does not comprise PEG or a peptide chain, the L groups may have a backbone chain of linked atoms which make up the - (A)rrr moiety of 2 to 10 atoms, most preferably 2 to 5 atoms, with 2 or 3 atoms being especially preferred. A minimum linker group backbone chain of 2 atoms confers the advantage that the imaging moiety is well- separated so that any undesirable interaction is minimised. Peptides of formula Z ¹ -[cMBP]-Z ² may be obtained by a method of preparation which comprises:

(i) solid phase peptide synthesis of a linear peptide which has the same peptide sequence as the desired cMBP peptide and in which the Cys ^a and Cys ^b are unprotected, and the Cys ^c and Cys ^d residues have thiol-protecting groups;

(ii) cleavage from the solid support and treatment of the peptide from step (i) with aqueous base in solution to give a monocyclic peptide with a first disulphide bond linking Cys ^a and Cys ^b ;

(iii) removal of the Cys ^c and Cys ^d thiol-protecting groups and cyclisation to give a second disulphide bond linking Cys ^c and Cys ^d , which is the desired bicyclic peptide product Z ¹ -[cMBP]-Z ² .

By the term "protecting group" is meant a group which inhibits or suppresses undesirable chemical reactions, but which is designed to be sufficiently reactive that it may be cleaved from the functional group in question under mild enough conditions that do not modify the rest of the molecule. After deprotection the desired product is obtained. Amine protecting groups are well known to those skilled in the art and are suitably chosen from: Boc (where Boc is tert-butyloxycarbonyl), Fmoc (where Fmoc is fluorenylmethoxycarbonyl), trifluoroacetyl, allyloxycarbonyl, Dde [i.e. 1 -(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl] or Npys (i.e. 3-nitro-2- pyridine sulfenyl). Suitable thiol protecting groups are Trt (Trityl), Acm (acetamidomethyl), f-Bu (tert-butyl), fe/f-Butylthio, methoxybenzyl, methylbenzyl or Npys (3-nitro-2-pyridine sulfenyl). The use of further protecting groups is described in 'Protective Groups in Organic Synthesis', Theorodora W. Greene and Peter G. M. Wuts, (John Wiley & Sons, 1991 ). Typical amine protecting groups are Boc and Fmoc, most typically Boc. Other typical thiol protecting groups are Trt and Acm. Further details of solid phase peptide synthesis are described in P. Lloyd- Williams, F. Albericio and E. Girald; Chemical Approaches to the

Synthesis of Peptides and Proteins, CRC Press, 1997. The cMBP peptides are best stored under inert atmosphere and kept in a

freezer. When used in solution, it is best to avoid pH above 7 since that risks scrambling of the disulfide bridges, and it is best to avoid low pH as this triggers aggregation of the peptide.

Z ¹ -[cMBP]-Z ² may have both Z ¹ and Z ² equal to M ^IG . Typical cMBP peptides and Z ¹ /Z ² groups are as described above. In particular, it is typical that the cMBP peptide comprises an Asp, Glu or Lys residue to facilitate conjugation as described for the typical cMBP peptides described above. It is most typical that the cMBP peptide comprises a Lys residue. The preparation of the Z ¹ -[cMBP]-Z ² is described above. A Z ¹ -[cMBP]-Z ³ peptide, where Z ³ is an active ester, can be prepared from Z ¹ -[cMBP]-Z ² , where Z ² is OH or a biocompatible cation (B ^c ), by conventional methods.

By the term "activated ester" or "active ester" is meant an ester derivative of the associated carboxylic acid which is designed to include a better leaving group, and hence permit more facile reaction with nucleophile, such as amines. Examples of suitable active esters are: N- hydroxysuccinimide (NHS), sulpho-succinimidyl ester, pentafluorophenol, pentafluorothiophenol, para-nitrophenol, hydroxybenzotriazole and PyBOP (i.e. benzotriazol-1 -yl-oxytripyrrolidinophosphonium hexafluorophosphate).

The active esters may be N-hydroxysuccinimide or pentafluorophenol esters, especially N-hydroxysuccinimide esters. Alternatively, an intramolecularly activated form of the carboxylic acid by formation of an anhydride may be used. The radioactive moiety may be at least one of an alpha ray (a) emitter, a beta ray (b) emitter and a gamma ray (y) emitter.

The beta ray emitter may be at least one of an electron (b ) emitter and a positron (b ⁺ ) emitter.

The compound may be for use in one or more of positron-emission tomography (PET), single-photon emission computed tomography

(SPECT), scintigraphy and radiotherapy. The compound may be for use in one or more of single-photon emission computed tomography (SPECT) and radiotherapy. The compound may be for use in radiotherapy.

The radioactive moiety may be selected from one or more of the group consisting of: ⁹⁰ Y, ¹⁷⁷ Lu, ¹⁸⁸ Re, ¹⁸⁶ Re, ⁶⁷ Cu, ²¹² Bi, ²¹³ Bi, ^{21 1} At, ²²⁵ Ac, ¹³¹ l,

¹⁶⁶ Ho, ¹⁴⁹ Pm, ¹⁹⁹ Au, ¹⁰⁵ Rh, ²²⁷ Th, ¹⁵³ Sm, ⁸⁹ Sr, ²²³ Ra, ⁷⁷ Br, ¹²³ l, ¹²⁵ l, ^99m Tc,

⁶⁷ Ga, ^{11 1} 1n, ⁶⁸ Ga, ⁶⁴ Cu, ⁸⁹ Zr, ¹¹ C, ¹⁵ 0, ¹³ N, ⁸² Rb and ¹⁸ F, and suitable salts thereof.

The radioactive moiety may be selected from one or more of the group consisting of: ⁹⁰ Y, ¹⁷⁷ Lu, ¹⁸⁸ Re, ¹⁸⁶ Re, ⁶⁷ Cu, ²¹² Bi, ²¹³ Bi, ^{21 1} At, ²²⁵ Ac, ¹³¹ l,

¹⁶⁶ Ho, ¹⁴⁹ Pm, ¹⁹⁹ Au, ¹⁰⁵ Rh, ²²⁷ Th, ¹⁵³ Sm, ⁸⁹ Sr, ²²³ Ra, ⁷⁷ Br, ¹²³ l, and ¹²⁵ l, and suitable salts thereof.

The radioactive moiety may be selected from one or more of the group consisting of: ⁶⁸ Ga, ⁶⁴ Cu, ⁸⁹ Zr, ¹¹ C, ¹⁵ 0, ¹³ N, ⁸² Rb and ¹⁸ F, and suitable salts thereof.

The radioactive moiety may be selected from one or more of the group consisting of: ^99m Tc, ⁶⁷ Ga and ¹¹¹ In, and suitable salts thereof. The radioactive moiety may be selected from one or more of the group consisting of: ⁶⁸ Ga, ¹⁸ F, ⁸⁹ Zr, ¹⁷⁷ Lu, ²²⁵ Ac, ²¹³ Bi, ²²⁷ Th and ⁹⁰ Y, and suitable salts thereof. The radioactive moiety may be selected from one or more of the group consisting of: ⁶⁸ Ga and ¹⁷⁷ Lu, and suitable salts thereof.

The radioactive moiety may be ¹⁷⁷ Lu, or suitable salts thereof. The chelating agent may be selected from one or more of the group consisting of: cyclen (1 ,4,7, 10-tetraazacyclododecane), cyclam (1 ,4,8, 1 1 - tetraazacyclotetradecane), TACN (1 ,4,7-triazacyclononane), THP

(tris(hydroxypyridinone)), DOTAGA (2,2',2”-(10-(1 ,4-dicarboxy-ethyl)- 1 ,4,7, 10-tetraazacyclododecane-1 ,4,7 -triy l)triacetic acid), NODAGA (1 ,4,7- triazacyclononane, 1 -glutaric acid-4, 7-acetic acid), TRAP (1 ,4,7- triazacyclononane phosphinic acid), NOPO (1 ,4,7-triazacyclononane-1 ,4- bis[methylene(hydroxymethyl)phosphinic acid]-7-[methylene(2- carboxyethyl)phosphinic acid), NOTA (1 ,4,7-triazacyclononane-1 ,4,7- trisacetic acid), DOTA (1 ,4,7, 10-tetraazacyclododecane-1 ,4,7, 10- tetraacetic acid), DATA ((6-pentanoic acid)-6-(amino)methy-1 ,4- diazepinetriacetate)), AAZTA (1 ,4-bis(carboxymethyl)-6- [bis(carboxymethyl)]amino-6-methylperhydro-1 ,4-diazepine), HBED-CC (N,N'-bis(2-hydroxy-5-(ethylene-beta-carboxy)benzyl)ethylene diamine N,N'-diacetic acid), and derivatives thereof.

The chelating agent may be at least one of: THP (tris(hydroxypyridinone)), DOTAGA (2,2',2”-(10-(1 ,4-dicarboxy-ethyl)-1 ,4,7, 10- tetraazacyclododecane-1 ,4,7-triyl)triacetic acid, DOTA (1 ,4,7, 10- tetraazacyclododecane-1 ,4,7,10-tetraacetic acid), and NODAGA (1 ,4,7- triazacyclononane, 1 -glutaric acid-4, 7-acetic acid). The chelating agent may be at least one of: DOTAGA (2,2',2”-(10-(1 ,4- dicarboxy-ethyl)-1 ,4,7, 10-tetraazacyclododecane-1 ,4,7 -triy l)triacetic acid), and DOTA (1 ,4,7, 10-tetraazacyclododecane-1 ,4,7, 10-tetraacetic acid).

The chelating agent may be DOTAGA (2,2',2”-(10-(1 ,4-dicarboxy-ethyl)- 1 ,4,7, 10-tetraazacyclododecane-1 ,4,7 -triy l)triacetic acid). The chelating agent may be DOTA (1 ,4,7, 10-tetraazacyclododecane-1 ,4,7, 10-tetraacetic acid).

In addition to SEQ-1 , the cMBP further comprises an Asp or Glu residue within 4 amino acid residues of either C- or N- cMBP peptide terminus, and— (L)nlM is functionalised with an amine group, which is conjugated to the carboxyl side chain of said Asp or Glu residue to give an amide bond.

In addition to SEQ-1 , the cMBP may comprise a Lys residue within 4 amino acid residues of either C- or N- cMBP peptide terminus, and -(L) _n IM may be functionalised with a carboxyl group, which is conjugated to the epsilon amine side chain of said Lys residue to give an amide bond. cMBP may comprise the amino acid sequence of either SEQ-2 or SEQ-3:

Ser-Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp- Cys ^b -T yr-Xaa ⁴ -Xaa ⁵ -Xaa ⁶ (SEQ-2); Ala-Gly-Ser-Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -

Trp-Cys ^b -Tyr-Xaa ⁴ -Xaa ⁵ -Xaa ⁶ -Gly-Thr (SEQ-3).

Xaa ³ may be Arg. In addition to SEQ-1 , SEQ-2 or SEQ-3, cMBP may further comprise at either the N- or C- terminus a linker peptide, which is chosen from -Gly- Gly-Gly-Lys (SEQ-4), -Gly-Ser-Gly-Lys- (SEQ-5) and -Gly-Ser-Gly-Ser-Lys (SEQ-6).

The Lys residue of the linker peptide is a typical location for conjugation of the -(L)n[IM] moiety. Some cMBP peptides comprise SEQ-3 together with the linker peptide of SEQ-4, having the 26-mer amino acid sequence (SEQ-7):

Ala-Gly-Ser-Cys ^a -Tyr-Cys ^c -Ser-Gly-Pro-Pro-Arg-Phe-Glu-Cys ^d -Trp-Cys ^b -

Tyr-Glu-Thr-Glu-Gly-Thr-Gly-Gly-Gly-Lys.

(SEQ-7) cMBP may have the amino acid sequence (SEQ-7):

Ala-Gly-Ser-Cys ^a -Tyr-Cys ^c -Ser-Gly-Pro-Pro-Arg-Phe-Glu-Cys ^d -Trp-

Cys ^b -Tyr-Glu-Thr-Glu-Gly-Thr-Gly-Gly-Gly-Lys.

Both Z ¹ and Z ² may independently be Q, optionally M ^IG .

Z ¹ may be acetyl and Z ² may be a primary amide n may be 1. n may be 0. cMBP peptides of SEQ-1 , SEQ-2, SEQ-3 and SEQ-7 may have Z ¹ = Z ² = M ^IG , and may have Z ¹ = acetyl and Z ² = primary amide.

The -(L)n[IM] moiety is suitably attached to either of the Z ¹ or Z ² groups or an amino acid residue of the cMBP peptide which is different to the cMet binding sequence of SEQ-1. Possible amino acid residues and sites of conjugation are as described above. When the -(L) _n [IM] moiety is attached to Z ¹ or Z ² , it may take the place of Z ¹ or Z ² by conjugation to the N- or C- terminus, and block in vivo metabolism in that way. The compound may be suitable for the preparation of an agent for use in radiotherapy, the compound having Formula I:

wherein:

Z ¹ is attached to the N-terminus of cMBP, and is Q;

Z ² is attached to the C-terminus of cMBP, and is Q;

wherein Q is a metabolism inhibiting group (M ^IG ), which is a biocompatible group that inhibits or suppresses in vivo metabolism of the peptide;

cMBP is a cMet binding cyclic peptide of 17 to 30 amino acids, which comprises the amino acid sequence (SEQ-1 ):

Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b - T yr-Xaa ⁴ -Xaa ⁵ -Xaa ⁶ ;

wherein: Xaa ¹ is Asn, His or Tyr;

Xaa ² is Gly, Ser, Thr or Asn;

Xaa ³ is Thr or Arg;

Xaa ⁴ is Ala, Asp, Glu, Gly or Ser;

Xaa ⁵ is Ser or Thr;

Xaa ⁶ is Asp or Glu; and Cys ^{a d} are each cysteine residues such that residues a and b as well as c and d are cyclised to form two separate disulphide bonds;

L is a synthetic linker group of formula -(A) _m - wherein each A is independently -CR2-, -CR=CR- -CºC-, -CR2CO2-, -CO2CR2-, -

NRCO-, -CONR-, -NR(C=0)NR- -NR(C=S)NR- -SO2NR-, -NRSO2- , -CR2OCR2-, -CR2SCR2-, CR2NRCR2-, a C4-8 cycloheteroalkylene group, a C ₄ -8 cycloalkylene group, a C5- ₁₂ arylene group, a C3- ₁₂ heteroarylene group, an amino acid, a sugar or a monodisperse polyethyleneglycol (PEG) building block;

each R is independently chosen from H, C1-4 alkyl, C2-4 alkenyl, C2-4 alkynyl, C1-4 alkoxyalkyl or C1-4 hydroxyalkyl;

m is an integer of value 1 to 20;

n is an integer of value 0 or 1 ; and

IM is a chelating agent suitable for complexing a radioactive moiety, wherein the chelating agent is at least one of: DOTAGA (2,2',2”-(10-(1 ,4-dicarboxy-ethyl)-1 ,4,7,10-tetraazacyclododecane- 1 ,4,7 -triy l)triacetic acid), and DOTA (1 ,4,7,10- tetraazacyclododecane-1 ,4,7,10-tetraacetic acid).

The compound may be suitable for the preparation of an agent for use in radiotherapy, the compound having Formula I:

wherein:

Z ¹ is attached to the N-terminus of cMBP, and is Q;

Z ² is attached to the C-terminus of cMBP, and is Q;

wherein Q is a metabolism inhibiting group (M ^IG ), which is a biocompatible group that inhibits or suppresses in vivo metabolism of the peptide;

cMBP is a cMet binding cyclic peptide of 17 to 30 amino acids, which comprises the amino acid sequence (SEQ-1 ):

Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b - Tyr-Xaa ⁴ -Xaa ⁵ -Xaa ⁶ ;

wherein: Xaa ¹ is Asn, His or Tyr;

Xaa ² is Gly, Ser, Thr or Asn;

Xaa ³ is Thr or Arg;

Xaa ⁴ is Ala, Asp, Glu, Gly or Ser;

Xaa ⁵ is Ser or Thr;

Xaa ⁶ is Asp or Glu;

and Cys ^a_d are each cysteine residues such that residues a and b as well as c and d are cyclised to form two separate disulphide bonds;

L is a synthetic linker group of formula -(A) _m - wherein each A is independently an amino acid or a monodisperse polyethyleneglycol (PEG) building block;

m is an integer of value 1 to 5;

n is 1 ; and

IM is a chelating agent suitable for complexing a radioactive moiety, wherein the chelating agent is at least one of: DOTAGA (2,2',2”-(10- (1 ,4-dicarboxy-ethyl)-1 ,4,7, 10-tetraazacyclododecane-1 ,4,7- triyl)triacetic acid), and DOTA (1 ,4,7,10-tetraazacyclododecane- 1 ,4,7, 10-tetraacetic acid). According to a second aspect of the invention there is provided a pharmaceutical composition comprising the compound of the first aspect and a biocompatible carrier, in a form suitable for mammalian

administration. The pharmaceutical composition may further comprise a radioactive moiety as described in the first aspect. The radioactive moiety can be complexed by the chelating agent.

The biocompatible carrier may be a solvent, typically an aqueous solvent, typically water. The solvent may be a fluid.

The "biocompatible carrier" may be a fluid, especially a liquid, in which the imaging agent can be suspended or dissolved, such that the composition is physiologically tolerable, i.e. can be administered to the mammalian body without toxicity or undue discomfort. The biocompatible carrier is suitably an injectable carrier liquid such as sterile, pyrogen-free water for injection; an aqueous solution such as saline (which may advantageously be balanced so that the final product for injection is isotonic); an aqueous solution of one or more tonicity-adjusting substances (e.g., salts of plasma cations with biocompatible counterions), sugars (e.g., glucose or sucrose), sugar alcohols (e.g., sorbitol or mannitol), glycols (e.g., glycerol), or other non-ionic polyol materials (e.g., polyethyleneglycols, propylene glycols and the like). The biocompatible carrier may be pyrogen-free water for injection or isotonic saline. The imaging agents and biocompatible carrier are each supplied in suitable vials or vessels which comprise a sealed container which permits maintenance of sterile integrity and/or radioactive safety, plus optionally an inert headspace gas (e.g., nitrogen or argon), whilst permitting addition and withdrawal of solutions by syringe or cannula. A preferred such container is a septum-sealed vial, wherein the gas-tight closure is crimped on with an overseal (typically of aluminium). The closure is suitable for single or multiple puncturing with a hypodermic needle (e.g., a crimped-on septum seal closure) whilst maintaining sterile integrity. Such containers have the additional advantage that the closure can withstand vacuum if desired (e.g., to change the headspace gas or degas solutions), and withstand pressure changes such as reductions in pressure without permitting ingress of external atmospheric gases, such as oxygen or water vapour.

The pharmaceutical composition may have a dosage for a single patient and may be provided in a suitable syringe or container.

According to a third aspect of the invention there is provided a kit for the preparation of the pharmaceutical composition of the second aspect, the kit comprising the compound of the first aspect in sterile, solid form such that upon reconstitution with a sterile supply of the biocompatible carrier of the second aspect, dissolution occurs to give the desired pharmaceutical composition.

The kit may further comprise a radioactive moiety as described in the first aspect. The radioactive moiety can be complexed by the chelating agent.

According to a further aspect of the invention there is provided a method of imaging of the mammalian body comprising use of at least one of the compound of the first aspect and the pharmaceutical composition of the second aspect.

The imaging may be in vivo.

The imaging may be at least one of PET imaging, scintigraphy and

SPECT imaging. The imaging may be SPECT imaging.

The imaging may be to obtain images of sites of cMet over-expression or localisation in vivo.

The imaging method, wherein optionally the compound of the first aspect or the pharmaceutical composition of the second aspect has been previously administered to the mammalian body. The imaging method may comprise the steps of:

a) administering at least one of the compound of the first aspect and the pharmaceutical composition of the second aspect;

b) detecting emission from the radioactive moiety, which is

generated by the decay of the radioactive moiety; and c) forming an image of the tissue surface of interest from the

emission of step (b).

The imaging method may be used to assist in detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy.

The imaging method may be used to assist in detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy of cancer or a pre-cancer condition.

A method of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression or monitoring therapy comprising the imaging method.

According to a further aspect of the invention there is provided the compound of the first aspect, or the pharmaceutical composition of the second aspect, for use as at least one of: an imaging agent in imaging of the mammalian body, and a radiotherapeutic agent in radiotherapy of the mammalian body. According to a further aspect of the invention there is provided the compound of the first aspect, or the pharmaceutical composition of the second aspect, for use as a radiotherapeutic agent in radiotherapy of the mammalian body. According to a further aspect of the invention there is provided the compound of the first aspect, or the pharmaceutical composition of the second aspect, for use as both: an imaging agent in imaging of the mammalian body, and a radiotherapeutic agent in radiotherapy of the mammalian body.

According to a further aspect of the invention there is provided at least one of the compound of the first aspect, and the pharmaceutical composition of claim the second aspect, for use as a medicament. According to a further aspect of the invention there is provided at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, for use in detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy. According to a further aspect of the invention, there is provided at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, for use in the detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy of cancer or a pre-cancer condition.

According to a further aspect of the invention there is provided at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, for use in the detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy of sites of cMet over-expression or localisation. According to a further aspect of the invention there is provided at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, for use in obtaining an image of, and/or treating conditions associated with, sites of cMet over-expression or localisation in vivo.

According to a further aspect of the invention there is provided a method of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy using at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect.

According to a further aspect of the invention there is provided a method of radiotherapy on the mammalian body using at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect.

According to a further aspect of the invention there is provided a method of both imaging and radiotherapy on the mammalian body using at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect.

According to a further aspect of the invention there is provided a method of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy of cancer or a pre-cancer condition, using at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect.

According to a further aspect of the invention there is provided a method of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and/or monitoring therapy of sites of cMet over- expression or localisation using at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect.

According to a further aspect of the invention there is provided a method of obtaining an image of sites of and/or treating conditions associated with cMet over-expression or localisation in vivo using at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect. According to a further aspect of the invention there is provided the use of at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect. According to a further aspect of the invention there is provided the use of at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, in at least one of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, monitoring of treatment, therapy, radiotherapy, monitoring of disease progression and monitoring therapy.

According to a further aspect of the invention there is provided the use of at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, as at least one of: an imaging agent, and a radiotherapeutic agent.

According to a further aspect of the invention there is provided the use of at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, as a radiotherapeutic agent.

According to a further aspect of the invention there is provided the use of at least one of: the compound of the first aspect, and the pharmaceutical composition of the second aspect, in at least one of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and monitoring therapy of cancer or a pre-cancer condition.

According to a further aspect of the invention there is provided the use of at least one of the compound of any the first aspect, and the

pharmaceutical composition of the second aspect, in at least one of detection, diagnosis, prognosis, prediction of outcome, surgery, staging, treatment, therapy, radiotherapy, monitoring of treatment, monitoring of disease progression and monitoring therapy of sites of cMet over expression or localisation.

According to a further aspect of the invention there is provided the use of at least one of the compound of the first aspect, and the pharmaceutical composition of the second aspect, in at least one of obtaining an image of, and treating conditions associated with, sites of cMet over-expression or localisation in vivo.

It will be appreciated that for in vivo use, the formulation is made into a form suitable for mammalian administration by, for example, reconstitution with a biocompatible carrier.

The alternative features and different embodiments as described apply to each and every aspect and each and every embodiment thereof mutatis mutandis. Brief Description of the Drawings

Embodiments of the invention will now be described, by way of example, with reference to the drawings, in which:

Fig. 1 depicts a compound of the invention comprising NODAGA (Compound 1 ) and a reaction scheme to obtain Compound 1 ;

Fig. 2 depicts a compound of the invention comprising TFIP

(Compound 2) and a reaction scheme to obtain Compound 2;

Fig. 3 depicts a compound of the invention comprising DOTA (Compound 3) and a reaction scheme to obtain Compound 3; Fig. 4 depicts a compound of the invention comprising DOTAGA (Compound 4) and a reaction scheme to obtain Compound 4;

Fig. 5 shows in vivo PET/CT imaging of ⁶⁸ Ga-Compound 3 (1 hour and 3 hours post injection) and ¹⁸ F-FDG (1 hour post injection);

Fig. 6 shows in vivo SPECT imaging of ¹⁷⁷ Lu-Com pound 3 (1.5 hours, 17 hours, 41 hours, 65 hours and 141 hours post injection);

Fig. 7 shows in vivo PET/CT imaging of ¹⁸ F-FDG (1 hour post injection); and

Fig. 8 shows in vivo SPECT imaging of ¹⁷⁷ Lu-Com pound 3 (4.5 hours, 20 hours, 45 hours, 67 hours and 141 hours post injection).

Detailed Description

Compounds useful as imaging or radiotherapy agents (or as precursors or as part of a kit) were prepared as described below.

Preparation of cMet Binding Peptide

Step (a): Synthesis of protected precursor linear peptide

The precursor linear peptide has the structure:

Ac-Ala-Gly-Ser-Cys-Tyr-Cys(Acm)-Ser-Gly-Pro-Pro-Arg-Phe-G lu- Cys(Acm)-Trp-Cys-Tyr-Glu-Thr-Glu-Gly-Thr-Gly-Gly-Gly-Lys-NFl 2

(comprising SEQ-7).

The peptidyl resin FI-Ala-Gly-Ser(tBu)-Cys(Trt)-Tyr(tBu)-Cys(Acm)- Ser(tBu)-Gly-Pro-Pro-Arg(Pbf)-Phe-Glu(OtBu)-Cys(Acm)-Trp(Boc )- Cys(Trt)-Tyr(tBu)-Glu(OtBu)-Thr^ ^{Me Me} pro)-Glu(OtBu)-Gly-Thr(tBu)-Gly- Gly-Gly-Lys(Boc)-Polymer (comprising SEQ-7) was assembled on an Applied Biosystems 433A peptide synthesizer using Fmoc chemistry starting with 0.1 mmol Rink Amide Novagel resin. An excess of 1 mmol pre-activated amino acids (using FIBTU) was applied in the coupling steps. Glu-Thr pseudoproline (Novabiochem 05-20-1122) was incorporated in the sequence. The resin was transferred to a nitrogen bubbler apparatus and treated with a solution of acetic anhydride (1 mmol) and NMM (1 mmol) dissolved in DCM (5 ml_) for 60 min. The anhydride solution was removed by filtration and the resin washed with DCM and dried under a stream of nitrogen.

The simultaneous removal of the side-chain protecting groups and cleavage of the peptide from the resin was carried out in TFA (10 ml_) containing 2.5 % TIS, 2.5 % 4-thiocresol and 2.5 % water for 2 hours and 30 min. The resin was removed by filtration, TFA removed in vacuo and diethyl ether added to the residue. The formed precipitate was washed with diethyl ether and air-dried affording 264 mg of crude peptide.

Purification by preparative FIPLC (gradient: 20-30 % B over 40 min where A = H2O/O.I % TFA and B = ACN/0.1 % TFA, flow rate: 10 mL/min, column: Phenomenex Luna 5m C18 (2) 50 x 21.20 mm, detection: UV 214 nm, product retention time: 30 min) of the crude peptide afforded 100 mg of pure cMet Binding Peptide linear precursor. The pure product was analysed by analytical HPLC (gradient: 10-40 % B over 10 min where A = H2CV0.1 % TFA and B = ACN/0.1 % TFA, flow rate: 0.3 mL/min, column:

Phenomenex Luna 3 m C18 (2) 50 x 2 mm, detection: UV 214 nm, product retention time: 6.54 min). Further product characterisation was carried out using electrospray mass spectrometry (MH2 ²⁺ calculated: 1464.6, MH2 ²⁺ found: 1465.1 ).

Step (b): Formation of Monocyclic Cvs4-16 disulfide bridge

Cys4-16; Ac-Ala-Gly-Ser-Cys-Tyr-Cys(Acm)-Ser-Gly-Pro-Pro-Arg-Phe- Glu-Cys(Acm)-Trp-Cys-Tyr-Glu-Thr-Glu-Gly-Thr-Gly-Gly-Gly-Lys -NFl2 (comprising SEQ-7). The linear precursor from step (a) (100 mg) was dissolved in 5 %

DMSO/water (200 ml_) and the solution adjusted to pH 6 using ammonia. The reaction mixture was stirred for 5 days. The solution was then adjusted to pH 2 using TFA and most of the solvent removed by evaporation in vacuo. The residue (40 ml_) was injected in portions onto a preparative HPLC column for product purification.

Purification by preparative HPLC (gradient: 0 % B for 10 min, then 0-40 % B over 40 min where A = H2O/O.I % TFA and B = ACN/0.1 % TFA, flow rate: 10 mL/min, column: Phenomenex Luna 5m C18 (2) 250 x 21.20 mm, detection: UV 214 nm, product retention time: 44 min) of the residue afforded 72 mg of pure cMet Binding Peptide monocyclic precursor. The pure product (as a mixture of isomers P1 to P3) was analysed by analytical HPLC (gradient: 10-40 % B over 10 min where A = H2O/O.I % TFA and B = ACN/0.1 % TFA, flow rate: 0.3 mL/min, column:

Phenomenex Luna 3m C18 (2) 50 x 2 mm, detection: UV 214 nm, product retention time: 5.37 min (P1 ); 5.61 min (P2); 6.05 min (P3)). Further product characterisation was carried out using electrospray mass spectrometry (MH ₂ ²⁺ calculated: 1463.6, MH ₂ ²⁺ found: 1464.1 (P1 ); 1464.4 (P2); 1464.3 (P3)).

Step (c): Formation of Second Cvs6-14 disulfide bridge

The monocyclic precursor from step (b) (72 mg) was dissolved in 75 % AcOH/water (72 mL) under a blanket of nitrogen. 1 M HCI (7.2 mL) and 0.05 M I2 in AcOH (4.8 mL) were added in that order and the mixture stirred for 45 min. 1 M ascorbic acid (1 mL) was added giving a colourless mixture. Most of the solvents were evaporated in vacuo and the residue (18 mL) diluted with water/0.1 % TFA (4 mL) and the product purified using preparative HPLC. Purification by preparative HPLC (gradient: 0 % B for 10 min, then 20-30 % B over 40 min where A = H ₂ O/0.1 % TFA and B = ACN/0.1 % TFA, flow rate: 10 mL/min, column: Phenomenex Luna 5m C18 (2) 250 x 21.20 mm, detection: UV 214 nm, product retention time: 43-53 min) of the residue afforded 52 mg of pure cMet Binding Peptide. The pure product was analysed by analytical HPLC (gradient: 10-40 % B over 10 min where A = H2O/O.I % TFA and B = ACN/0.1 % TFA, flow rate: 0.3 mL/min, column: Phenomenex Luna 3m C18 (2) 50 x 2 mm, detection: UV 214 nm, product retention time: 6.54 min). Further product characterisation was carried out using electrospray mass spectrometry (MH2 ²⁺ calculated: 1391.5, MH2 ²⁺ found: 1392.5).

Preparation of Compound 1

With reference to the reaction scheme at Fig. 1 , Compound 1 was prepared as follows.

GMP grade cMet Binding Peptide (150.0 mg, 49.8 pmol) obtained from Bachem was dissolved in dry DMF (1.9 mL) in a 10 mL round bottomed flask under nitrogen. NODAGA-NHS ester (43.80 mg, 1.2 equivalents) obtained from CheMatec was dissolved in dry DMF (600 pL) and dry DIPEA (173 pL, 20.0 equivalents) obtained from Sigma Aldrich (99.5% Biotech grade) was added. The active ester solution was added to the peptide solution upon which a precipitate formed. The suspension was stirred for 1 hour at 25°C, at which point a sample was analysed by HPLC, showing incomplete reaction. The suspension was stirred for a further 1 hour, at which point a further sample was analysed by HPLC, again showing incomplete reaction. NODAGA-NHS ester (8.7 mg, 0.52 equivalents) and DIPEA (34.7 pL, 4 equivalents) were added to the reaction mixture. After 3 hours 30 minutes the reaction was stopped, even although conversion of the starting peptide to the product was incomplete (approx. 5% starting peptide remained). The reaction mixture was added ice cold MTBE (15 ml_) and the precipitate was centrifuged (2 minutes, 3,260 rpm, 5 °C). The crude product was dissolved in 1 ml_ of water, which yielded a biphasic liquid, which was purified by semi-preparative HPLC (AA 100 mM, pH 7, AcN, 1 % per minute, 10 ml_ per min, column Zorbax C18 30 x 250 mm, 3 injection, t _R = 26.73 minutes). Compound 1 was obtained in moderate yield (76.9 mg, 49%) and excellent purity (> 98%, 210 and 254 nm). HPLC and MALDI/TOF confirmed that Compound 1 had been obtained.

HPLC Results

(Eluent A: 0.1 % TFA in H2O, Eluent B: 0.09% TFA in Acetonitrile; Column: Agilent Zorbax Eclipse Plus 95A C18, 2.1 x 150mm, 3.5um P/N 959763- 902; Gradient: 5% B for 2.5 min, then 5% to 90% B in 85 min, then 90% B for 2.5 min, then 90% to 5% B in 2.5 min, then 5% B for 2.5 min;

Detection: 210 nm)

• t _R cMet peptide: 29.2 minutes; t _R product = 30.1 minutes (Eluent A: 0.1 M ammonium acetate in water, Eluent B: Acetonitrile;

Column: Agilent Zorbax Eclipse Plus 95A C18, 2.1 x 150mm, 3.5um P/N 959763-902; Gradient: 5% B for 2.5 min, then 5% to 90% B in 85 min, then 90% B for 2.5 min, then 90% to 5% B in 2.5 min, then 5% B for 2.5 min; Detection: 210 nm)

· t _R cMet peptide: 21.0 minutes; t _R product = 19.15 minutes

(Eluent A: 0.1 % TFA in H2O, Eluent B: 0.09% TFA in Acetonitrile; Column: Agilent Zorbax Eclipse Plus 95A C18, 2.1 x 150mm, 3.5um P/N 959763- 902; Gradient: 5% B for 2.5 min, then 5% to 90% B in 17 min, then 90%B for 2.5 min, then 90% to 5% B in 2.5 min, then 5% B for 2.5 min;

Detection: 210 nm)

• t _R product = 12.6 minutes MALDI/TOF Results

• Peptide (reanalysed): 2,786.98 (M+4H)

• Product: 3,141 (calculated product mass = 3,140.43)

Preparation of Compound 2

Compound 2 was prepared in accordance with the reaction scheme at Fig. 2, and as per the following description.

GMP grade c-Met peptide (30.0 mg, 9.97 pmol) and p-NCS-Bz-TFIP (14.37 mg, 1.5 equiv.) obtained from CheMatec were dissolved in dry DMF (1 ml_) in a 10 mL round bottom flask. Dry DIPEA (26.0 pL, 15.0 equiv.) was added on which a precipitate formed. The partially solubilised suspension was stirred. FIPLC analysis showed almost full conversion of the peptide after 2 hours and full conversion after 4 hours, by which time the solution is cloudy with some precipitate. To the reaction mixture was added ice cold MTBE (15 mL) and the precipitate was centrifuged (2min, 3260 rpm, 5°C). The washing was repeated with cold MTBE (6 mL) and the precipitate was centrifuged (2min, 3260 rpm, 5°C). The resulting white solid was dried under a flow of argon and then in vacuo (31.95 mg). The crude product was dissolved in 400 pL water and 400 pL AcN, and purified by semi preparative HPLC (TFA 0.1 % in FhO, AcN, 0.75% per minute, 20 mL per min, column Zorbax C18 21.2x250mm, 1 injection, t _R =34.3 min, Trace file 521 ). The compound obtained in good yield and purity (89% UV 254 nm). HPLC, ESI+/MS and MALDI/TOF confirmed that Compound 2 had been obtained.

HPLC Results

(Eluent A: 0.1 % TFA in H2O, Eluent B: 0.09% TFA in Acetonitrile; Column: Agilent Zorbax Eclipse Plus 95A C18, 2.1 x 150mm, 3.5um P/N 959763- 902; Gradient: 5% B for 2.5 min, then 5% to 90% B in 85 min, then 90%B for 2.5 min, then 90% to 5% B in 2.5 min, then 5% B for 2.5 min;

Detection: 210 nm)

· t _R product = 13.7 minutes

ESI+/MS Results

• Product: 1 ,872.8.3 (M+2H) ²⁺ ; 1 ,248.5 (M+3H) ³⁺ MALDI/TOF Results

• Starting peptide: 2,786.98 (M+4H) ⁺

• Product: 3,738 (calculated product mass = 3,741.43)

Preparation of Compound 3

DOTA-NHS is commercially available as an activated species for the labelling of amines. It can be used for ⁶⁸ Ga and ¹⁷⁷ Lu chelation. DOTA- NHS was conjugated with the cMet Binding Peptide as per the reaction scheme in Fig. 3 to provide Compound 3. Further details are provided below.

GMP grade cMet Binding Peptide (10 mg, 3.17 pmol) obtained from

Bachem was dissolved in dry DMF (100 pL) in a 1.5 mL Eppendorf tube and DIPEA (8.26 pL, 15.0 equivalents) obtained from Sigma Aldrich (99.5% Biotech grade) was added. DOTA-NHS (4.10 mg, 1.7 equivalents) obtained from CheMatec was dissolved in dry DMF (50 pL) and was added to the amine solution. The reaction mixture was flushed with Argon gas and reacted under positive pressure of Argon gas for approx. 24 hours at 20 ^° C. A sample was taken after 1 hour and was analysed by HPLC. A further sample was taken after approx. 24 hours and was analysed by ESI+/MS and MALDI/TOF to confirm complete reaction.

HPLC, ESI+/MS and MALDI/TOF all confirmed complete conversion of the cMet Binding Peptide to Compound 3.

HPLC Results (Eluent A: 0.1 % TFA in H ₂ 0, Eluent B: 0.09% TFA in Acetonitrile; Column: Agilent Zorbax Eclipse Plus 95A C18, 2.1 x 150mm, 3.5um P/N 959763-902; Gradient: 5% B for 2.5 min, then 5% to 90% B in 85 min, then 90%B for 2.5 min, then 90% to 5% B in 2.5 min, then 5% B for 2.5 min; Detection: 210 nm)

• To = tR cMet peptide: 29.2 minutes

• T _{I H} = t _R cMet peptide: no peak; t _R product: 28.9 minutes ESI+/MS Results

• Reaction mixture after approx. 24 hours - positive ionisation:

1 ,585.3 (M+2H) ²⁺ ; 1 ,056.9 (M+3H) ³⁺

MALDI/TOF Results

Peptide (reanalysed): 2,785.05

Reaction mixture after approx. 24 hours: 3,170 (calculated product mass = 3,169.44) Preparation of Compound 4

DOTAGA anhydride is commercially available as an activated species for the labelling of amines. It can be used for ⁶⁸ Ga and ¹⁷⁷ Lu chelation.

DOTAGA anhydride was conjugated with the cMet Binding Peptide as per the reaction scheme in Fig. 4 to provide Compound 4. Further details are provided below.

GMP grade cMet Binding Peptide (25 mg, 7.92 pmol) obtained from Bachem was dissolved in dry DMF (300 pL) in a 10 mL round bottomed flask previously made moisture free by placing in an over at 180 °C.

DIPEA (21 pl_, 15.0 equivalents) obtained from Sigma Aldrich (99.5% Biotech grade) was added to the round bottomed flask and flushed with Argon gas. DOTAGA anhydride (7.26 mg, 2.0 equivalents) obtained from CheMatec was dissolved in dry DMF (300 mI_) in an Eppendorf tube and was added to the amine solution. The reaction mixture was sonicated to dissolve then flushed with Argon gas and reacted under positive pressure of Argon gas for approx. 4 hours at approx. 90 °C.

Sample were taken after 30 minutes, 1 hour, 1 hour 30 minutes, 2 hours and four hours, and were analysed by FIPLC. Each sample taken was analysed by MALDI/TOF and the sample taken at 4 hours was analysed by ESI+/MS to confirm complete reaction.

FIPLC, ESI+/MS and MALDI/TOF all confirmed complete conversion of the cMet Binding Peptide to Compound 4.

HPLC Results (Eluent A: 0.1 % TFA in H ₂ 0, Eluent B: 0.09% TFA in Acetonitrile; Column: Agilent Zorbax Eclipse Plus 95A C18, 2.1 x 150mm, 3.5um P/N 959763-902; Gradient: 5% B for 2.5 min, then 5% to 90% B in 85 min, then 90%B for 2.5 min, then 90% to 5% B in 2.5 min, then 5% B for 2.5 min; Detection: 210 nm)

• T 30 _MIN = t _R cMet peptide: 29.214 minutes; t _R product: 28.854

minutes

· TI H = t _R cMet peptide: 29.105 minutes; t _R product: 28.724 minutes

• T- _IH 30 _MIN = t _R cMet peptide: 29.112 minutes; t _R product: 28.745

minutes

• Ϊ2 _H = t _R cMet peptide: 29.607 minutes; t _R product: 28.796 minutes

• T4 _H = t _R cMet peptide: 29.560 minutes; t _R product: 28.747 minutes

ESI+/MS Results

• Reaction mixture after approx. 4 hours - positive ionisation: 1 ,621.4 (M+2H) ²⁺ , 1 ,632.3 (M+Na+H) ²⁺ , 1 ,081.0 (M+3H) ³⁺ MALDI/TOF Results

• Reaction mixture after approx. 4 hours: 3,244.3 (M+H) ⁺ ; 3266

(M+Na) ⁺ (calculated product mass = 3,241.50)

The following experiments were performed on Compound 3 and

Compound 4:

• Residual Solvent Analysis (Experiment 1 );

• Determination of Counter Ion Stoichiometry (Experiment 2);

• Competition Binding Assay by Fluorescence Polarisation

(Experiment 3);

· Radiolabelling Compound 3 and Compound 4 with ¹⁷⁷ Lu

(Experiment 4); and

• Radiolabelling Compound 3 and Compound 4 with ⁶⁸ Ga

(Experiment 5). Experiment 1 : Residual Solvent Analysis of Compounds 3 and 4

Compounds 3 and 4 were tested for the following residual solvents: dimethylformamide (DMF); acetonitrile (MeCN); diisopropylethylamine (DIPEA); tert-butyl methyl ether (TBME); dichloromethane (DCM); and trifluoroacetic acid (TFA).

(a) Procedures

DMF, MeCN, DIPEA, TBME and DCM analysis was performed by Fleadspace Gas Chromatography (GC) as follows.

Samples of Compounds 3 and 4 were prepared, in duplicate, by accurately weighing out approximately 10 mg of each compound into separate HPLC headspace vials. 1 ml_ of dimethylamine (DMA) was added to each of the vials and the vials were sealed with crimp caps.

The prepared samples were analysed against a standard, which included the required solvents of interest.

The solvents in the standard were prepared at the working standard concentrations outlined in Table 1.

Note ¹ : ICH Limit = International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Limit.

Note ² : Density values taken from Sigma-Aldrich, all density values at 25°C.

n/a = not applicable

Table 1 : Working Standard Concentrations

For analysis, 1 mL of standard was accurately pipetted into a 20 mL headspace vial and securely capped. One vial was prepared for each required injection of standard.

The samples and standards were analysed by GC on a Thermo Trace 1300 GC with Tri-Plus 300 Headspace Autosampler under the conditions outlined in Table 2.

Table 2: GC and Headspace Parameters

TFA analysis was performed by HPLC as follows.

A standard stock solution of TFA was prepared by pipetting 335 pL TFA into 100 ml_ of 0.008N sulfuric acid to give a 5 mg/mL stock. The stock solution was then diluted with 0.008N sulfuric acid to give standards at 0.1 mg/mL, 0.05 mg/mL, 0.025 mg/mL, 0.010 mg/mL and 0.005 mg/mL.

The standards were analysed by HPLC under the conditions outlined in Table 3. This produced a standard curve for quantitation of the amount of TFA in Compounds 3 and 4. The standard curve covered the range 500 to 10,000 ppm.

Samples of Compounds 3 and 4 were prepared, singly due to lack of availability of material, by accurately weighing out 20 mg of each compound into separate 2 ml_ volumetric flasks. The flasks were then made to volume with 0.008N sulfuric acid to provide 10 mg/mL solutions.

Both samples formed gels at 10 mg/mL, such that they were not suitable for injection onto the HPLC column. The samples were further diluted to 2 mg/mL. These samples were still viscous, but suitable for HPLC injection. The injection volume was increased to compensate for the dilution factor in the samples. The HPLC conditions for TFA analysis are outlined in Table 3.

Table 3: HPLC Conditions for TFA Analysis (b) Results

The results obtained for the residual solvent determination by gas chromatography (GC) on Compounds 3 and 4 are shown in Table 4.

Note ¹ : ICH Limit = International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use Limit.

Note ² : DMF was detected as carryover in the blank injections by GC, and is reported as a maximum potential result, which is still below the ICH limit. Note ³ : DIPEA is not classified by the ICH Guideline Q3C (R5) for Residual Solvents, and as a result has no specified limit

nd = not detected Table 4: Summary of Residual Solvent Analysis Results

TFA residual limits could not be determined by the proposed method due to dissociation of the TFA from the salt. Dissociation of TFA resulted in a TFA response from the samples that was far in excess of the anticipated level of <5000 ppm.

Therefore, the FIPLC analysis was deemed unsuitable for determination of residual TFA in the samples. (c) Conclusion

The residual solvents detected in Compounds 3 and 4 were within their respective International Council for Flarmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) limits, which means that both Compound 3 and Compound 4 are suitable for human administration. Experiment 2: Determination of Counter Ion Stoichiometry of

Compounds 3 and 4

The trifluoroacetic acid (TFA) stoichiometry of Compounds 3 and 4 was determined by HPLC analysis. (a) Procedure

Compounds 3 and 4 are both considered penta TFA salts. As such, the theoretical percentage of TFA in the compounds was calculated as follows: · Molecular weight of TFA = 114.02 g/mol

• Molecular weight of penta TFA salt = 570.1 g/mol

• Molecular weight of compound 3 (penta salt) = 3739.6 g/mol

• Molecular weight of compound 4 (penta salt) = 3811.6 g/mol Therefore, the theoretical percentage of TFA in each of the compounds is:

• Compound 3 = (570.1/3739.6) x 100 = 15.24 % TFA

• Compound 4 = (570.1/3811.6) x 100 = 14.96 % TFA To determine stoichiometry, samples were prepared at 1 mg/mL and analysed against a TFA standard at 0.15 mg/mL, which was the intended counterion content (15 %).

A TFA standard was prepared in duplicate at approximately 0.15 mg/mL by diluting 100 pL of TFA to 10 mL of 0.008N sulphuric acid to give a 15 mg/mL stock, which was then diluted (1 mL to 100 mL in 0.008N sulphuric acid) to give a 0.15 mg/mL standard solution.

Samples of Compounds 3 and 4 were prepared at approximately 1 mg/mL by weighing 5 mg of each compound into separate 5 mL volumetric flasks. The flasks were made to volume with 0.008N sulphuric acid.

The samples and standards were analysed by HPLC using the conditions outlined in Table 5.

Table 5: HPLC Conditions for TFA Analysis

The recovery of the samples against the standards was calculated factoring in weights used and the dilutions. The recovery of the samples would determine the stoichiometry and the results would follow this pattern:

• Penta salt = 100 % recovery

· Tetra salt = 80 % recovery

• Tris salt = 60 % recovery

• Bis salt = 40 % recovery

• Mono salt = 20 % recovery (b) Results

The standard recovery was 107.0 %. This was attributed to the standard preparation procedure that was followed. Specifically, pure TFA was difficult to handle due to its volatility. This caused problems in handling and measuring out the pure volatile material.

Compound 3 gave a recovery of 91.86 %.

Compound 4 gave a recovery of 99.06 %.

The recoveries were within normal confidence limits placed on a

counterion determination.

The testing confirmed penta stoichiometry for Compound 3 and

Compound 4 within 10 % confidence limits.

Experiment 3: Competition Binding Assay of Compounds 3 and 4 by Fluorescence Polarisation (FP)

The half maximal inhibitory concentration (ICso) and dissociation constant (K _d ) values were determined by competition fluorescence polarisation (FP) assay for the binding of cMet binding cyclic peptide (unlabelled), cMet- DOTA (Compound 3) and cMet-DOTAGA (Compound 4) to cMet receptor.

The principle of the fluorescence polarisation method can briefly be described as follows:

Monochromatic light passes through a horizontal polarizing filter and excites fluorescent molecules in the sample. Only those molecules that are oriented properly in the vertically polarized plane adsorb light, become excited, and subsequently emit light. The emitted light is measured in both horizontal and vertical planes. The anisotropy value (A), is the ratio between the light intensities following the equation:

A = (Intensity with horizontal polarizer - Intensity with vertical

polarizer)/(lntensity with horizontal polarizer + 2* Intensity with vertical polarizer).

The fluorescence anisotropy measurements were performed in a 96-well flat bottom plate using a Molecular Devices M5 multi-mode plate reader.

The assay buffer used was phosphate-buffered saline (PBS), pH 7.4 with 0.01 % Tween 20.

Stock Preparation

Fluorescent probe (cMet binding cyclic peptide with fluorescent label

(Cy5)) was dissolved in assay buffer to give a 1 mM stock. A 1 mM parent stock and 50 nM working stock were also prepared. cMet receptor (100 pg) was dissolved in assay buffer (1 ml_) to give a parent stock of 775 nM. Working stocks of 500 nM and 167 nM were also prepared.

Peptides (cMet binding cyclic peptide (unlabelled), Compound 3 and Compound 4) were dissolved in assay buffer to give a parent stock of either 0.5 or 1 mM. Working stocks of 67 pM were also prepared.

Peptide Competition Assay

A 2-fold dilution screen of peptides (cMet binding cyclic peptide

(unlabelled), Compound 3 and Compound 4; 30 pL/well of 67 pM stock) giving final concentrations of 20 pM to 20 nM was added to the plate. cMet receptor (30 pL/well of 167 mM stock) giving a final concentration of 50 nM was also added. Fluorescent probe (40 pL/well of 50 nM stock) giving a final concentration of 20 nM (100 pl_ total volume) was also added. Each well was repeated in triplicate. 100 pL assay buffer (in triplicate) was used as a non-fluorescent blank. The plate was incubated at 30 °C for 10 minutes before scanning. The plate was scanned in triplicate at ex/em/cut-off filter(COF) 640/675/665 nm at room temperature (25 °C). The anisotropy was plotted against competing peptide concentration for each of cMet peptide (unlabelled), Compound 3 and Compound 4.

IC50 values were determined by data fitting with the following equation using KaleidaGraph v4.03:

where r is the observed anisotropy, ro is the anisotropy of the free probe, n is the anisotropy of the fully bound probe, and [peptide] is the competing peptide concentration.

K _d values were determined by data fitting with the following equation using KaleidaGraph v4.03: *1 ^“ r ₀

r = r ₀ 4 -

^' K<|p, ([peptide] 4· _d )\

1 4 K [cMet] }

where r is the observed anisotropy, ro is the anisotropy of the free probe, n is the anisotropy of the fully bound probe, [peptide] is the competing peptide concentration, K _dp is the dissociation constant for cMet receptor and the fluorescent probe, and K _d is the dissociation constant for the competing peptide binding to the cMet receptor.

The mean IC50 values and K _d values are provided in Table 6 below.

Table 6: Mean IC50 Values and K _d Values for cMet Binding Cyclic Peptide

(Unlabelled), Compound 3 and Compound 4 The results showed that cMet binding cyclic peptide (unlabelled),

Compound 3 and Compound 4 have comparable affinity for the cMet receptor and any variations in IC50 and K _d values were well within experimental error. Experiment 4: Radiolabelling Compound 3 and Compound 4 with

¹⁷⁷ Lu

A study was carried out to determine the feasibility of radiolabelling

Compounds 3 and 4 with Lutetium-177 ( ¹⁷⁷ Lu).

Pilot Study

Various peptide (Compounds 3 and 4) to ¹⁷⁷ Lu ratios were tested to evaluate the corresponding radiolabelling yields by HPLC and Instant Thin-Layer Chromatography (ITLC).

The radiolabelling procedure was performed using 0.4 M ammonium acetate at pH 5.6 (buffer 1 for tests 1 to 8) or 0.4 M ammonium acetate and 0.325 M gentisic acid at pH 4 (buffer 2 for tests 9 to 12). [ ¹⁷⁷ Lu]LuCl3 with a specific activity of > 500 MBq/nmol was used for the radiolabelling studies. A specified volume (V _I 77 _LU in Table 8) of [ ¹⁷⁷ Lu]LuCl3 was mixed with the appropriate buffer and 1 nmol of peptide (Compound 3 or

Compound 4). The reaction mixture was incubated at 80 °C for an incubation time of 10, 20 or 30 minutes in a thermomixer system. A summary of the radiolabelling tests with various ratios of Compounds 3 and 4 to ¹⁷⁷ Lu are outlined in Table 7. The specific conditions for each test are outlined in Table 8. At the end of incubation, 1 pL of the mixture was injected on the HPLC system and analysed using the conditions outlined in Table 9.

Table 7: Radiolabelling tests with various ratios of Compounds 3 and 4 to ¹⁷⁷ Lu

V = volume

m = minutes

Table 8: Experimental conditions for each test outlined in Table 7

Table 9: HPLC Conditions

The radiolabelling yield and radiochemical purity (RCP) was determined using HPLC and ITLC as follows. The radiolabelling yield defines the percentage of incorporation of ¹⁷⁷ Lu before purification (i.e. , the efficacy of radiolabelling).

Radiolabelling Yield by ITLC

The radiolabelling yield by ITLC was determined using the following equation:

where Rf is the retention factor, which is defined as the ratio of the distance travelled by a component in a sample to the distance travelled by the solvent front from the original point of application of the sample. Rf is 0 when the component remains at the point of application or origin. Rf is 1 when the component migrates with the solvent front.

Radiolabelling Yield and Radiochemical Purity by HPLC

The radiolabelling yield by HPLC was determined using the following equation: Are® Peak #2 -f Area Peak #3 4- Area Pea #4

Rat olabeUng yield x 10

'£ Areas Peak #

where area peak #2 is free ¹⁷⁷ Lu, area peak #3 is by-product (or

Compound 3 or 4 labelled with ¹⁷⁷ Lu when there is no by-product peak) and area peak #4 is Compound 3 or 4 labelled with ¹⁷⁷ Lu (when there is a by-product peak).

The radiochemical purity was determined using the following equation:

where area peak #2 is free ¹⁷⁷ Lu and area peak #3 Compound 3 or 4 labelled with ¹⁷⁷ Lu.

The results of the radiolabelling tests are provided in Table 10.

Table 10: Radiolabelling Yields, Radiochemical Purity and Specific Activity

Results for Tests 1 to 12. Compounds 3 and 4 were both successfully labelled with ¹⁷⁷ Lu at 30 and 60 MBq/nmol in 10 minutes at 80 °C.

It was found that increasing the incubation time to 20 or 30 minutes resulted in poorer radiochemical purity. Buffer 1 and buffer 2 both enabled complete radiolabelling of Compounds 3 and 4.

The initial results showed >99 % incorporation (radiolabelling yield) of the radionuclide and >99 % radiochemical purity with Compounds 3 and 4 after 10 minutes incubation with ¹⁷⁷ Lu.

Optimisation Study

Further tests were carried out to raise the specific activity to at least 120 MBq/nmol. The radiolabelling procedure was performed using 0.4 M ammonium acetate and 0.325 M gentisic acid at pH 4 (buffer 2). ¹⁷⁷ LuCl3 with a specific activity of > 500 MBq/nmol was used for the radiolabelling studies. A specified volume (V _I 77 _LU in Table 12) of ¹⁷⁷ LuCl3 was mixed with buffer 2 and 1 nmol of peptide (Compound 3 or Compound 4). The reaction mixture was incubated at 80 °C for an incubation time of 10 minutes in a thermomixer system. A summary of the further radiolabelling tests with various ratios of Compounds 3 and 4 to ¹⁷⁷ Lu are outlined in Table 1 1. The specific conditions for each test are outlined in Table 12. At the end of incubation, 1 pL of the mixture was injected on the HPLC system and analysed using the conditions outlined in Table 9.

Table 1 1 : Further radiolabelling tests with various ratios of Compounds 3 and 4 to ¹⁷⁷ Lu

V = volume

m = minutes

Table 12: Experimental conditions for each test outlined in Table 1 1

The stability of the radiolabelled Compounds 3 and 4 (Compound 3- ¹⁷⁷ Lu radioconjugate and Compound 4- ¹⁷⁷ Lu radioconjugate) was also analysed by HPLC 24 hours after the initial radiolabelling. The radiolabelling yield and radiochemical purity (RCP) were determined using HPLC and ITLC as defined above.

The results of the further radiolabelling tests are provided in Table 13.

Table 13: Radiolabelling Yields, Radiochemical Purity and Specific Activity

Results for Tests 13 to 24. Compounds 3 and 4 were both successfully labelled with ¹⁷⁷ Lu at 120 and 150 MBq/nmol at 80 °C for 10 minutes using 0.4 M ammonium acetate and 0.325 M gentisic acid at pH 4 as a buffer.

The radiochemical yields and radiochemical purities were > 95%.

After 24 hours in solution, the HPLC results showed that the radiochemical purity was still > 90%. The impurities observed after 24 hours may be due to radiolysis. Clinical Study

A radiolabelling experiment in a clinical environment was also performed.

In this experiment, the starting activity of ¹⁷⁷ Lu was 7.6 GBq.

The radiolabelling experiment was performed as follows. Compound 3 (32 nmol) was dissolved in ultrapure water (2 pg/pL) and 1.5 ml_ of 0.4 M sodium acetate buffer at pH 4.8 (8 mg/mL). Gentisic acid was added and the mixture was transferred to a ¹⁷⁷ Lu V-vial. The vial was heated for 25 minutes at 95 °C. After dissolving the mixture with water for injection and subsequent sterile filtration, 6.9 GBq of Compound 3 conjugated to ¹⁷⁷ Lu was achieved. A specific activity of > 200MBq/nmol (n=3) was achieved. The radiochemical yield and radiochemical purity were both > 99 %. The stability of the injection solution was also found to be very good with > 98 % radiochemical purity and < 2% of two unknown impurities observed after 24 hours at room temperature.

Conclusion

The radiochemical purities and specific activities obtained mean that a relevant amount of radioactivity can be brought to the tumour (i.e. , site of cMet over-expression) for targeted radiotherapy using this approach. A relevant amount of radioactivity is described as 2 to 8 GBq, typically 7.4 GBq. Furthermore, using the procedure described above means that large amounts of“cold” peptide (i.e., unlabelled peptide) are not required, which would saturate the cMet receptors and prevent any radioactivity being brought to the site of the tumour.

Experiment 5: Radiolabelling Compound 3 and Compound 4 with ⁶⁸ Ga

Pilot Study

A pilot study was conducted to evaluate radiolabelling feasibility of Compounds 3 and 4 with ⁶⁸ Ga. Radiolabelling yields and radiochemical purities (RCP) were determined by HPLC.

The radiolabelling procedure was performed using 1 M sodium acetate buffer at pH 4.5. [ ⁶⁸ Ga]GaCl3 elution with cationic pre-purification was used for the radiolabelling studies. A specified volume (V _68Ga in Table 15) of [ ⁶⁸ Ga]GaCl3 was mixed with buffer, water, ethanol and 4 to 16 nmol of peptide (Compound 3 or Compound 4). The reaction mixture was incubated at 95 °C for an incubation time of 5 to 10 minutes in a

thermomixer system. A summary of the radiolabelling tests with various ratios of Compounds 3 and 4 to ⁶⁸ Ga are outlined in Table 14. The specific conditions for each test are outlined in Table 15. At the end of incubation, 2.5 pl_ of the mixture was injected on the HPLC system and analysed using the conditions outlined in Table 16.

Table 14: Radiolabelling tests with various ratios of Compounds 3 and 4 to ⁶⁸ Ga

V = volume

m = minutes

Table 15: Experimental conditions for each test outlined in Table 14

Table 16: HPLC Conditions

The radiolabelling yield and radiochemical purity (RCP) were determined using HPLC. The radiolabelling yield defines the percentage of

incorporation of ⁶⁸ Ga before purification (i.e., the efficacy of radiolabelling).

Radiolabelling Yield and Radiochemical Purity by HPLC

The radiolabelling yield by HPLC was determined using the following equation:

100

where area peak #2 is free ⁶⁸ Ga, area peak #3 is by-product (or

Compound 3 or 4 labelled with ⁶⁸ Ga when there is no by-product peak) and area peak #4 is Compound 3 or 4 labelled with ⁶⁸ Ga (when there is a by-product peak).

The radiochemical purity was determined using the following equation:

I§0

where area peak #2 is free ⁶⁸ Ga and area peak #3 Compound 3 or 4 labelled with ⁶⁸ Ga.

The results of the radiolabelling tests are provided in Table 17.

Table 17: Radiolabelling Yield, Radiochemical Purity and Specific Activity

Results for Tests 1 to 3. Compounds 3 and 4 were both successfully labelled with ⁶⁸ Ga using the conditions outlined above. However, after purification, specific activity only reached 12 MBq/nmol.

In the pilot study, approximately 60 % radiochemical purity was obtained for both Compounds 3 and 4 after incubation with ⁶⁸ Ga. No radiolysis was observed.

Repeat Pilot Study with Extended Labelling Time

Various peptide (Compounds 3 and 4) to ⁶⁸ Ga ratios were tested to evaluate the corresponding radiolabelling yields by HPLC and Instant Thin-Layer Chromatography (ITLC).

The radiolabelling procedure was performed using 1 M sodium acetate buffer at pH 4.5. ⁶⁸ GaCl3: fractionated elution was used for the

radiolabelling studies. In a microtube a specified volume, ss _Ga in Table 19, (activity measured in the microtube approximately 7.3 MBq) of ⁶⁸ GaCl3 was mixed with (0.11 x Ves _Ga ) of buffer and 0.24 to 1.36 nmol of peptide (Compound 3 or Compound 4). The reaction mixture was incubated at 95 °C for an incubation time of 10 minutes in a thermomixer system. A summary of the radiolabelling tests with various ratios of Compounds 3 and 4 to ⁶⁸ Ga are outlined in Table 18. The specific conditions for each test are outlined in Table 19. At the end of incubation, the microtube was centrifuged, and 2.5 pL of the mixture was injected on the HPLC system and analysed using the conditions outlined in Table 16.

For ITLC, the following procedures were followed:

• 1 pL of mixture was spotted on ITLC-SG paper and eluted with citrate buffer (0.1 M, pH 5) as a mobile phase (ITLC 1 ); and

• 1 pL of mixture was spotted on ITLC-SG paper and eluted with a solution of ammonium acetate (5 M)/methanol 1/1 (ITLC 2).

Table 18: Radiolabelling tests with various ratios of Compounds 3 and 4 to ⁶⁸ Ga

V = volume

m = minutes

Table 19: Experimental conditions for each test outlined in Table 18

The radiolabelling yield and radiochemical purity (RCP) was determined using HPLC as described above. The radiolabelling yield by ITLC was determined as follows. Radiolabelling Yield by ITLC

The radiolabelling yield by ITLC was determined using the following equation:

where Rf is the retention factor, which is defined as the ratio of the distance travelled by a component in a sample to the distance travelled by the solvent front from the original point of application of the sample. Rf is 0 when the component remains at the point of application or origin. Rf is 1 when the component migrates with the solvent front.

The results of the radiolabelling tests are provided in Table 20.

Table 20: Radiolabelling Yields, Radiochemical Purity and Specific Activity

Results for Tests 4 to 11. Compounds 3 and 4 were both successfully labelled with ⁶⁸ Ga using the conditions outlined above. However, the radiolabelled Compounds 3 and 4 (Compound 3- ⁶⁸ Ga radioconjugate and Compound 4- ⁶⁸ Ga

radioconjugate) were not pure enough to be suitable for intravenous administration to the human body. It was found that ethanol may be added to prevent radiolysis.

A specific activity of 26 MBq/nmol (test 8) was achieved with a

radiochemical purity of approximately 83 %. Optimisation Study

Further tests were carried out to optimise ⁶⁸ Ga incorporation into

Compounds 3 and 4 based on the results of the pilot studies. Compound 3 was used for the optimisation study.

The radiolabelling procedure was performed using sodium acetate buffer,

1 M at pH 4.5 (buffer 1 ) or sodium acetate buffer, 0.5 M at pH 4.5 (buffer 2). ⁶⁸ GaCl3: fractionated elution was used for the radiolabelling studies. Heating at 95 °C:

In a microtube a specified volume, V _68Ga in Table 22, (activity measured in the microtube approximately 7.3 MBq) of ⁶⁸ GaCl3 was mixed with (0.11 x V _68Ga ) of the appropriate buffer, 0.24 nmol of peptide (Compound 3 or Compound 4) and 11.3 pL of ethanol. The reaction mixture was incubated at 95 °C for an incubation time of 10 or 15 minutes in a thermomixer system.

Heating at 110 °C:

In a sealed glass v-vial a specified volume, V _68Ga in Table 22, (activity measured in the microtube approximately 29.2 MBq) of ⁶⁸ GaCl3 was mixed with (0.11 x V _68Ga ) of the appropriate buffer, 0.96 nmol of peptide

(Compound 3 or Compound 4) and 45.4 pL of ethanol. The reaction mixture was incubated at 110 °C for an incubation time of 10 minutes in a heating block.

At the end of incubation, the microtube was centrifuged, and 2.5 to 5 pl_ of the mixture was injected on the HPLC system and analysed using the conditions outlined in Table 16. A summary of the radiolabelling tests with various ratios of Compounds 3 and 4 to ⁶⁸ Ga are outlined in Table 21. The specific conditions for each test are outlined in Table 22. For ITLC, the following procedures were followed:

• 1 pL of mixture was spotted on ITLC-SG paper and eluted with citrate buffer (0.1 M, pH 5) as a mobile phase (ITLC 1 ); and

• 1 pL of mixture was spotted on ITLC-SG paper and eluted with a solution of ammonium acetate (5 M)/methanol 1/1 (ITLC 2).

Table 21 : Radiolabelling tests with various ratios of Compounds 3 and 4 to ⁶⁸ Ga

V = volume

m = minutes

EtOH = ethanol Table 22: Experimental conditions for each test outlined in Table 21

The radiolabelling yield and radiochemical purity (RCP) were determined using HPLC and ITLC as defined above. The results of the optimisation tests are provided in Table 23.

Table 23: Radiolabelling Yields, Radiochemical Purity and Specific Activity

Results for Tests 12 to 23. The following conclusions were derived from the optimisation study:

• increasing the incubation temperature to 110 °C resulted in lower radiolabelling yields (see tests 12 to 15 (95 °C) compared to tests 16 to 17 (110 °C));

• a longer incubation time did not significantly increase the

radiolabelling yield (see tests 12 and 14 (10 minutes) compared to tests 13 and 15 (15 minutes));

• the addition of ethanol did not significantly prevent radiolysis (the results showed that radiolysis was never higher than 5% with or without the addition of ethanol); • the addition of ethanol appeared to increase the formation of ⁶⁸ Ga colloids;

• the pH of below 3.8 is required to ensure that an acceptable

specific activity is reached; and

· a purification step (preferably using a SEP-PAK C18 cartridge) prior to HPLC injection was required in order to reach aa suitable radiochemical purity.

During the optimisation study, a specific activity of up to 25 MBq/nmol (test 18) was achieved with a radiochemical purity of approximately 83 %.

Conclusion

The radiochemical purities and specific activities obtained mean that a relevant amount of radioactivity can be brought to the tumour (i.e. , site of cMet over-expression) for imaging using this approach. A relevant amount of radioactivity is described as approximately 12.5 to 75 MBq for experimental agents in the development stage.

The following further experiment was carried out using Compound 3:

· In Vivo Dosimetry Study (Experiment 6).

Experiment 6: In Vivo Dosimetry Study of Compound 3

A dosimetry study was carried out using Compound 3 to investigate the suitability of the compounds described herein for use in imaging and radiotherapy.

(a) Patient Background

Details of the two human patients that took part in the study are provided in Table 24.

Table 24: Patient Details for In Vivo Study.

(b) Procedures

Compound 3 was radiolabelled with ⁶⁸ Ga to provide an imaging agent ( ⁶⁸ Ga-Compound 3). The radiolabelling procedure used was as follows.

[ ⁶⁸ Ga]GaCl3was mixed with buffer (1 M sodium acetate buffer at pH 4.5) and Compound 3. The reaction mixture was incubated at 95 °C for an incubation time of 10 minutes. A specific activity of 25 MBq/nmol was achieved with a radiochemical purity of approximately 98 % without purification.

Compound 3 was radiolabelled with ¹⁷⁷ Lu to provide a therapeutic agent ( ¹⁷⁷ Lu-Compound 3). The radiolabelling procedure used was as follows. Compound 3 was dissolved in ultrapure water (2 pg/mI) and 1.5 ml_ of 0.4 M sodium acetate buffer at pH 4.8 (8 mg/mL). Gentisic acid was added and the mixture was transferred to a ¹⁷⁷ Lu V-vial. The vial was heated for 25 minutes at 95 °C. After dissolving the mixture with water for injection and subsequent sterile filtration, 6.9 GBq of ¹⁷⁷ Lu-Com pound 3 was achieved. A specific activity of > 200MBq/nmol (n=3) was achieved.

Patient 1 was administered with the imaging agent ( ⁶⁸ Ga-Compound 3) seven days before the therapeutic agent ( ¹⁷⁷ Lu-Com pound 3) was injected into the patient. For patient 1 , the ⁶⁸ Ga had an activity of 240 MBq and the ¹⁷⁷ Lu had an activity of 835 MBq. Pre-therapeutic positron emission tomography/computed tomography (PET/CT) imaging was carried out 1 hour and 3 hours post injection with the imaging agent. One day prior to administration of the therapeutic agent, patient 1 was administered with ¹⁸ F-fluorodeoxyglucose ( ¹⁸ F-FDG). The ¹⁸ F had an activity of 227 MBq. PET/CT imaging was carried out 1 hour post injection with ¹⁸ F-FDG.

Patient 1 was then administered with the therapeutic agent. Pre- therapeutic single-photon emission computed tomography (SPECT) imaging was then carried out 1.5 hours, 17 hours, 41 hours, 65 hours and 141 hours post injection with the therapeutic agent. Patient 2 was administered with ¹⁸ F-FDG four days before the therapeutic agent ( ¹⁷⁷ Lu-Compound 3) was injected into the patient. For patient 2, the ¹⁸ F had an activity of 208 MBq and the ¹⁷⁷ Lu had an activity of 959 MBq. PET/CT imaging was carried out 1 hour post injection with ¹⁸ F-FDG.

Patient 2 was then administered with the therapeutic agent. Pre- therapeutic SPECT imaging was then carried out 4.5 hours, 20 hours, 45 hours, 67 hours and 141 hours post injection with the therapeutic agent.

For comparison, a third patient presenting with prostate cancer was administered with prostate-specific membrane antigen (PSMA) which is considered, at present, one of the most successful targets for imaging and therapy in nuclear medicine. The procedure used was as follows. The patient was administered with an imaging agent (PSMA labelled with ¹⁸ F) nineteen days before a therapeutic agent (PSMA radiolabelled with ¹⁷⁷ Lu) was injected into the patient. The ¹⁸ F had an activity of 250 MBq and the ¹⁷⁷ Lu had an activity of 9185 MBq. The activity of the ¹⁷⁷ Lu-PSMA therapeutic agent was approximately ten times higher than the activity of the ¹⁷⁷ Lu-Compound 3 therapeutic agents used in the dosimetry study.

This was because dosimetry studies have already been completed for the PSMA agent and the higher dosage is considered safe for use in vivo. PET/CT imaging was carried out 1 hour post injection with ¹⁸ F-PSMA. The patient was then administered with the ¹⁷⁷ Lu-PSMA therapeutic agent. Pre-therapeutic SPECT imaging was then carried out 19 hours, 43 hours and 65 hours post injection with the therapeutic agent. (c) Imaging

PET/CT imaging was performed using a Siemens Biograph mCT Flow PET/CT. SPECT imaging was performed using a Siemens Intevo SPECT/CT. Pre-therapeutic PET/CT imaging results for patient 1 are shown in Figure

5. The images show accumulation of ⁶⁸ Ga-Compound 3 (referred to on the image as ⁶⁸ Ga-cMET) in tumours at both 1 hour and 3 hours post injection (p.i.). ¹⁸ F-FDG is also shown to accumulate in tumours 1 hour post injection.

Pre-therapeutic SPECT imaging results for patient 1 are shown in Figure

6. The image shows accumulation and retention of ¹⁷⁷ Lu-Com pound 3 in tumours up to 141 hours post injection (p.i.). Pre-therapeutic PET/CT imaging results for patient 2 are shown in Figure

7. The image shows accumulation of ¹⁸ F-FDG in tumours 1 hour post injection.

Pre-therapeutic SPECT imaging results for patient 2 are shown in Figure 8. The image shows accumulation and retention of ¹⁷⁷ Lu-Com pound 3 in tumours up to 141 hours post injection (p.i.).

(d) Results

The results of the dosimetry study of the therapeutic agent ( ¹⁷⁷ Lu- Compound 3) in patient 1 are provided in Table 25. The results of the dosimetry study of the therapeutic agent ( ¹⁷⁷ Lu-Compound 3) in patient 2 are provided in Table 26. For comparison, the results for the ¹⁷⁷ Lu-PSMA therapeutic agent are provided in Table 27.

Vol = volume

h = hours

Table 25: Dosimetry Results of ¹⁷⁷ Lu-Com pound 3 in Patient 1 ( ¹⁷⁷ Lu Activity was 835 MBq).

VOI = Volume of Interest

Vol = volume

h = hours Table 26: Dosimetry Results of ¹⁷⁷ Lu-Com pound 3 in Patient 2 ( ¹⁷⁷ Lu Activity was 959 MBq).

h = hours

Table 27: Dosimetry Results of ¹⁷⁷ Lu-PSMA therapeutic agent ( ¹⁷⁷ Lu Activity was 9185 MBq).

The results show the accumulated dose of the therapeutic agents in the key tissues and organs. Although the mean dose obtained in the tumours using ¹⁷⁷ Lu-Com pound 3 was lower than that obtained using ¹⁷⁷ Lu-PSMA, this was to be expected because of the lower activity of ¹⁷⁷ Lu provided to the patients using Compound 3. To evaluate the results, a literature search on dosimetry values for approved radiotherapeutic agents was conducted. ¹⁷⁷ Lu-DOTATATE is an approved compound for systemic radiotherapy. Brogsitter et al.

( Nuklearmedizin , 2017, Volume 56(1 ), pages 1 -8) reported that ¹⁷⁷ Lu- DOTATATE delivered a tumour dose of 5.53 Gy/GBq (median 2.70 Gy/GBq; range 0.44-15.3 Gy/GBq). Organ doses were reported to be as follows: kidney (2.03 ± 0.96 Gy/GBq), liver (1.67 ± 1.73 Gy/GBq), spleen (4.50 ± 3.69 Gy/GBq) and whole body (0.15 ± 0.08 Gy/GBq). The tumour-to-kidney dose ratio was reported as 2.4 ± 5.6. Nicolas et al. (J Nucl Med, 2017, Volume 58, page 1435, doi:

10.2967/jnumed.117.191684) reported that ¹⁷⁷ Lu-DOTATATE delivered a tumour dose of 0.333 Gy/GBq for a 4 cm tumour and had a tumour residence time of 6.4 hours (range 5.4-7.3 hours).

Furthermore, Okamoto et al. (J Nucl Med, 2016, Volume 116, doi:

10.2967/jnumed.116.178483) reported that ¹⁷⁷ Lu-PSMA-l&T delivered tumour lesions with a mean absorbed dose per cycle of 3.2 ± 2.6 Gy/GBq (range 0.22-12 Gy/GBq).

Typical limitations found during the literature search were either 23 Gy to the kidneys or 2 Gy to the bone marrow.

(e) Conclusion

The tumour doses delivered by ¹⁷⁷ Lu-Compound 3 are within the range of the approved radiotherapeutic agent ¹⁷⁷ Lu-DOTATATE and late stage clinical development radiotherapeutic agent ¹⁷⁷ Lu-PSMA. The tumour half-life was also found to be in a similar timeframe to ¹⁷⁷ Lu-PSMA and longer than ¹⁷⁷ Lu-DOTATATE. Additionally, organ doses to the kidney, liver and spleen using ¹⁷⁷ Lu-Compound 3 were all below the results reported for ¹⁷⁷ Lu-DOTATATE.

Therefore, the dosimetry study shows that the compounds described herein are suitable for use in radiotherapy because the dose delivered to tumours is within the range observed for radiotherapeutic agents that have been approved or are in late stage of clinical development.

Various modifications and variations to the described embodiments of the invention will be apparent to those skilled in the art without departing from the scope and spirit of the invention. Although the invention has been described in connection with specific embodiments, it should be understood that the invention as claimed should not be unduly limited to such specific embodiments. Indeed, various modifications of the described modes of carrying out the invention which are obvious to those skilled in the art are intended to be covered by the present invention.

Abbreviations

Conventional single letter or 3-letter amino acid abbreviations are used.

AAZTA: 1 ,4-bis(carboxymethyl)-6-[bis(carboxymethyl)]amino-6- methylperhydro-1 ,4-diazepine

Acm: Acetamidom ethyl

ACN (or MeCN): Acetonitrile

Boc: tert- Butyloxycarbonyl

Bz: Benzoyl

Cyclam: 1 ,4,8,11 -tetraazacyclotetradecane

Cyclen: 1 ,4,7, 10-tetraazacyclododecane

CRC: Colorectal cancer

CT: Computed tomography

DATA: (6-pentanoic acid)-6-(amino)methy-1 ,4-diazepinetriacetate) DCM: Dichloromethane

Dde: 1 -(4,4-dimethyl-2,6-dioxocyclohexylidene)ethyl

DIPEA: N,N-diisopropylethylamine

DMA: Dimethylamine

DMF: Dimethylformamide

DMSO: Dimethylsulfoxide

DOTA: 1 ,4,7,10-tetraazacyclododecane-1 ,4,7,10-tetraacetic acid DOTAGA: 2,2',2”-(10-(1 ,4-dicarboxy-ethyl)-1 ,4,7,10- tetraazacyclododecane-1 ,4,7 -triy l)triacetic acid

ESI+/MS: Electrospray ionization mass spectrometry

EtOH: Ethanol

FDG: Fluorodeoxyglucose

FP: Fluorescence Polarisation

Fmoc: 9-Fluorenylmethoxycarbonyl

GC: Gas Chromatography GBq: Gigabecquerel

GMP: Good manufacturing practices

HBED-CC: N,N'-bis(2-hydroxy-5-(ethylene-beta- carboxy)benzyl)ethylenediamine N,N'-diacetic acid

HBTU: 0-Benzotriazol-1 -yl-N,N,N',N'-tetramethyluronium

hexafluorophosphate

HGF: Hepatocyte growth factor

HPLC: High performance liquid chromatography

HSPyU: 0-(N-succinimidyl)-N,N,N',N'-tetramethyleneuronium

hexafluorophosphate

IC50: Half Maximal Inhibitory Concentration

ITLC: Instant Thin-Layer Chromatography

K _d : Dissociation Constant

MALDI/TOF: Matrix-assisted laser desorption ionization time-of-flight mass spectrometry

MBq: Megabecquerel

MeCN: Acetonitrile

MTBE: Methyl tert-butyl ether

NCS: /V-chloro-succinimide

NHS: /V-hydroxy-succinimide

NMM: /V-Methylmorpholine

NMP: 1 -Methyl-2-pyrrolidinone

NODAGA: 1 ,4,7-triazacyclononane, 1 -glutaric acid-4, 7-acetic acid

NOPO: 1 ,4,7-triazacyclononane-1 ,4- bis[methylene(hydroxymethyl)phosphinic acid]-7-[methylene(2- carboxyethyl)phosphinic acid

NOTA: 1 ,4,7-triazacyclononane-1 ,4,7-trisacetic acid

Npys: 3-nitro-2-pyridine sulfenyl

PEG: Polyethyleneglycol

PET: Positron emission tomography Pbf: 2,2,4,6,7-Pentamethyldihydrobenzofuran-5-sulfonyl PBS: Phosphate-buffered saline

PSMA: Prostate-specific membrane antigen

PyBOP: benzotriazol-1 -yl-oxytripyrrolidinophosphonium hexafluorophosphate

RCP: Radiochemical Purity

SPECT: Single-photon emission computed tomography tBu: f-butyl

TACN: 1 ,4,7-triazacyclononane

TBME: tert-butyl methyl ether

TFA: Trifluoroacetic acid

THP: tris(hydroxypyridinone)

TIS: Triisopropylsilane

TRAP: 1 ,4,7-triazacyclononane phosphinic acid

Trt: Trityl

Sequence Listing Free Text

SEQ-1

Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b -Tyr-Xaa ⁴ -

Xaa ⁵ -Xaa ⁶

Xaa ¹ is Asn, His or Tyr;

Xaa ² is Gly, Ser, Thr or Asn;

Xaa ³ is Thr or Arg;

Xaa ⁴ is Ala, Asp, Glu, Gly or Ser;

Xaa ⁵ is Ser or Thr; and

Xaa ⁶ is Asp or Glu.

17-mer cMET binding peptide.

SEQ-2

Ser-Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp-Cys ^b -Tyr-

Xaa ⁴ -Xaa ⁵ -Xaa ⁶

Xaa ¹ is Asn, His or Tyr;

Xaa ² is Gly, Ser, Thr or Asn;

Xaa ³ is Thr or Arg;

Xaa ⁴ is Ala, Asp, Glu, Gly or Ser;

Xaa ⁵ is Ser or Thr; and

Xaa ⁶ is Asp or Glu.

18-mer cMET binding peptide.

SEQ-3 Ala-Gly-Ser-Cys ^a -Xaa ¹ -Cys ^c -Xaa ² -Gly-Pro-Pro-Xaa ³ -Phe-Glu-Cys ^d -Trp- Cys ^b -T y r-Xaa ⁴ -Xaa ⁵ -Xaa ⁶ -G ly-Th r

Xaa ¹ is Asn, His or Tyr;

Xaa ² is Gly, Ser, Thr or Asn;

Xaa ³ is Thr or Arg;

Xaa ⁴ is Ala, Asp, Glu, Gly or Ser;

Xaa ⁵ is Ser or Thr; and

Xaa ⁶ is Asp or Glu.

22-mer cMET binding peptide.

SEQ-4

Gly-Gly-Gly-Lys

Tetrapeptide sequence that is part of cMET binding peptide.

SEQ-5

Gly-Ser-Gly-Lys

Tetrapeptide sequence that is part of cMET binding peptide.

SEQ-6

Gly-Ser-Gly-Ser-Lys

Five peptide sequence that is part of cMET binding peptide.

SEQ-7

Ala-Gly-Ser-Cys-Tyr-Cys-Ser-Gly-Pro-Pro-Arg-Phe-Glu-Cys-Trp- Cys-Tyr- G I u-Th r-G I u-G ly-Th r-G ly-G ly-G ly-Lys 26-mer cMET binding peptide.