Login| Sign Up| Help| Contact|

Patent Searching and Data


Title:
FIBRONECTIN-BINDING PEPTIDES FOR USE IN TUMOR OR FIBROSIS DIAGNOSIS AND THERAPY
Document Type and Number:
WIPO Patent Application WO/2023/057034
Kind Code:
A1
Abstract:
The present invention relates to fibronectin-binding peptides according to the sequence Fnl5BS - L1 - Fnl4BS - L2 - Fnl3BS - L3 - Fnl2BS which are useful in tumor or fibrosis diagnosis and therapy. Instant peptides show improved fibronectin-binding and biodistribution properties compared to the prior art. Furthermore, instant peptides may be conjugated to a payload and are useful in the treatment and/or prevention of diseases associated with pathological fibronectin accumulation, including cancer and fibrosis. Instant peptides are also useful in diagnosis of diseases associated with pathological fibronectin accumulation, including cancer and fibrosis.

Inventors:
VOGEL VIOLA (CH)
CHABRIA MAMTA (CH)
VALPREDA GIULIA (CH)
TRACHSEL BELINDA (CH)
BEHE MARTIN (CH)
Application Number:
PCT/EP2021/025388
Publication Date:
April 13, 2023
Filing Date:
October 05, 2021
Export Citation:
Click for automatic bibliography generation   Help
Assignee:
ETH ZUERICH (CH)
SCHERRER INST PAUL (CH)
International Classes:
C07K14/31
Domestic Patent References:
WO2017216223A12017-12-21
WO2007128563A12007-11-15
WO2017216223A12017-12-21
Foreign References:
US20150320825A12015-11-12
Other References:
ARNOLDINI SIMON ET AL: "Novel peptide probes to assess the tensional state of fibronectin fibers in cancer", NATURE COMMUNICATIONS, vol. 8, no. 1, 27 November 2017 (2017-11-27), XP055922905, Retrieved from the Internet DOI: 10.1038/s41467-017-01846-0
SAMUEL HERTIG ET AL: "Engineering Mechanosensitive Multivalent Receptor-Ligand Interactions: Why the Nanolinker Regions of Bacterial Adhesins Matter", NANO LETTERS, vol. 12, no. 10, 14 September 2012 (2012-09-14), US, pages 5162 - 5168, XP055425114, ISSN: 1530-6984, DOI: 10.1021/nl302153h
VOGEL VIOLA: "Unraveling the Mechanobiology of Extracellular Matrix", ANNUAL REVIEW OF PHYSIOLOGY., vol. 80, no. 1, 10 February 2018 (2018-02-10), US, pages 353 - 387, XP055925493, ISSN: 0066-4278, DOI: 10.1146/annurev-physiol-021317-121312
HYNES, R. 0., SCIENCE, vol. 326, no. 5957, 2009, pages 1216 - 1219
ZARDI ET AL., EMBO J., vol. 6, no. 8, 1987, pages 2337 - 42
CARNEMOLLA ET AL., J. CELL BIOL., vol. 108, no. 3, 1989, pages 1139 - 48
WILHELM ET AL.: "Analysis of nanoparticle delivery to tumours", NATURE REVIEWS MATERIALS, vol. 1, 2016, pages 1 - 12
BERTRAND ET AL., ADVANCED DRUG DELIVERY REVIEWS, vol. 66, 2014, pages 2 - 25
CHABRIA ET AL., NATURE COMMUNICATIONS, vol. 1, 2010, pages 135
CAO ET AL., PNAS, vol. 109, no. 19, 8 May 2015 (2015-05-08), pages 7251 - 7256
HERTING, NANO LETT., vol. 12, 2012, pages 5132 - 5168
S. ARNOLDINIA. MOSCAROLIM. CHABRIAM. HILBERTS. HERTIGR. SCHIBLIM. BEHEV. VOGEL: "Novel peptide probes to assess the tensional state of fibronectin fibers in cancer.", NAT COMMUN, vol. 8, no. 1, November 2017 (2017-11-01), pages 1793
D. JARAMILLOA. MOSCAROLIA. OXENIUSM. BEHEV. VOGEL: "Fibronectin fibers are highly tensed in healthy organs in contrast to tumors and virus-infected lymph nodes.", MATRIX BIOLOGY PLUS, vol. 8, November 2020 (2020-11-01), pages 100064
"Remington: The Science and Practice of Pharmacy", 2005, MACK PUBLISHING COMPANY
"Pharmaceutical Formulation Development of Peptides and Proteins", 2000, PHARMACEUTICAL PRESS
PALLICER, J. M.KRAMER, S. D.: "Evaluation of fluorescence anisotropy to assess drug-lipid membrane partitioning", J PHARM BIOMED ANAL, vol. 71, 2012, pages 219 - 227, XP028942674, DOI: 10.1016/j.jpba.2012.08.009
GRUNBERG, J.KNOGLER, K.WAIBEL, R.NOVAK-HOFER, I.: "High-yield production of recombinant antibody fragments in HEK-293 cells using sodium butyrate", BIOTECHNIQUES, vol. 34, 2003, pages 968 - 972, XP001183588
LITTLE, W. C.SMITH, M. L.EBNETER, U.VOGEL, V: "Assay to mechanically tune and optically probe fibrillar fibronectin conformations from fully relaxed to breakage", MATRIX BIOL, vol. 27, 2008, pages 451 - 461, XP022757522, DOI: 10.1016/j.matbio.2008.02.003
Attorney, Agent or Firm:
VOSSIUS & PARTNER PATENTANWÄLTE RECHTSANWÄLTE mbB (DE)
Download PDF:
Claims:
Claims A fibronectin binding peptide comprising the sequence:

Fnl5BS - L1 - Fnl4BS - L2 - Fnl3BS - L3 - Fnl2BS wherein:

Fnl5BS is a polypeptide sequence selected from

Gln-Val-Thr-Thr-Gly-Ser-Asn (SEQ ID NO.: 1),

Gln-Val-Thr-Thr-Ala-Ser-Asn (SEQ ID NO.: 2),

Gln-Val-Thr-Thr-Val-Ser-Asn (SEQ ID NO.: 3), and

Gln-Val-Thr-Thr-Ser-Ser-Asn (SEQ ID NO.: 4);

Fnl4BS is a polypeptide sequence selected from

Val-Glu-Phe-Thr-Glu-Glu-Ser (SEQ ID NO.: 5),

Val-Glu-Phe-Ser-Glu-Glu-Ser (SEQ ID NO.: 6),

Val-Glu-Phe-Cys-Glu-Glu-Ser (SEQ ID NO.: 7),

Val-Glu-Phe-Asn-Glu-Glu-Ser (SEQ ID NO.: 8), and

Val-Glu-Phe-GIn-Glu-Glu-Ser (SEQ ID NO.: 9);

Fnl3BS is a polypeptide of sequence Gly-lle-Val-Thr-Gly-Ala-Val (SEQ ID NO.: 10);

Fnl2BS is a polypeptide of sequence (His-Thr-Thr-Val-Glu-Asp-Thr (SEQ ID NO.: 11); and

L1 , L2 and L3 are each a polypeptide sequence comprising 0, 1 or 2 amino acid residues. The fibronectin binding peptide of claim 1 , wherein

Fnl5BS is a polypeptide of sequence according to SEQ ID NO.: 1 ; and/or

Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5. The fibronectin binding peptide of claim 1 or 2, wherein

Fnl5BS is a polypeptide of sequence according to SEQ ID NO.: 1 ; and

Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5. The fibronectin binding peptide of any one of claims 1 to 3, wherein

L1 is a single amino acid residue Leu; and/or

L2 is a single amino acid residue selected from Leu, lie, Vai, Ala and Met, preferably Leu; and/or L3 is a dipeptide of sequence Ser-Asp. The fibronectin binding peptide of any one of claims 1 to 4, wherein

L1 is a single amino acid residue Leu; and L2 is a single amino acid residue Leu; and

L3 is a dipeptide of sequence Ser-Asp. The fibronectin binding peptide of any one of claims 1 to 5, comprising a polypeptide sequence Gln-Val-Thr-Thr-Gly-Ser-Asn-Leu-Val-Glu-Phe-Thr-Glu-Glu-Ser-Leu-Gly-lle-Val-Thr-Gly-Ala- Val-Ser-Asp-His-Thr-Thr-Val-Glu-Asp-Thr (SEQ ID NO: 12). The fibronectin binding peptide of any one of claims 1 to 6, having a polypeptide sequence according to SEQ ID NO: 12. The fibronectin binding peptide of any one of claims 1 to 7, characterized by binding to Fib1 (SEQ ID NO: 14) with a KD of 5.0 nM or tighter, as preferably determined by using a fluorescence polarization assay. The fibronectin binding peptide of any one of claims 1 to 8, further conjugated to a payload, wherein the payload is directly conjugated to the N or C terminus of the said polypeptide sequence through an amide bond, or wherein the payload is conjugated to the N or C terminus of the said polypeptide sequence via a linker. The fibronectin binding peptide of any one of claims 1 to 9, wherein the linker comprises a peptide moiety, a PEG moiety, a moiety derived from cadaverine or a C1-12 alkylene moiety. The fibronectin binding peptide of any one of claims 1 to 10, wherein the payload is a biologically active molecule or an imaging agent. The fibronectin binding peptide of claim 11 , wherein the payload is a biologically active molecule. The fibronectin binding peptide of claim 12, wherein the biologically active molecule is selected from the group consisting of cytostatic agent, cytotoxic agent, cytokine, transcription factor inhibitor, proteasome and protease inhibitor, apoptosis modulator, cell cycle modulator, angiogenesis inhibitor, hormone or hormone derivative, photodynamic therapy molecule, nano- and microparticle for thermoablation therapy, radionuclide, miRNA, siRNA and immunomodulatory antigen molecule, preferably wherein the cytostatic agent is selected from Doxorubicin, Paclitaxel, Chlorambucil, Topotecan and Vincristine; preferably wherein the cytokine is selected from lnterleukin-2, lnterleukin-7, Interferon-y and tumor necrosis factor; preferably wherein the transcription factor inhibitor is selected from Curcumin, Ribavirin and Genistein; preferably wherein the apoptosis modulator is selected from Imatinib, Erlotinib and Bryostatin; preferably wherein the cell cycle modulator is selected from Flavopiridol and Roscovitine; preferably wherein the angiogenesis inhibitor is selected from Endostatin, Celexocib, ADH-1 (exherin) and Sunitinib; preferably wherein the hormone and hormone derivative is selected from Flutamide, Fosfestrol, Tamoxifen and Relaxin; preferably wherein the radionuclide is selected from 68Ga, 64Cu, 90Y, 111ln, 131l, 161Tb, 169Er and 177Lu; preferably wherein the miRNA or the siRNAs is a miRNA or a siRNA specific for CD40, CD80 or CD86. The fibronectin binding peptide of claim 13, wherein the biologically active molecule is selected from the group consisting of Paclitaxel, Chlorambucil, Endostatin, Sunitinib, lnterleukin-7, 177Lu, and 111ln. The fibronectin binding peptide of claim 11, wherein the payload is an imaging agent. The fibronectin binding peptide of claim 15, wherein the imaging agent comprises a radionuclide, a fluorescent dye, a chemiluminescent agent, a bioluminescent agent, a spectrally resolvable inorganic fluorescent semiconductor nanocrystal, a metal nanoparticle, a nanocluster, a paramagnetic metal ion, an enzyme, a colorimetric label, biotin, dioxigenin, a hapten or a protein. The fibronectin binding peptide of claim 15, wherein the imaging agent is selected from the group consisting of radionuclide, MRI active compound, ultrasound contrast agent, fluorophore, marker for PET and SPECT, preferably selected from 44Sc, 64Cu, 67/68Ga 99mTc, 111ln, fluorophore in the far red/near-IR spectral region, and Gd-based and Fe-oxide particle based MRI contrast agent. The fibronectin binding peptide of claim 17, wherein the imaging agent is selected from 68Ga, 99mTc, 111ln, 44Sc and 64Cu. The fibronectin binding peptide of any one of claims 1 to 10, wherein the payload comprises a radionuclide, preferably selected from 67Cu, 90Y, 111ln, 131l, 161Tb, 169Er and 177Lu or preferably selected from 44Sc, 64Cu, 67/68Ga "Tc, and 111ln. The fibronectin binding peptide of any one of claims 1 to 10, wherein the payload is [111ln]ln- NODAGA moiety. A pharmaceutical composition comprising the fibronectin binding peptide of any one of claims 1 to 20 and a pharmaceutically acceptable carrier. The fibronectin binding peptide of any one of claims 1 to 14, 19 and 20 or the pharmaceutical composition of claim 21 for use in therapy. The fibronectin binding peptide of any one of claims 1 to 14, 19 and 20 or the pharmaceutical composition of claim 21 for use in the treatment or prevention of a disease associated with pathologic fibronectin accumulation. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 23, wherein the disease associated with pathologic fibronectin accumulation is selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 24, wherein the autoimmune diseases is selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 24, wherein the fibrosis is selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 24, wherein the cancer is selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 27, wherein the lung cancer is a non-small lung cell cancer. The fibronectin binding peptide of any one of claims 1 to 11 or 15 to 20 or the pharmaceutical composition of claim 21 for use in diagnosis. The fibronectin binding peptide of any one of claims 1 to 11 or 15 to 20 or the pharmaceutical composition of claim 21 for use in diagnosis of a disease associated with pathologic fibronectin accumulation. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 30, wherein the disease associated with pathologic fibronectin accumulation is selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 31 , wherein the autoimmune diseases is selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 31 , wherein the fibrosis is selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 31 , wherein the cancer is selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer. The fibronectin binding peptide for use or the pharmaceutical composition for use of claim 34, wherein the lung cancer is a non-small lung cell cancer.

Description:
Fibronectin-binding peptides for use in tumor or fibrosis diagnosis and therapy

Field of the invention

The present invention relates to fibronectin-binding peptides for use in tumor or fibrosis diagnosis and therapy. Instant peptides show improved fibronectin-binding and biodistribution properties compared to the prior art. Furthermore, instant peptides may be conjugated to a payload and are useful in the treatment and/or prevention of diseases associated with pathological fibronectin accumulation, including cancer and fibrosis. Instant peptides are also useful in diagnosis of diseases associated with pathological fibronectin accumulation, including cancer and fibrosis.

Background

Fibronectin (Fn) is a high-molecular weight (~440kDa) glycoprotein of the extracellular matrix (ECM) that binds to membrane-spanning receptor proteins called integrins (Hynes, R. 0. (2009), Science 326(5957): 1216-1219). Similar to integrins, fibronectin binds among other binding partners extracellular matrix (ECM) components such as collagen, fibrin, and heparan sulfate proteoglycans. Fibronectin exists as a protein dimer, consisting of two nearly identical monomers linked by a pair of disulfide bonds. The fibronectin protein is produced from a single gene, but alternative splicing of its pre- mRNA leads to the creation of several isoforms. Soluble plasma fibronectin is a major protein component of blood plasma that is produced by hepatocytes and circulates in body fluids at high concentrations of about 300 pg/mL. Insoluble cellular fibronectin is a major component of the ECM. It is secreted by various cells, primarily fibroblasts, as a soluble protein dimer and is then assembled into an insoluble matrix in a complex cell- mediated process.

Fibronectin plays a major role in cell adhesion, growth, migration and differentiation, and it is important for processes such as wound healing and embryonic development.

Altered fibronectin expression, degradation and organization has been associated with a number of pathologies, including cancer and fibrosis. Several of the morphological changes observed in tumors and tumor-derived cell lines have been attributed to altered fibronectin expression, increased fibronectin degradation and/or altered expression of fibronectin-binding receptors, such as different integrin types (a5pi , av01 , av03, av05, av06 or av08 integrins).

In lung carcinoma fibronectin expression is increased, especially in non-small cell lung carcinoma. The adhesion of lung carcinoma cells to fibronectin enhances tumorigenicity and confers resistance to apoptosis-inducing chemotherapeutic agents. Fibronectin has been shown to stimulate the gonadal steroids that interact with vertebrate androgen receptors, which are capable of controlling the expression of cyclin D and related genes involved in cell cycle control. These observations suggest that fibronectin may promote lung tumor growth/survival and resistance to therapy, and it could represent a target for the development of new anticancer drugs. Fibronectin acts as a potential biomarker for radioresistance. FN- FGFR1 fusion is frequent in phosphaturic mesenchymal tumors.

W02007/128563A1 teaches fusion proteins comprising an antibody or functional fragment thereof specifically binding the extracellular domain of oncofetal fibronectin (ED-B) and a specific effector selected from the cytokines IL-10, IL-15, IL-24 and GM-CSF (Granulocyte-macrophage colony-stimulating factor) for the manufacture of a medicament for treating tumors or chronic inflammatory diseases, in particular atherosclerosis, arthritis and psoriasis. ED-B is a 91-amino-acid type III homology domain that is inserted into the fibronectin molecule by a mechanism of alternative splicing at the level of the primary transcript whenever tissue remodeling takes place [Zardi et al., Embo J. 6(8): 2337-42 (1987)]. ED-B is essentially undetectable in healthy adult tissues. Its expression is strongly associated with the remodeling of the ECM and angiogenesis. The domain is abundant in many aggressive tumors and, depending on the tumor type, displays either predominantly vascular or diffuse stromal patterns of expression [Carnemolla et al., J. Cell Biol. 108(3): 1139-48 (1989)].

Compared to peptides, nanoparticles and antibodies for targeting live biological targets have a major setback when it comes to their permeability and retention at the target tissue (see Wilhelm et al, Analysis of nanoparticle delivery to tumours, Nature Reviews Materials 1 , (2016) 1-12).

Antibodies are large proteins with a molecular weight of 150 kDa and a hydrodynamic radius of 15 to 20 nm. Moreover, antibodies and fragments thereof are relatively sensitive to environmental and metabolic challenges. Smaller fragments of antibodies such as monomers and the dimers of the Fab recognition patterns still represent bulky molecules with sizes of around 50 to 100 kDa, respectively. Smaller targeting compounds include proteins, peptides, nucleic acid-based ligands, e.g. aptamers, and small molecules [Bertrand et al., Advanced Drug Delivery Reviews 66, (2014): 2-25]. These smaller molecules have the advantage of a faster diffusion and faster targeting of the target tissue resulting in more homologous distribution within a pathological tissue like cancer or fibrosis.

However, one major and generally accepted drawback of therapeutic peptides is their poor stability in blood plasma leading to a short half-life time and, consequently, reduced therapeutic or diagnostic efficacy. Rapid degradation of peptides in blood serum is often observed to result in a loss of affinity to the target protein. Therefore, strategies for stabilization have to be introduced. There are natural peptides mainly originating from amphibians and reptiles, which show a higher metabolic stability in human blood than the related human analogues due to evolutionary engineering. Another possibility to increase stability is chemically by changing the metabolic cutting sites within a peptide. This includes the replacement of natural amino acids by unnatural amino acids or a chemical modification of the amide bonds.

In the context of bacterial wound infection, Chabria et al. (Nature Communications, 1 :135, 2010, 1-9) report that specific binding of bacterial FnBR via backbone hydrogen bonds can be mechanically regulated by "stretching" Fn-fibers in vitro and suggest that cell-generated forces are sufficiently high to deactivate specific binding of bacterial adhesins to Fn-fibers. The authors thus speculate that the mechanobiology of the Fn-comprising ECM might regulate bacterial and cell- binding events, virulence and the course of infection.

Cao et al. [PNAS, vol. 109, 19:7251-7256, May 8, 2015] report phage display-based molecular probes LNLPHG and RFSAFY that discriminate force-induced structural states of fibrillar fibronectin in vivo, a so-called "relaxed" (preferentially bound by LN LPHG ) and a "strained" (preferentially bound by RFSAFY) state of Fn fibers. Phages displaying SRWYRI, ARERFY and GSNSKY preferentially also bound the relaxed state with lower but significant binding affinity. Random phage displayed- peptide probes exhibited strain-selective binding to manually extruded fibronectin (Fn) fibers, cell- derived Fn ECM and ex vivo living lung slices. The authors speculate on the possible future use of these peptide probes for mapping molecular strain events in unmodified native ECM microenvironments as well as for targeting Fn (ECM) in altered structural states associated with disease. On the other hand, the authors admit that there still is no direct evidence that extensibility of Fn within fibers and Fn type III domain unfolding events observed under artificial strain conditions actually occur in vivo. Hence, it is highly speculative whether or not peptides identifying either the "relaxed" or "strained" Fn could function as tumor markers, in particular, because only the phages displaying those peptides were tested, but not the peptides alone. Hertig et al. (Nano Lett, 12, 5132-5168, 2012) disclose the isolation and further engineering of bacterially derived Fn- binding proteins (FnBPs). The natural FnBPs are covalently linked to the bacterial cell membrane and can contain several intrinsically disordered Fn-binding repeats (FnBRs). Interestingly, the FnBRs expressed by several gram-positive bacteria and a spirochete show little homology, though they all recognize and bind the same domains of Fn. Conserved residues are mostly found in the Fnl-binding motifs, with the E- D/E-T/S motif being highly conserved and found in almost every FnBR. Fn features five Fnl modules, which are spaced apart by peptide linkers and all of which can serve as FnBP binding partners.

In summary, fibronectin is a prevalent protein in the plasma and ECM of tissues, which can be upregulated in fibrosis and cancer tissues. Splice variants of fibronectin have utility for targeting splice variant-specific cancer types. The binding of naturally occurring and phage-display-based FnBPs can vary with the natural relaxed and the artificially strained state of Fn (S. Arnoldini, A. Moscaroli, M. Chabria, M. Hilbert, S. Hertig, R. Schibli, M. Behe, and V. Vogel, “Novel peptide probes to assess the tensional state of fibronectin fibers in cancer.,” Nat Commun, vol. 8, no. 1 , p. 1793, Nov. 2017; C. M. Fonta, S. Arnoldini, D. Jaramillo, A. Moscaroli, A. Oxenius, M. Behe, and V. Vogel, “Fibronectin fibers are highly tensed in healthy organs in contrast to tumors and virus-infected lymph nodes.,” Matrix Biology Plus, vol. 8, p. 100046, Nov. 2020).

The document WO 2017/216223 further teaches compositions comprising fibronectin-binding peptides linked to a diagnostic or therapeutic agent.

Summary of the invention

It was an object of the present invention to provide novel fibronectin-binding peptide sequences, with improved affinity for fibronectin, in particular for Fib1 construct, and with improved biodistribution properties.

The object is achieved by the embodiments described herein and as characterized by the claims.

The present inventors have found that FnBPA5.1 sequence, which is derived from the FnBPA5 sequence (SEQ ID NO.: 13) upon three amino acid substitutions and two deletions, shows surprisingly improved affinity for Fi b 1 , as measured in the fluorescence polarization assay (Example 1 , Figure 1 ). The present inventors have further studied the biodistribution of the fibronectin-binding peptides of the present invention and have surprisingly found that FnBPA5.1 sequence with a radioisotope label has improved uptake in tumors in comparison to the FnBPA5 sequence as known from the prior art, as demonstrated in the experiments with PC3 xenograft mice (Example 4, Figure 4 and Example 6 and 7, Figure 6), as well as studies in 67NR orthotopic and syngeneic breast tumor mice (Example 5, Figure 5, and Examples 8 and 9, Figure 7). It has been further surprisingly established that at the same time the fibronectin binding peptide of the present invention demonstrate lower uptake in spleen and liver in comparison to the FnBPA5 sequence as known from the prior art, which as known to the skilled person is a desired feature from the biodistribution point of view.

The invention will be summarized in the following embodiments.

In a first embodiment, the present invention relates to a fibronectin binding peptide comprising the sequence:

Fnl5BS - L1 - Fnl4BS - L2 - Fnl3BS - L3 - Fnl2BS wherein:

Fnl5BS is a polypeptide sequence selected from

Gln-Val-Thr-Thr-Gly-Ser-Asn (SEQ ID NO.: 1), Gln-Val-Thr-Thr-Ala-Ser-Asn (SEQ ID NO.: 2), Gln-Val-Thr-Thr-Val-Ser-Asn (SEQ ID NO.: 3), and Gln-Val-Thr-Thr-Ser-Ser-Asn (SEQ ID NO.: 4);

Fnl4BS is a polypeptide sequence selected from

Val-Glu-Phe-Thr-Glu-Glu-Ser (SEQ ID NO.: 5), Val-Glu-Phe-Ser-Glu-Glu-Ser (SEQ ID NO.: 6),

Val-Glu-Phe-Cys-Glu-Glu-Ser (SEQ ID NO.: 7),

Val-Glu-Phe-Asn-Glu-Glu-Ser (SEQ ID NO.: 8), and

Val-Glu-Phe-GIn-Glu-Glu-Ser (SEQ ID NO.: 9);

Fnl3BS is a polypeptide of sequence Gly-lle-Val-Thr-Gly-Ala-Val (SEQ ID NO.: 10);

Fnl2BS is a polypeptide of sequence His-Thr-Thr-Val-Glu-Asp-Thr (SEQ ID NO.: 11); and

L1 , L2 and L3 are each a polypeptide sequence comprising 0, 1 or 2 amino acid residues.

In a particular embodiment, the present invention relates to the fibronectin binding peptide of the present invention, wherein Fnl5BS is a polypeptide of sequence according to SEQ ID NO.: 1 ; and/or Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5.

In a further particular embodiment, the present invention relates to the fibronectin binding peptide of the present invention, wherein Fnl5BS is a polypeptide of sequence according to SEQ ID NO.: 1 ; and Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein L1 is a single amino acid residue Leu; and/or L2 is a single amino acid residue selected from Leu, lie, Vai, Ala and Met, preferably Leu; and/or L3 is a dipeptide of sequence Ser-Asp.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein L1 is a single amino acid residue Leu; and L2 is a single amino acid residue Leu; and L3 is a dipeptide of sequence Ser-Asp.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, comprising a polypeptide sequence Gln-Val-Thr-Thr-Gly-Ser-Asn-Leu- Val-Glu-Phe-Thr-Glu-Glu-Ser-Leu-Gly-lle-Val-Thr-Gly-Ala-Val- Ser-Asp-His-Thr-Thr-Val-Glu-Asp-Thr (SEQ ID NO: 12).

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, having a polypeptide sequence according to SEQ ID NO: 12.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, characterized by binding to Fib1 (SEQ ID NO: 14) with a KD of 5.0 nM or tighter, as preferably determined by using a fluorescence polarization assay.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, further conjugated to a payload.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload is directly conjugated to the N or C terminus of the said polypeptide sequence through an amide bond, or wherein the payload is conjugated to the N or C terminus of the said polypeptide sequence via a linker.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the linker comprises a peptide moiety, a PEG moiety, a moiety derived from cadaverine or a C1-12 alkylene moiety.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload is a biologically active molecule (BAM) or an imaging agent.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload is a biologically active molecule (BAM).

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the biologically active molecule is selected from the group consisting of cytostatic agent, cytotoxic agent, cytokine, transcription factor inhibitor, proteasome and protease inhibitor, apoptosis modulator, cell cycle modulator, angiogenesis inhibitor, hormone or hormone derivative, photodynamic therapy molecule, nano- and microparticle for thermoablation therapy, radionuclide, miRNA, siRNA and immunomodulatory antigen molecule.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the biologically active molecule is selected from the group consisting of Paclitaxel, Chlorambucil, Endostatin, Sunitinib, lnterleukin-7, 177 Lu, and 111 ln.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload is an imaging agent.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the imaging agent comprises a radionuclide, a fluorescent dye, a chemiluminescent agent, a bioluminescent agent, a spectrally resolvable inorganic fluorescent semiconductor nanocrystal, a metal nanoparticle, a nanocluster, a paramagnetic metal ion, an enzyme, a colorimetric label, biotin, dioxigenin, a hapten or a protein.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the imaging agent is selected from the group consisting of radionuclide, MRI active compound, ultrasound contrast agent, fluorophore, marker for PET and SPECT, preferably selected from 44 Sc, 64 Cu, 67/68 Ga 99m Tc, 111 1n, fluorophore in the far red/near-IR spectral region, and Gd-based and Fe-oxide particle based MRI contrast agent.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the imaging agent is selected from 68 Ga, 99m Tc, 111 ln, 44 Sc and In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload comprises a radionuclide, preferably selected from 67 Cu, 90 Y, 1 11 1n, 131 l, 161 Tb, 169 Er and 177 Lu or preferably selected from 44 Sc, 64 Cu, 67/68 Ga 99m Tc, and 111 ln.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload is [ 111 ln]ln-NODAGA moiety.

In a further embodiment, the present invention relates to a pharmaceutical composition comprising the fibronectin binding peptide as described herein and a pharmaceutically acceptable carrier.

In again a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in therapy.

In again a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention, or the pharmaceutical composition of the present invention for use in the treatment or prevention of a disease associated with pathologic fibronectin accumulation.

In a particular embodiment, the present invention relates to the fibronectin binding peptide for use of the present invention or the pharmaceutical composition for use of the present invention, wherein the disease associated with pathologic fibronectin accumulation is selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis.

In a further particular embodiment, the present invention relates to the fibronectin binding peptide for use of the present invention or the pharmaceutical composition for use of the present invention, wherein the autoimmune diseases is selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis.

In again a further particular embodiment, the present invention relates to the fibronectin binding peptide for use of the present invention or the pharmaceutical composition for use of the present invention, wherein the fibrosis is selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis.

In again a further particular embodiment, the present invention relates to the fibronectin binding peptide for use of the present invention or the pharmaceutical composition for use of the present invention, wherein the cancer is selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer.

In again a further particular embodiment, the present invention relates to the fibronectin binding peptide for use of the present invention or the pharmaceutical composition for use of the present invention, wherein the lung cancer is a non-small lung cell cancer.

In a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis. In a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis of a disease associated with pathologic fibronectin accumulation.

In a particular embodiment, the present invention relates to the fibronectin binding peptide for use or the pharmaceutical composition for use of the present invention, wherein the disease associated with pathologic fibronectin accumulation is selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis.

In a further particular embodiment, the present invention relates to the fibronectin binding peptide for use or the pharmaceutical composition for use of the present invention, wherein the autoimmune diseases is selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis.

In again a further particular embodiment, the present invention relates to the fibronectin binding peptide for use or the pharmaceutical composition for use of the present invention, wherein the fibrosis is selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis.

In again a further particular embodiment, the present invention relates to the fibronectin binding peptide for use or the pharmaceutical composition for use of the present invention, wherein the cancer is selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer.

In again a further particular embodiment, the present invention relates to the fibronectin binding peptide for use or the pharmaceutical composition for use of the present invention, wherein the lung cancer is a non-small lung cell cancer.

Brief description of figures

Figure 1 : Affinity measurements of Cy5-labelled FnBPA5.1 and FnBPA5 towards the N-terminal 30 kDa fragment of Fibronectin (Fib1) according to SEQ ID NO: 14. Curves display triplicates measurements of fluorescence polarization. Error bars display standard deviations. Analysis was conducted using GraphPad Prism. KD is shown in nM.

Figure 2: Intensity ratio of Cy5-labelled peptides to Alexa488-labelled Fibronectin relaxed (7% strain) or stretched (380% strain) fibers. Normalized values: the mean of the intensity ratio of each peptide to relaxed Fibronectin fibers was set to 1 and the remaining value was scaled accordingly. Data from 10 to 15 fibers with error bars being standard deviations. P-values were obtained from unpaired two-tailed student’s t-tests (Graph PadPrism).

Figure 3: Degradation kinetics of [ 111 ln]ln-FnBPA5.1 upon incubation in human blood plasma up to 24 h at 37 °C. Data points show the mean ± SD (n=3). Data was fitted by nonlinear fit (GraphPad Prism). Figure 4: Biodistribution of 111 ln-labeled NODAGA-FnBPA5 and its engineered version NODAGA- FnBPA5.1 in PC-3 tumor-bearing CD1 nu/nu mice 24 hours after injection. Results are shown as averages of % injected activity per gram ± SD (n=4) .

Figure 5: Biodistribution of 111 ln-labeled NODAGA-FnBPA5 and its engineered version NODAGA- FnBPA5.1 in 67NR tumor-bearing mice 24 hours after injection. Results are shown as averages of % injected activity per gram ± SD (n=4) .

Figure 6: SPECT images (A) and autoradiographs (B) 24 h after injection of [ 111 ln]ln-NODAGA FnBPA5.1 in a 67NR orthotopic and syngeneic breast tumor model.

Figure 7. SPECT images (top) and autoradiographs (bottom) of mice lungs 14 days after intra-tracheal instillation with Bleomycin and 24 h after injection of [ 111 ln]ln-NODAGA FnBPA5.1.

Detailed description of the invention

The invention is described in detail in the following embodiments. It is to be understood that all the combinations of features as disclosed herein are envisaged.

Fibronectin-binding peptides

In a first embodiment, the present invention relates to a fibronectin binding peptide comprising the sequence:

Fnl5BS - L1 - Fnl4BS - L2 - Fnl3BS - L3 - Fnl2BS .

Fnl5BS as defined herein refers to Fnl5 binding sequence, which according to the present invention is a polypeptide sequence selected from

Gln-Val-Thr-Thr-Gly-Ser-Asn (SEQ ID NO.: 1),

Gln-Val-Thr-Thr-Ala-Ser-Asn (SEQ ID NO.: 2),

Gln-Val-Thr-Thr-Val-Ser-Asn (SEQ ID NO.: 3), and

Gln-Val-Thr-Thr-Ser-Ser-Asn (SEQ ID NO.: 4).

Preferably, Fnl5BS is a polypeptide of sequence according to SEQ ID NO.: 1.

Fnl4BS as defined herein refers to Fnl4 binding sequence, which according to the present invention is a polypeptide sequence selected from

Val-Glu-Phe-Thr-Glu-Glu-Ser (SEQ ID NO.: 5),

Val-Glu-Phe-Ser-Glu-Glu-Ser (SEQ ID NO.: 6),

Val-Glu-Phe-Cys-Glu-Glu-Ser (SEQ ID NO.: 7),

Val-Glu-Phe-Asn-Glu-Glu-Ser (SEQ ID NO.: 8), and

Val-Glu-Phe-GIn-Glu-Glu-Ser (SEQ ID NO.: 9);

Preferably, Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5.

Thus preferably, the present invention relates to an embodiment wherein Fn 15BS is a polypeptide of sequence according to SEQ ID NO.: 1 ; and/or Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5. In a further preferred embodiment, Fnl5BS is a polypeptide of sequence according to SEQ ID NO.: 1 ; and Fnl4BS is a polypeptide of sequence according to SEQ ID NO.: 5.

As defined herein, Fnl3BS, which refers to a Fnl3 binding sequence, is a polypeptide of sequence Gly-lle-Val-Thr-Gly-Ala-Val (SEQ ID NO.: 10).

As further defined herein, Fnl2BS which refers to Fnl2 binding sequence, is a polypeptide of sequence (His-Thr-Thr-Val-Glu-Asp-Thr (SEQ ID NO.: 1 1).

L1 , L2 and L3 are each a polypeptide sequence comprising 0, 1 or 2 amino acid residues. L1 , L2 and L3 are linkers connecting Fnl5 binding sequence (Fnl5BS) and Fnl4 binding sequence (Fnl4BS), Fnl4 binding sequence (Fnl4BS) and Fnl3 binding sequence (Fnl3BS), and Fnl3 binding sequence (Fnl3BS) and Fnl2 binding sequence (Fnl2BS), respectively. At the same time, L1 , L2 and L3 preferably do not necessarily contribute to the binding affinity through direct interactions with the residues of fibronectin.

Thus, L1 is polypeptide sequence comprising 0, 1 or 2 amino acid residues. Preferably, L1 is a single amino acid residue Leu.

L2 is polypeptide sequence comprising 0, 1 or 2 amino acid residues. Preferably L2 is a single amino acid residue selected from Leu, lie, Vai, Ala and Met. More preferably, L2 is Leu.

L3 is polypeptide sequence comprising 0, 1 or 2 amino acid residues. Preferably L3 is a dipeptide of sequence Ser-Asp.

Most preferably, in the embodiments of the present invention, L1 is a single amino acid residue Leu; and L2 is a single amino acid residue Leu; and L3 is a dipeptide of sequence Ser-Asp.

Preferably, the fibronectin binding peptide of the present invention, comprises a polypeptide sequence Gln-Val-Thr-Thr-Gly-Ser-Asn-Leu-Val-Glu-Phe-Thr-Glu-Glu-Ser- Leu-Gly-lle-Val-Thr-Gly-Ala- Val-Ser-Asp-His-Thr-Thr-Val-Glu-Asp-Thr (SEQ ID NO: 12). More preferably, the fibronectin binding peptide of the present invention has a polypeptide sequence according to SEQ ID NO: 12.

The preferred sequence of FnBPA5.1 (SEQ Id NO: 12) of the present invention differs from FnBPA5 sequence (SEQ ID NO: 13) of the prior art in that:

- Glu residue at position 5 in the sequence of FnBPA5 known from the prior art (SEQ ID: 13), (which corresponds to the position 5 of Fn I5BS sequence - SEQ ID NO.: 1), is replaced with glycine;

- Asp residue at position 12 of the prior art sequence of FnBPA5 (SEQ ID NO.: 13) (which corresponds to the position 4 of Fnl4BS sequence - SEQ ID NO: 5) is replaced with a Thr residue;

- Thr residue at position 16 of the prior art sequence of FnBPA5 (SEQ ID NO.:13) (which corresponds to the first residue of L2) is replaced with Leu;

- Lys residue at the position 17 and Lys residue at the position 34 the prior art sequence of FnBPA5 (SEQ ID NO.: 13) are deleted. The present inventors have surprisingly found that the resulting peptide sequence, herein referred to as FnBPA5.1 sequence (SEQ ID NO: 12) shows improved affinity for Fib1 , improved uptake in tumors and lower uptake in spleen and liver. It is noted that it is conceivable to the skilled person that similar substitutions at the same position are likely to result with the same effect on affinity for Fi b 1 , and/or lead to improved uptake in tumors and lower uptake in spleen and liver, as described herein. Therefore, the present invention also encompasses the embodiments wherein the Glu residue at position 5 of FnBPA5 sequence (SEQ ID NO: 13) has been replaced with residues with similar properties to glycine, for example with a residue selected from Ala, Vai and Ser. The resulting Fnl5 binding sequences, also referred to as Fnl5BS, are selected from SEQ ID NO: 2 to 4. The present invention further encompasses the embodiments, wherein the Asp residue at position 12 of the prior art sequence of FnBPA5 (SEQ ID NO.: 13) has been replaced with residues with similar properties to Thr, for example with a residue selected from Ser, Cys, Asn and Gin. The resulting Fnl5 binding sequences, also referred to as Fnl4BS, are selected from SEQ ID NO.: 6 to 9. It is further conceivable to the skilled person that Thr residue at position 16 of the prior art sequence of FnBPA5 (SEQ ID NO.: 13) may be replaced with a residue similar in properties to Leu, for example a residue selected from lie, Vai, Ala and Met.

The present invention encompasses fibronectin binding peptides as described herein, which bind to fibronectin, in particular which bind to Fib1. Preferably, the fibronectin binding peptide of the present invention as defined herein binds to fibronectin, preferably to Fib1 , with an affinity better than that measured for a peptide according to SEQ ID NO. : 13, which is also referred to as FnBPA5 peptide known from the prior art. As indicated in Fig. 1 , the said affinity of FnBPA5 peptide to Fib1 corresponds to KD = 102.3 nM.

Preferably, said affinity is measurable by using a fluorescence anisotropy assay, using a peptide with N-terminally appended Cy5 label (as described in Preparative Example 1). Detailed protocol for the measurement is included in Example 1.

Thus, in a preferred embodiment the fibronectin binding peptide of the present invention is characterized by binding to Fib1 (construct according to SEQ ID NO: 14) with a KD of 100 nM or tighter, 50 nM or tighter, 25 nM or tighter, 10 nM or tighter, 5.0 nM or tighter, as preferably determined by using a fluorescence anisotropy assay as described herein. The term “or tighter” refers preferably to higher affinities, which can be expressed by lower KD values.

Fibronectin-binding peptide-payload conjugates

In a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention, as described hereinabove, further conjugated to a payload. In other words, the fibronectin binding peptide of the present invention is in certain embodiments linked to a payload. According to the present invention, there is no specific restriction as to how the fibronectin binding peptide and the payload are linked to each other, as long as the fibronectin binding peptide and the payload are linked in a manner that is sufficiently stable under physiological conditions, preferably in blood plasma, to physically and/or chemically con nect/allocate/bind the components together until they reach the target site. The fibronectin binding peptide and the payload may be linked to each other covalently or non- covalently, e.g. by hydrophobic interaction, van der Waals forces, electrostatic attraction, etc. or via one or more spacers or at least one linker. The said linker in certain embodiments may be a cleavable linker. The expression "cleavable linker" means any linker which can be cleaved physically or chemically. Examples for physical cleavage are cleavage by light, radioactive emission or heat, while examples for chemical cleavage include cleavage by redox-reactions, hydrolysis, pH-dependent cleavage or cleavage by enzymes.

As understood herein, the payload moiety can be directly conjugated to any amino acid residue within the fibronectin binding peptide of the invention (or to any suitable chemical group therein), using any chemical coupling known in the art or described herein suitable for the conjugation of the payload moiety preferably to an amino acid residue (e.g., an amino acid side chain). Accordingly, said coupling may result in one or more chemical groups spaced between the payload moiety and the amino acid (e.g., amino acid side chain) of the fibronectin-binding peptide of the invention, which groups form as a result of the coupling reaction, as known in the art.

Alternatively, as described herein, the payload moiety may be conjugated to any amino acid residue within the fibronectin binding peptide of the invention indirectly, that is, via a linker group. In such embodiments, the payload is conjugated to a linker group, which linker group is conjugated to an amino acid residue within the fibronectin binding peptide of the invention. The conjugation between the payload and the linker group and between the linker group and an amino acid residue or chemical group of the fibronectin binding peptide of the invention may be any conjugation method and/or compound suitable for effecting such conjugation as described herein or as otherwise known in the art.

The conjugation of the payload moiety may be directed to any amino acid residue within the fibronectin binding peptide of the invention. Thus, the payload moiety may be directly or indirectly conjugated to an amino acid residue within the fibronectin binding peptide of the invention. Preferably, the payload moiety may be directly or indirectly conjugated to an amino acid residue that is at an N-terminal end or C-terminal end of the fibronectin binding peptide of the invention. Alternatively or additionally, the payload moiety may be directly or indirectly conjugated to an internal amino acid residue within the fibronectin binding peptide of the invention. As used throughout this disclosure, an internal residue or internal chemical group references an amino acid residue or chemical group of the fibronectin binding peptide of the invention that is not at the terminus of a peptide chain. As is known in the art, conjugation methods (whether direct or indirect) may require the chemical modification of one or both sites of conjugation (e.g., modification of an amino acid residue and/or modification of the payload moiety). Accordingly, the present invention also encompasses chemical modification of the fibronectin binding peptide of the invention.

Preferably, the fibronectin binding peptide of the present invention relates to an embodiment, wherein the payload is directly conjugated to the N or C terminus of the said polypeptide sequence through an amide bond. Further preferably, the payload is directly conjugated to the N or C terminus of the said polypeptide sequence through an amide bond.

Alternatively, the payload may be conjugated to the N or C terminus of the said polypeptide sequence via a linker. Preferred linkers of the present invention comprise a moiety selected from a peptide moiety, a PEG moiety, a moiety derived from cadaverine and a C1-12 alkylene moiety. Preferably, the linker comprises a peptide moiety. Preferably, the linker is the peptide moiety is of sequence Gly-Gly-Gly or of sequence Cys-Gly-Gly-Gly (SEQ ID NO: 15). As understood to the skilled person, the linker may be N-terminally acetylated.

The payload may preferably be conjugated to the linker via amide bond formation or maleimide- thiol conjugation.

The payload in the present invention is not particularly limited. In the preferred embodiment, the payload is a biologically active molecule (BAM) or an imaging agent.

In certain preferred embodiments of the present invention, the payload is a biologically active molecule (BAM).

Preferably, the biologically active molecule as encompassed by the present invention is selected from the group consisting of cytostatic agent, cytotoxic agent, cytokine, transcription factor inhibitor, proteasome and protease inhibitor, apoptosis modulator, cell cycle modulator, angiogenesis inhibitor, hormone or hormone derivative, photodynamic therapy molecule, nano- and microparticle for thermoablation therapy, radionuclide, miRNA, siRNA and immunomodulatory antigen molecule.

As understood herein, the preferably cytostatic agent is selected from Doxorubicin, Paclitaxel, Chlorambucil, Topotecan and Vincristine.

As further understood herein, preferably cytokine is selected from lnterleukin-2, lnterleukin-7, Interferon-y and tumor necrosis factors. Further suitable cytokines for use as payload according to the present invention are, for example, interleukin 2, interleukin 7, interferon a-2a, interferon a-2b, interferon- la, interferon-ip, interferon y-ip, tumor necrosis factor, and any derivatives thereof.

As further understood herein, transcription factor inhibitor is preferably selected from Curcumin, Ribavirin and Genistein. Further suitable transcription factor inhibitors for use as payload according to the present invention are, for example compounds that inhibit activation of N F-KB such as curcumin (diferuloylmethane) epigallocatechin-3-gallate (EGCG; green tea polyphenols), phenanthrolines, pyrrolinedithiocarba- mate (PDTC), quercetin, tepoxaline (5-(4- chlorophenyl)-N-hydroxy-(4- methoxyphenyl)-N-m ethyl-1 H-pyrazole-3-propan- amide), PMC (2,2,5,7,8-pentamethyl-6- hydroxychromane), benzyisocyanate, resveratol, genistein, lupeol, lycopene, panepoxydone, epoxyquinomicin C, dehydroxymethylepoxy- quinomicin (DHMEQ), cycloepoxydon, gliotoxin, as well as 1-KB-alpha phosphorylation and/or degradation inhibitors such as PS-1 ,145, BAY-11-7082 (E3[(4- methylphenyl)-sulfonyl]-2-propenenitri le), BAY-11 -7085 (E3[(4-t- butylphenyl)-sulfonyl]-2-propenenitrile), cycloepoxydon; 1 -hydroxy-2-hydroxy-methyl-3-pent-l-enylbenzene, sanguinarine (pseudochelerythrine, 13-methyl-[l,3]-benzo- dioxolo-[5,6-c]-l,3-dioxolo-4,5 phenanthridinium), sulfasalazine, capsaicin (8- methyl-N-vanillyl-6- nonenamide ), emodin (3-methyl-l,6,8-trihydroxy- anthraquinone), erbstatin (tyrosine kinase inhibitor), estrogen (E2), gliotoxin, genistein, resiniferatoxin, and miscellaneous inhibitors of NF- KB such as beta-amyloid protein, glucocorticoids (dexamethasone, prednisone, methylprednisolone), leptomycin B (LMB), O,O'-bismyristoyl thiamine disulfide (BMT), ADP ribosylation inhibitors, e.g., bi-, tri, or tetracyclic lactames, 1 ,8-naphtalimide derivatives, phenanthridin-6-ones, 3,4-dihydro-5-methyl- isoquinolin-1 (2H)-one, benzoxazole-4-carboxamide, 1 , 6-nap hthyri di ne-5(6H)-ones, q ui nazoli n [3,4- d]pyrimidin-4(3H)-ones, 1 ,5-dihydroxyisoquinoline, 2-methyl-quinazolin-4[3H]-ones, l,llb-dihydro- [2H] benzopyrano [4,3,2-de]isoquinolin-3-one, atrial natriuretic peptide (ANP), atrovastatin (HMG- CoA reductase inhibitor), calcitriol (1 a,25-dihydroxyvitamine D3), E3330 (quinone derivative), herbimycin A, hypericin, hydroquinone (HQ), KT-90 (morphine synthetic derivatives), mevinolin, 5'- methylthioadenosine (MTA), pentoxifylline (1-(5'-oxohexyl)3,7-dimethylxanthine, PTX), phenyl-N-tert-butylnitrone (PBN), pituitary adenylate cyclase-activating polypeptide (PACAP), quinadril (ACE inhibitor), ribavirin, secretory leukocyte protease inhibitor (SLPI), serotonin derivative (N-(p-coumaroyl) serotonin, silymarin, vasoactive intestinal peptide (VIP), D609 (phosphatidylcholine-phospho- lipase C inhibitor), R031-8220 (PKG inhibitor), SB203580 (p38 MAPK inhibitor), triptolide (PG490, extract of Chinese herb), LY294,002, mesalamine, wortmannin (fungal metabolite), or CHS 828 (N- (6-(p-chlorophenoxy)-hexyl )-N'-cyano-N„- 4-pyridylguanidine ), sesquiterpene lactones such as parthenoilde, helenalin, miller-9E-enolid and budlein A.

As understood herein, proteasome and protease inhibitors are preferably selected from peptide aldehydes: ALLnL (N-acetyl-leucinyl-leucynil-norleucynal, MG101), LLM (N-acetyl-leucinyl-leucynil- methional), Z-LLnV (carbobenzoxyl-leucinyl-leucyni I- norvalinal, MG115), Z-LLL (carbobenzoxyl- leucinyl-leucynil-leucynal, MG132), boronic acid derivatives, e.g. PS-273, PS-293, PS-296, PS-303, PS- 305, PS-313, PS-321 , PS-325, PS-334, PS-341 , PS-364, PS-352, PS-383, lactacystine, beta-lactone, boronic acid peptide, ubiquitin ligase inhibitors deoxyspergualin, APNE (N-acetyl-DL-p henylalanine-beta- naphthylester), BTEE (N-benzoyl L-tyrosine- ethylester), DCIC (3,4-dichloroisocoumarin), DFP (diisopropylfluorophosphate), TPCK (N-alpha-tosyl- L-phenylalanine chloromethyl ketone), and TLCK (N- alpha-tosyl-L-lysine chloromethyl ketone).

As further understood herein, apoptosis modulator is preferably selected from Imatinib, Erlotinib and Bryostatin. Further suitable apoptosis modulators for use as payload according to the present invention are, for example, farnesyl transferase inhibitors, e.g. R115777, SCH66336, BMS214662, Imatinib, 17-AAG, EGFR inhibitors, e.g. ZD1839, ZD647, BIBW 2992, or erlotinib, MEK inhibitors, e.g. PD 032590, RAF inhibitors e.g. BAY43-9006, PKG inhibitors, e.g. UCN-01 , PKC-412, Bryostatin, ISIS-3521 , LY333531 , safingol, CGP-41251 (midostaurin), HDAC inhibitors, e.g., suberoyl-3-aminopyridineamide hydroxamic acid, lonidamine, apoptin, survivin, rapamycin, CCI-779, RAD001 (everolimus), PXD101 , tyrosine kinase inhibitors, e.g. Iressa, OSI-774, STI-571 , inhibitors of enzymes in the mitogen-activated protein kinase pathway e.g., PD-098059, U-0126. Especially preferred cell cycle modulators for use accord ing to the present invention are, for example, flavopiridol, bryostain-1 , roscovitine, BMS-387032, perifosine, or lovastatin.

As further understood herein, preferably cell cycle modulator is selected from Flavopiridol and Roscovitine.

As further understood herein, angiogenesis inhibitor is preferably selected from Endostatin, Celexocib, ADH-1 (exherin) and Sunitinib. Further suitable angiogenesis inhibitors for use as payload according to the present invention are, for example thalidomide, endostatin, celecoxib, ABT-510, combrestatin A4, dalteparin, dimethyl-xanthenone acetic acid, lenalidomide, LY317615 (enzastaurin), PPI-2458, ADH-1 (exherin), AG- 013736, AMG-706, AZD2171 , Bay 43-9006 (sorafenib), BMS-582664, CH IR-265, GW786034 (pazopanib), PI-88, PTK787/ZK 222584 (vatalanib), RAD001 (everolimus), SU 11248 (sunitinib), suramin, XL184, ZD6474, ATM-161 , or EMO 121974 (cilenigtide), and saposin-A derived peptides inducing thrombospondin-1 (preferably featuring Seq. I D Nos. 4 (DWLPK) and 5 (DWLP) of US Patent 2015/0320825 Al).

As further understood herein, hormone and hormone derivative is preferably selected from Flutamide, Fosfestrol, Tamoxifen and Relaxin. Further suitable hormones or hormone derivatives for use as payload according to the present invention are, for example, aminogluthemid, buserilin, cyproteronacetate, droloxifen, ethinylestradiol, flutamid, formesta, fosfestrol, gestonoroncaproate, goserilin, leuprolein, lynestrenol, medrogeston, medroxyprogesteronacetate, megestrolactetate, octreotid, relaxin, tamoxifen, toremifin, triptorelin, anastrazole, exemestane, or letrozole.

As further understood herein suitable miRNAs and siRNAs are, for example, those that are specific for CD40, CD80 and CD86, and also any agents that target clustered regularly interspaced short palindromic repeat (CRISPR) components for gene-editing purposes, or antigens that modulate the immune system, for example, insulin-associated antigens, P31 , whole gliadin, myelin oligodendrocyte glycoprotein (preferably amino acids 35-55), proteolipid protein 1 (preferably amino acids 139-151 and 178-191), Factor V (preferably amino acids 75-89, 1723-1737 and 2191-2210).

It is to be understood that radionuclides, are preferably not bound directly to the fibronectin binding peptide of the invention or the linker but are comprised in a complexing or chelator which can be conjugated as payload to the fibronectin binding peptide of the invention. Thus, as understood herein, a reference to radionuclide as payload is meant to be understood as a chelator charger with a radionuclide. Chelators that may be conjugated to the fibronectin binding peptide of the invention include, but are not limited to, 1 ,4,7,10-tetraazacyclododecane-1,4,7,1 O-tetraacetic acid (DOTA), diethylenetriaminepentaacetic (DTPA), desferrioxamine (DFO) and triethylenetetramine (TETA), 1 ,4,8,11- tetraazabicyclo[6.6.2]hexadecane-4, 11 -diacetic acid (CB-TE2A); ethylenediaminetetraacetic acid (EDTA); ethylene glycolbis(2-aminoethyl)-N,N,N',N'-tetraacetic acid (EGTA); 1 ,4,8,11- tetraazacyclotetradecane-1 ,4,8,11 -tetraacetic acid (TETA); ethylenebis-(2-4 hydroxy-phenylglycine) (EHPG); 5-CI-EHPG; 5BrEHPG; 5-Me-EHPG; 5t-Bu-EHPG; 5-sec-Bu-EHPG; benzodiethylenetriamine pentaacetic acid (benzo-DTPA); dibenzo-DTPA; phenyl-DTPA, diphenyl-DTPA; benzyl-DTPA; dibenzyl- DTPA; bis-2(hydroxybenzyl)-ethylene-diaminediacetic acid (HBED) and derivatives thereof; Ac-DOTA; benzo-DOTA; dibenzo-DOTA; 1 ,4,7-triazacyclononane N,N',N"-triacetic acid(NOTA); benzo-NOTA; 1 ,4,7-triazacyclononane N,N'-diacetic acid N”-glutaminic acid(NODAGA), benzo-TETA, benzo-DOTMA, where DOTMA is 1 ,4,7, 10-tetraazacyclotetradecane-1 ,4,7,10-tetra(methyl tetraacetic acid), benzo- TETMA, where TETMA is 1 ,4,8,11 -tetraazacyclotetradecane-1 ,4,8,11-(methyl tetraacetic acid); derivatives of 1 ,3-propylenediaminetetraacetic acid (PDTA); triethylenetetraaminehexaacetic acid (TTHA); derivatives of 1 ,5,10-N,N',N"-tris(2,3- dihydroxybenzoyl)-tricatecholate (LICAM); and 1 ,3,5- N,N',N"-tris(2,3- dihydroxybenzoyl)aminomethylbenzene (MECAM), or other metal chelators. In certain embodiments, the payload may comprise more than one chelator. Other preferred chelators can be selected from the group consisting of cyclic DPT A (diethylene triaminepentaacetic acid ) anhydride, ethylenediaminetetraacetic acid (EDTA), DOTA (1 ,4,7, 10- tetraazacyclododecane-1 ,4,7,10- tetraacetic acid), and OTA (l,4,7-triazonane-l,4,7-triacetic acid).

As further understood herein, radionuclide is in certain embodiments preferably selected from are 67 Cu, 90 Y, 111 ln, 131 l, 161 Tb, 169 Er, and 177 Lu. An especially preferred radionuclide for use in the present invention is 177 Lu or 131 l. Alternatively, the radionuclide can be selected from the group consisting of 90 Y and 111 ln. Further suitable radionuclides include those emitting p + ( 62 Cu, 64 Cu, 68 Ga, 76 Br, 82 Rb, 124 l, 44 Sc, 43 Sc, 89 Sr or any other p + emitting isotope), 0 (e.g. 90 Y, 177 Lu, 161 Tb, 64 Cu, 67 Cu, 47 Sc or any other p emitting isotope), a ( 225 Ac, 213 Bi, 211 At, 223/ 25 Ra or any other a emitting isotope), or Auger electron emitter ( 161 Tb, 169 Er, 111 ln or any other Auger electron emitting isotope), or any combination of therapeutic applicable radio-emissions. Most preferably, the biologically active molecule is selected from the group consisting of Paclitaxel, Chlorambucil, Endostatin, Sunitinib, lnterleukin-7, 177 Lu, and 111 ln.

In a further embodiment of the present invention, the payload is an imaging agent. The imaging agent may be any imaging agent known in the art. The fibronectin binding peptide of the invention, when conjugated to an imaging agent, may be used in the visualization of cells and/or tissues in vitro and/or in vivo. When the fibronectin binding peptide is used for the visualization of a target cell or tissue in vitro, care has to be taken an imaging agent is selected that is functional under the imaging conditions. Similar criteria apply for imaging agents that are used for the visualization of target cells and/or tissues in vivo. However, for in vivo applications, additional care has to be taken that the imaging agent is biocompatible, e.g. has no toxic or otherwise detrimental effects on the subject that compound of the invention comprising the imaging agent is administered to.

The term "imaging agent" as used herein refers to any element, molecule, functional group, compound, fragments thereof or moiety that facilitates detection of an agent (e.g., the compound of the invention) to which it is conjugated. Examples of imaging agents include, but are not limited to: various ligands, radionuclides, fluorescent dyes (for specific exemplary fluorescent dyes, see below), chemiluminescent agents (such as, for example, acridinum esters, stabilized dioxetanes, and the like), bioluminescent agents, spectrally resolvable inorganic fluorescent semiconductor nanocrystals (i.e., quantum dots), metal nanoparticles (e.g., gold, silver, copper, platinum, etc.) nanoclusters, paramagnetic metal ions, enzymes (for specific examples of enzymes, see below), colorimetric labels (such as, for example, dyes, colloidal gold, and the like), biotin, dioxigenin, haptens, and proteins for which antisera or monoclonal antibodies are available. It is to be understood that the imaging agent may be conjugated to the fibronectin binding peptide of the invention directly or indirectly via a linker, or that the imaging agent may be comprised in a molecule that is conjugated to the compound of the invention directly or indirectly via a linker. The skilled person would understand which imaging agents may be conjugated directly to the fibronectin binding peptide of the invention or a linker and which imaging agents need to be embedded in a molecule that can be conjugated to the compound of the invention or a linker. For example, if the imaging agent is a radionuclide, the radionuclide is preferably embedded in a molecule (e.g. chelated by a chelator being part of the said molecule) that can be conjugated to the fibronectin binding peptide of the invention or to the linker.

Preferably, the imaging agent comprises a radionuclide, a fluorescent dye, a chemiluminescent agent, a bioluminescent agent, a spectrally resolvable inorganic fluorescent semiconductor nanocrystal, a metal nanoparticle, a nanocluster, a paramagnetic metal ion, an enzyme, a colorimetric label, biotin, dioxigenin, a hapten or a protein. Preferably, the imaging agent comprises a radionuclide, fluorescent dye, a chemiluminescent agent, or a bioluminescent agent. In another embodiment, the imaging agent is selected from the group consisting of radionuclide, MRI active compound, ultrasound contrast agent, fluorophore, marker for PET and SPECT, preferably selected from 44 Sc, 64 Cu, 67/68 Ga 99m Tc, 111 1n, fluorophore in the far red/near-IR spectral region, and Gd-based and Fe-oxide particle based MRI contrast agent.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the imaging agent is selected from 99m Tc, 111 ln, 44 Sc and 64 Cu.

In again a further particular embodiment the present invention relates to the fibronectin binding peptide of the present invention, wherein the payload comprises a radionuclide, preferably selected from 64 Cu, 90 Y, 1 11 1n, 131 l, 161 Tb, 169 Er and 177 Lu or preferably selected from 44 Sc, 64 Cu, 67/68 Ga 99m Tc, and 111 ln.

In certain embodiments, the fibronectin-binding peptide of the invention may be conjugated to one or more contrast/imagi ng agents (e.g., fluorescent dyes, (chelated) radionuclides (SPECT, PET), MR- active agents, CT-agents).

In certain embodiments, a contrast/imaging agent may be conjugated to the fibronectin binding peptide of the invention for medical or biological imaging. The fibronectin binding peptides of the present invention may be useful in certain imaging techniques, which may include positron emission tomography (PET), single photon emission computed tomography (SPECT), computerized tomography (CT), magnetic resonance imaging (MRI), optical bioluminescence imaging, optical fluorescence imaging, and combinations thereof. In certain embodiments, the contrast/imaging agent may be any molecule, substance or compound known in the art for PET, SPECT, CT, MRI, and optical imaging. The contrast agent may be radionuclides, radiometals, positron emitters, beta emitters, gamma emitters, alpha emitters, paramagnetic metal ions, and supraparamagnetic metal ions. The contrast agents include, but are not limited to, iodine, fluorine, Cu, Zr, Lu, At, Yt, Ga, In, Tc, Gd, Dy, Fe, Mn, Ba and BaSO4.

In certain embodiments, the imaging agent may be a fluorescent reporter. In certain embodiments, the fluorescent reporter may be a near infrared or far red dye. In certain embodiments, the fluorescent reporter may be selected from the group consisting of a fluorophore, fluorochrome, dye, pigment, fluorescent transition metal, and fluorescent protein. In certain embodiments, the fluorescent reporter is selected from the group consisting of Cy5, Cy5.5, Cy2, FITC, TRITC, Cy7, FAM, Cy3, Cy3.5, Texas Red, ROX, HEX, JA133, AlexaFluor 488, AlexaFluor 546, AlexaFluor 633, AlexaFluor 555, AlexaFluor 647, DAPI, TMR, R6G, GFP, enhanced GFP, CFP, ECFP, YFP, Citrine, Venus, YPet, CyPet, AMCA, Spectrum Green, Spectrum Orange, Spectrum Aqua, Lissamine and Europium.

Exemplary imaging agents include, for example, the following: Cy5.5, Cy5, Cy7.5 and Cy7 (GE® Healthcare); AlexaFluor660, AlexaFluor680, AlexaFluor790, and AlexaFluor750 (Invitrogen); VivoTag™ 680, VivoTag™-S680, VivoTag ™-S750 (VISEN Medical); Dy677, Dy682, Dy752 and Dy780 (Dyomics ®); DyLight ® 547, and/or DyLight ® 647 (Pierce); HiLyte Fluor™ 647, HiLyte Fluor™ 680, and HiLyte Fluor™ 750 (AnaSpec ®); IRDye ® 800CW, IRDye ® 800RS, and IRDye ® 700DX (Li-Cor ®); ADS780WS, ADS830WS, and ADS832WS (American Dye Source); XenoLight CF™ 680, XenoLight CF™ 750, XenoLight CF™ 770, and XenoLight Di R (Caliper ® Life Sciences); and Kodak ® X-SIGHT ® 650, Kodak ® X-SIGHT 691 , Kodak ® X-SIGHT 751 (Carestream ® Health).

Preferably the fibronectin binding peptide of the present invention relates to an embodiment, wherein the payload is [ 111 1 n]ln-NODAGA moiety.

Pharmaceutical compositions

In a further embodiment, the present invention relates to a pharmaceutical composition comprising the fibronectin binding peptide as described herein and a pharmaceutically acceptable carrier. As detailed herein, the fibronectin binding peptide of the invention, preferably including a payloadconjugate (/.e., a biologically active molecule or an imaging agent conjugated to the fibronectin binding peptide of the invention either directly or indirectly via a linker) may affect targeting of the payload to the a target cell or tissue. In certain embodiments, the payload-conjugate may also affect intracellular transport of the payload into a target cell. Accordingly, in preferred embodiments, the invention encompasses a pharmaceutical composition comprising a fibronectin-binding peptide of the invention, e.g., a payload-conjugate, and a pharmaceutically acceptable carrier or excipient.

Such a carrier or excipient includes, but is not limited to, saline, buffered saline, dextrose, water, glycerol, ethanol, and/or combinations thereof. The pharmaceutical compositions also may include additional therapeutic agents for the treatment of the given disease being treated. The formulation is made to suit the mode of administration. In general, methods of administering polypeptides are well known in the art and can be applied to administration of the conjugates of the invention.

Administration is by any of the routes normally used for introducing a fibronectin-binding peptide into ultimate contact with blood. Suitable methods of administering such fibronectin-binding peptide and their conjugates in the context of the present invention to a patient are available including oral and parenteral routes. Although more than one route can be used to administer a particular composition, a particular route can often provide a more immediate and more effective action or reaction than another route.

Preferably the payload-conjugates of the fibronectin-binding peptide of the invention are administered by parenteral modes of administration, in particular by intravenous, intraperitoneal, intramuscular, intradermal, subcutaneous intrathecal, intraocular, retrobulbar, intrapulmonary or intraarticular means. Such administration routes and appropriate formulations are generally known to those of skill in the art. Formulations suitable for parenteral administration include aqueous and nonaqueous, isotonic sterile injection solutions, which can contain antioxidants, buffers, bacteriostats, and solutes that render the formulation isotonic with the blood of the intended recipient, and aqueous and non- aqueous sterile suspensions that can include suspending agents, solubilisers, thickening agents, stabilizers, and preservatives. Fibronectin-binding peptide and their conjugates can also be administered via liposomes.

The fibronectin-binding peptides and conjugates thereof of the invention, alone or in combination with other suitable components, can also be made into aerosol formulations (/.e., they can be “nebulised”) to be administered via inhalation. Aerosol formulations can be placed into pressurized acceptable propellants, such as dichlorodifluoromethane, propane, nitrogen, and the like.

In a preferred embodiment, the pharmaceutical compositions of the invention are provided in lyophilized form to be reconstituted prior to administration. Buffers and solutions for the reconstitution of the pharmaceutical compositions may be provided along with the pharmaceutical formulation to produce aqueous compositions of the present invention for administration.

Pharmaceutically acceptable carriers are determined in part by the particular composition being administered, as well as by the particular method used to administer the composition. Accordingly, there are a wide variety of suitable formulations of pharmaceutical compositions of the present invention. Pharmaceutically acceptable carriers and excipients are well known in the art, and one or more conjugates of the invention can be formulated into pharmaceutical compositions by well-known methods (see, e.g., Remington: The Science and Practice of Pharmacy, 21st edition, A. R. Gennaro, Ed., Mack Publishing Company (2005); Pharmaceutical Formulation Development of Peptides and Proteins, S. Frokjaer and L. Hovgaard, Eds., Taylor & Francis (2000); and Handbook of Pharmaceutical Excipients, 3rd edition, A. Kibbe, Ed., Pharmaceutical Press (2000)).

Pharmaceutical compositions comprising one or more fibronectin-binding peptides and/or payload-conjugates thereof of the invention are optionally tested in one or more appropriate in vitro and/or in vivo animal models of disease, to confirm efficacy, tissue metabolism, and to estimate dosages, according to methods well known in the art. Thus, it is understood that the suitable dose of a composition according to the present invention will depend upon the age, health and weight of the recipient, kind of concurrent treatment, if any, frequency of treatment, and the nature of the effect desired. However, the dosage is tailored to the individual subject, as is determinable by one of skill in the art, without undue experimentation. The total dose of therapeutic agent may be administered in multiple doses or in a single dose. In certain embodiments, the compositions are administered alone, in other embodiments the compositions are administered in conjunction with other therapeutics directed to the disease or directed to other symptoms thereof.

The fibronectin binding peptides in the present invention may be administered alone or in combination with adjuvants that enhance stability, facilitate administration of pharmaceutical compositions containing them, provide increased dissolution or dispersion, increase inhibitory activity, provide adjunct therapy, and the like, including other active ingredients. Advantageously such combination therapies utilize lower dosages of the conventional therapeutics, thus avoiding possible toxicity and adverse side effects incurred when those agents are used as monotherapies. The above described fibronectin binding peptides may be physically combined with the conventional therapeutics or other adjuvants into a single pharmaceutical composition.

The dose administered to a patient, in the context of the present invention, is sufficient to affect a beneficial therapeutic response in the patient over time, or, e.g., to inhibit infection by a pathogen, to reduce or prevent the symptoms of a disease state, or other appropriate activity, depending on the application. The dose is determined by the efficacy of a particular composition/formulation, and the activity, stability or serum half-life of the BAM polypeptide conjugate employed and the condition of the patient, as well as the body weight or surface area of the patient to be treated. The size of the dose is also determined by the existence, nature, and extent of any adverse side-effects that accompany the administration of a particular composition/formulation, or the like in a particular patient. In some embodiments, dosage levels range from about 0,5 pg - 100 mg/dose for a 70 kg patient. Although one dose per day may be sufficient, up to 5 doses per day may be given. For oral doses, up to 2000 mg/day may be required. For radionuclide therapy a dose every 4 to 8 week for 2 to 8 times may be applicable. As the person skilled in the art will appreciate, lower or higher doses may be required depending on particular factors. For instance, specific doses and treatment regimens will depend on factors such as the patient's general health profile, the severity and course of the patient's disorder or disposition thereto, and the judgment of the treating physician. For example, the fibronectin binding peptides of the present invention can be administered the same way as other peptide-based medicaments.

The fibronectin binding peptides in the present invention may be formulated into capsules the same way other peptide-based medicaments are formulated. Each capsule may contain 100 to 500, preferably 150 to 300, more preferably 200 to 250 mg of a compound of the invention. For example, non- medicinal ingredients in capsules for the compounds of the present invention are - capsule shell: D&C yellow No. 10, FD&C blue No. 1 , FD&C red No. 3, FD&C yellow No. 6, gelatin and titanium dioxide. Bottles of 100. (see also Martindale: the complete drug reference, 34 Edition, 2005, Pharmaceutical Press, p 612.).

Therapeutic application

In one embodiment, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in therapy. Therapy is herein preferably understood as treatment and/or prevention, more preferably as treatment. In a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for use in the treatment or prevention of a disease associated with pathologic fibronectin accumulation. The term "pathological fibronectin accumulation" as used herein, refers to any disease or condition in which the amount of fibronectin deposited at a given site is higher than in a healthy state. For example, pathological fibronectin accumulation is found regularly in fibrosis or cancer.

As used herein, the term "fibrosis" can refer to any disease characterized by fibrosis, including but not limited to systemic sclerosis, multifocal fibrosclerosis, sclerodermatous graft-vs-host- disease, nephrogenic systemic fibrosis, organ specific fibrosis, mediastinal fibrosis, myelofibrosis, retroperitoneal fibrosis, progressive massive fibrosis, Crohn's Disease, Keloid, arthrofibrosis, Peyronie's Disease, Dupuytren's Contracture, adhesive capsulitis, and the like. Illustrative organ specific fibrosis include, but are not limited to, pulmonary fibrosis, pulmonary hypertension, cystic fibrosis, asthma, chronic obstructive pulmonary disease, liver fibrosis, kidney fibrosis, fibrosis of the pancreas, non-alcoholic steatohepatitis (NASH), lymph node fibrosis, corneal fibrosis, fibrous cartilage, endometriosis, and the like. Many fibrosis diseases, disorders or conditions have disordered and/or exaggerated deposition of extracellular matrix in affected tissues. Fibrosis may be associated with inflammation, occur as a symptom of underlying disease, and/or caused by surgical procedure or injuries with limited wound healing capacities.

A "cancer" or "tumor" as used herein refers to an uncontrolled growth of cells which interferes with the normal functioning of the bodily organs and systems. Examples of cancer include, but are not limited to B-cell lymphomas (Hodgkin's lymphomas and/or non-Hodgkin's lymphomas), brain tumor, breast cancer, colon cancer, lung cancer, hepatocellular cancer, gastric cancer, pancreatic cancer, cervical cancer, ovarian cancer, liver cancer, bladder cancer, cancer of the urinary tract, thyroid cancer, renal cancer, carcinoma, melanoma and other skin cancers, head and neck cancer (preferably head and neck squamous cell carcinoma), brain cancer, and prostate cancer, including but not limited to androgendependent prostate cancer and androgen-independent prostate cancer.

Preferably, the disease associated with pathogenic fibronectin accumulation is a disease associated with abnormal accumulation of soluble plasma fibronectin and/or insoluble ECM fibronectin. Thus, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in the treatment and/or prevention of a disease associated with abnormal accumulation of soluble plasma fibronectin and/or insoluble ECM fibronectin

Further preferably, the disease associated with pathologic fibronectin accumulation is selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis. Thus, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in the treatment and/or prevention of a disease selected from fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis.

As understood herein the autoimmune diseases is preferably selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis. Thus, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in the treatment and/or prevention of a disease selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis.

As further understood herein, preferably the fibrosis is selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis. Thus, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in the treatment and/or prevention of a disease selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis.

As further understood herein, the cancer is preferably selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer. Thus, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in the treatment and/or prevention of a disease selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer.

Preferably, the lung cancer is a non-small lung cell cancer. Thus, the present invention relates to the fibronectin binding peptide of the present invention as described hereinabove or the pharmaceutical composition of the present invention as described hereinabove for use in the treatment and/or prevention of non-small cell lung cell cancer.

The present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatment or prevention of a disease associated with pathologic fibronectin accumulation. The disease associated with pathologic fibronectin accumulation is as described hereinabove.

Thus accordingly, the present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatment or prevention of a disease associated with abnormal accumulation of soluble plasma fibronectin and/or insoluble ECM fibronectin. Further accordingly, the present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatmentor prevention of a disease selected from fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis.

Further accordingly, the present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatmentor prevention of a disease selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis.

Further accordingly, the present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatmentor prevention of a disease selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis.

Further accordingly, the present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatmentor prevention of a disease selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer.

Further accordingly, the present invention further relates to use of the fibronectin binding peptide of the present invention as described hereinabove, or the pharmaceutical composition of the present invention for the manufacture of a medicament for use in the treatment or prevention of non-small cell lung cell cancer.

In a further embodiment, the present invention relates to a method of treatment or prevention (preferably to a method of treatment) of a disease associated with pathologic fibronectin accumulation. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof. The subject herein is preferably defined as a human subject, preferably suffering from a disease associated with pathologic fibronectin accumulation. The disease associated with pathologic fibronectin accumulation is as defined hereinabove.

Thus accordingly, the present invention further relates to a method of treatment or prevention (preferably to a method of treatment) of a disease associated with abnormal accumulation of soluble plasma fibronectin and/or insoluble ECM fibronectin. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof. Further accordingly, the present invention further relates to a method of treatment or prevention (preferably to a method of treatment) of a disease selected from fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof.

Further accordingly, the present invention further relates to a method of treatment or prevention (preferably to a method of treatment) of a disease selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof.

Further accordingly, the present invention further relates to a method of treatment or prevention (preferably to a method of treatment) of a disease selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof.

Further accordingly the present invention further relates to a method of treatment or prevention (preferably to a method of treatment) of a disease selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof.

Further accordingly, the present invention further relates to a method of treatment or prevention (preferably to a method of treatment) of non-small cell lung cell cancer. The said method comprises the step of administering the therapeutically effective amount of the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention to the subject in need thereof.

Particularly useful fibronectin binding peptides of the present invention are those bearing a biologically active molecule as a payload, as described hereinabove.

Diagnostic use

In a further embodiment, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis. Preferably, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis of a disease associated with pathologic fibronectin accumulation. The disease associated with pathologic fibronectin accumulation is as described hereinabove. The fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention are useful in diagnosis of a disease selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis. Thus, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis of a disease selected from the group consisting of fibrosis, cancer, lymphedema, immune disease, autoimmune disease, and atherosclerosis.

Further accordingly, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis of autoimmune diseases, preferably selected from systemic sclerosis, diabetes type 1 , Graves’ disease, multiple sclerosis and rheumatoid arthritis.

Further accordingly, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis of fibrosis, preferably selected from pulmonary fibrosis, liver fibrosis, and kidney fibrosis.

Further accordingly, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in diagnosis of cancer, preferably selected from breast cancer, head and neck squamous cell carcinoma, prostate cancer, renal cancer, pancreatic cancer and lung cancer.

Further accordingly, the present invention relates to the fibronectin binding peptide of the present invention or the pharmaceutical composition of the present invention for use in in diagnosis of non-small lung cell cancer.

Particularly useful fibronectin binding peptides of the present invention are those bearing an imaging agent as a payload, as described hereinabove.

Examples

The following examples are merely illustrative of the present invention and should not be construed to limit the scope of the invention which is defined by the appended claims.

Preparative example 1 - Preparation of NODAGA- or Cy5-labelled fibronectin binding peptides.

NODAGA- and/or Cyanine5 (Cy5) conjugated fibronectin-binding peptides (of FnBPA5.1 sequence according to SEQ ID NO: 12 or of FnBPA5 sequence according to SEQ ID NO.: 13) were synthesized to obtain HPLC purity greater than 95%. The peptide-conjugates were synthetized via introduction of the desired moiety (e.g. NODAGA or Cy5) at the N-terminus of the fibronectin-binding peptide via amide bond formation or maleimide-thiol conjugation. A short spacer of three glycines (and an additional cysteine residue in the case of conjugates obtained via maleimide-thiol chemistry) between the last N-terminal amino-acid of the fibronectin-binding peptide and the payload (herein NODAGA, Cy5) was added, resulting in the following structure: payload-GGG-fibronectin-binding peptide or payload-CGGG-fibronectin-binding peptide

The peptide-conjugates were obtained as lyophilized powders in HPLC purity greater than 95%. Linear peptide sequences were synthesized via automatized solid-phase peptide synthesis employing standard Fmoc/tBu protocols, following which a final conjugation step via maleimide-thiol conjugation at the N-terminus of the fibronectin-binding sequence provided the final NODAGA or Cy5-conjugates. A short spacer of three glycines and an additional cysteine residue between the last N-terminal amino-acid of the fibronectin-binding sequence and the functionalization (chelator, dye) was introduced.

NODAGA-FnBPA5.1 (sequence: Ac-C(Mal-NODAGA)-GGG-

QVTTGSNLVEFTEESLGIVTGAVSDHTTVEDT) (SEQ ID NO.: 16) was obtained from Bachem (Bubendorf, Switzerland) upon conjugation of the N-terminal Cys-activated sequence with Maleimide- NODAGA (Chematech, Dijion, France).

Cy5-FnBPA5.1 (sequence: C(Mal-Cy5)-GGG-QVTTGSNLVEFTEESLGIVTGAVSDHTTVEDT) (SEQ ID NO.: 17) was obtained upon conjugation of the N-terminal Cys-activated sequence (Cys- FnBPA5.1 , PSL GmbH, Heidelberg, Germany) with Cy5-Maleimide (Lumiprobe, Hannover, Germany). Cys-FnBPA5.1 was dissolved in PBS (50 mM, pH 5.5) to a cone, of 30 mM. Following Cy5-Maleimide addition (1 equiv.), the solution was stirred up to 2h. Upon dilution (x10), the mixture was directly purified by means of RP-HPLC (Merck-Hitachi LaChrom HPLC) on a Jupiter Proteo 90 A, 4 m, 250 x 10 mm, Phenomenex (Aschaffenburg, Germany) RP C18 semi-preparative column. MeCN + 0.1 % TFA (A) and H2O + 0.1 % TFA (B) were employed as mobile phases and a gradient of 30 to 90% A in B over 15 minutes was employed. Upon lyophilization, Cy5-FnBPA5.1 was obtained as a blue powder in > 95% purity. MALDI-FTICR-MS: m/z calculated [M+H]+for Cy5-FnBPA5.1 4215.0114; found: 4215.0114.

To prepare [ 111 ln]ln-NODAGA-FnBPA5.1 , NODAGA-FnBPA5.1 was dissolved in 10% DMF TraceSELECT® Water (Sigma-Aldrich, Buchs, Switzerland) at 1 mg/mL, and further diluted with TraceSELECT® Water to a final concentration of 0.1 mM. The conjugate was labeled with [ 111 InJInCh (Mallinckrodt, Wollerau, Switzerland) in metal-free ammonium acetate (0.5 M, pH 5.5) at a molar activity of 6 MBq/nmol, followed by a 15 min incubation step at 50 °C. An Eppendorf Thermomixer comfort (Eppendorf, Hamburg, Germany) was used for heating and simultaneous shaking of the labelling mixture. Upon labelling, an aliquot of the reaction mixture was subjected to quality control by means of RP-yHPLC. RP-yHPLC of 111 In-labelled peptide was performed on an Agilent 1200 Series Gradient HPLC (Santa Clara, USA) equipped with a Gabi Star gamma detector (Raytest, Straubenhardt, Germany). MeCN + 0.1 % TFA (A) and H2O +0.1 % TFA (B) were employed as mobile phases. Quality control of radio-labeling reactions was conducted on a ReproSil Pur, 120 A, 3 pm, 100 x 4.6 mm (Dr. Maisch GmbH, Germany) RP C18 analytical column, with a gradient ranging from 10 to 80 % A in B over 10 min, at a flow rate of 1 mL per min.

Example 1 - Affinity Determination of Cy5-labeled FnBPA5.1 towards Fib1 using Fluorescence Polarization.

For the affinity measurement experiment, Cy5-FnBPA5.1 (according to SEQ DI NO: 12) and Cy5-FnBPA5 (according to SEQ DI NO: 13) (48 nM) were mixed with different concentrations of Fib 1 - N-terminal 30 kDa fragment of fibronectin according to SEQ ID NO.: 14 (0 nM - 4.5 pM) in PBS pH 7.4. Samples were incubated for 1 h (37°C, 70 rpm) and fluorescence polarization was measured in triplicates using the Pherastar FSX plate reader (BMG Labtech; Optic module: FP 590-50 675-50 675-50). Background fluorescence was subtracted and fluorescence polarization was converted to anisotropy and fitted using the binding equation described by Pallicer et al. (Pallicer, J. M., and Kramer, S. D. (2012) Evaluation of fluorescence anisotropy to assess drug-lipid membrane partitioning, J Pharm Biomed Anal 71 , 219-227) to derive the dissociation constant KD. The results are shown in Figure 1.

Fib1 , the 30 kDa N-terminal fragment of fibronectin containing the N-terminal Fnl1-5 modules, was expressed in human embryonic kidney cells (HEK-293). For this, the cDNA of Fib1 containing a 6- His tag at the C-terminal end for affinity purification via Ni-NTA agarose (Qiagen, Basel, Switzerland) was cloned into the Hindlll/BamHI site of the mammalian expression vector pcDNA3.1 + (Invitrogen, Basel, Switzerland). Proper cDNA insertion into the vector was confirmed by DNA sequencing (Microsynth, Balgach, Switzerland). HEK-293 cells were transfected using the calcium phosphate method. After Geneticin selection, the most efficient cell clone was used for production and Fi b 1 was purified from cell culture supernatants as previously described (Grunberg, J., Knogler, K., Waibel, R., and Novak-Hofer, I. (2003). High-yield production of recombinant antibody fragments in HEK-293 cells using sodium butyrate, Biotechniques 34, 968-972). Finally, Fib1 was dialyzed against PBS pH 7.4.

Example 2 - Fibronectin fiber stretch assay.

Fibronectin was extracted from human blood plasma (Zurcher Blutspendedienst SRK, Switzerland) using gelatin sepharose chromatography. Fibronectin fibers were manually pulled from a concentrated droplet of fibronectin in PBS (95% unlabeled and 5% A488-labeled protein) using a sharp pipette tip and deposited onto a flexible silicone sheet (SMI, USA), rinsed and rehydrated in PBS. Thereafter, fibers were either relaxed (about 7% strain) or stretched (about 380% strain) as defined by Little et al. (Little, W. C., Smith, M. L., Ebneter, U. & Vogel, V. Assay to mechanically tune and optically probe fibrillar fibronectin conformations from fully relaxed to breakage. Matrix Biol. 27, 451-461 (2008)) After a blocking step with BSA (Sigma-Aldrich, Buchs, Switzerland) to avoid unspecific attachment of binding ligands to fibers or to the silicone sheet, the fibers were incubated with Cy5-labelled FnBPA5 or 5.1 (150 nM) for 1 h and imaged after a washing step by means of confocal microscopy. The results are shown in Figure 2.

Example 3 - Plasma Stability Studies.

Plasma stability of FnBPA5.1 was assessed by incubating 7.5 MBq of 111 ln[ln]-NODAGA FnBPA5.1 in human blood plasma (Kantonsspital Aarau, Switzerland) at 37 °C under gentle agitation. At different time points (0, 0.5, 1 , 4 and 24 h) aliquots were drawn and proteins were precipitated by the addition of an equal volume of MeCN. Upon centrifugation (14000 rpm, 10 min), the supernatant was filtered through a Mini-UniPrep Filter into a MiniPrep Whatman tube (Whatman Inc., NJ, USA) and analyzed by means of RP-yHPLC. Data are represented as percentages of recovered test compound at the individual time-points normalized to the reference sample at time 0 min. The results are shown in Figure 3.

Example 4 - Biodistribution in PC-3 xenografts.

Animal studies were carried out according to the Swiss Animal Protection Law under the license AG75700. For tumor implantation, 5 x 10 6 PC-3 cells in 100 pL PBS were injected subcutaneously into both shoulders of female CD1 nu/nu mice (Charles River, Germany) under isoflurane/oxygen anesthesia. Tumor growth was inspected regularly and tumors were measured using a caliper. Five weeks after tumor implantation, mice were injected via the tail vein with approximately 100-150 kBq of the corresponding 111 ln-labelled radiotracers, previously diluted with PBS to a concentration of 1-1.5 MBq/mL. At 24 h p.i., mice were euthanized using CO2. The organs of interest were harvested, weighed and counted by means of gamma counter together with three standards containing 100 pL of the injection solution. The percentage of injected activity per gram (%IA/g) was calculated based on the average of the standards set at 100%. The results are shown in Figure 4.

Example 5 - Biodistribution in a orthotopic and syngeneic breast tumor model.

Animal studies were carried out according to the Swiss Animal Protection Law under the license AG75700. For tumor implantation, 40’000 67NR cells in 50 pL PBS were injected subcutaneously into the mammary fat pad at the 4 th nipple of female Balb/c mice (Charles River, Germany) under isoflurane/oxygen anesthesia. Tumor growth was inspected regularly and tumors were measured using a caliper. Two weeks after tumor implantation, mice were injected via the tail vein with approximately 100- 150 kBq of the corresponding 111 ln-labelled radiotracers, previously diluted with PBS to a concentration of 1-1.5 MBq/mL. At 24 h p.i., mice were euthanized using CO2. The organs of interest were harvested, weighed and counted by means of gamma counter together with three standards containing 100 pL of the injection solution. The percentage of injected activity per gram (%IA/g) was calculated based on the average of the standards set at 100%. The results are shown in Figure 5.

Example 6 - Orthotopic and syngeneic breast tumor model - SPECT/CT imaging studies. Female Balb/c mice with a 67NR breast tumor were injected into the tail vein with 10-15 MBq of 111 ln-labelled NODAGA-FnBPA5.1 , previously diluted with PBS to a concentration of 10-15 MBq/mL. At 24 h p.i., mice were put under isoflurane/oxygen anesthesia and subjected to a SPECT/CT scan with a NanoSPECT/CT camera (Mediso Medical Imaging Systems, Budapest, Hungary). Data was reconstructed with HiSPECT software (version 1.4.3049, Scivis GmbH, Gottingen, Germany) and analyzed using VivoQuant (version 3.5, inviCRO Imaging Services and Software, Boston USA). SPECT images were processed after application of a post-reconstruction filter. Scale of activity was set to 0 - 3.9 Bq/voxel. The results are shown in Figure 6A.

Example 7 - Orthotopic and syngeneic breast tumor model - Autoradiography.

After CO2 euthanasia of SPECT/CT mice of Example 6, they were instantly perfused with 10 mL Ringer acetate supplemented with 50’000 units of Heparin through the right heart ventricle. Thereafter, 5 mL of OCT/PBS (50:50) were infused and tumors were excised and placed in OCT on dry ice. After full freezing, 10 pm cryosections were cut, dried for 30 min and exposed to a high resolution phosphor screen for 16 h. The screen was analyzed using a phosphor imager (Cyclone Plus, Perkin Elmer). The results are shown in Figure 6B.

Example 8 - Experimental Lung Disease Model of Fibrosis induced through Bleomycin - SPECT/CT imaging studies.

Female C57BL/6 mice were instilled with 2 U/kg bodyweight Bleomycin (Bleomycin Baxter). For this mice were anesthetized by intraperitoneal injection of a mix of ketamine (80 mg/kg bodyweight) and xylazine (10 mg/kg). Mice were left in a chamber containing 100% oxygen for 5-10 min, before intratracheal application of Bleomycin.

Two weeks after Bleomycin instillation, mice were injected into the tail vein with 10-15 MBq of [ 111 ln]ln-NODAGA FnBPA5.1 , previously diluted with PBS to a concentration of 10-15 MBq/mL. At 24 h p.i., mice were put under isoflurane/oxygen anesthesia and subjected to a SPECT/CT scan with a NanoSPECT/CT camera (Mediso Medical Imaging Systems, Budapest, Hungary). Data was reconstructed with HiSPECT software (version 1.4.3049, Scivis GmbH, Gottingen, Germany) and analyzed using VivoQuant (version 3.5, inviCRO Imaging Services and Software, Boston USA). SPECT images were processed after application of a post-reconstruction filter. Scale of activity was set to 0 - 2.6 Bq/voxel. The results are shown in Figure 7.

Example 9 - Experimental Lung Disease Model of Fibrosis induced through Bleomycin - Autoradiography.

After CO2 euthanasia of SPECT/CT mice of Example 8, they were instantly perfused with 10 mL Ringer acetate supplemented with 50’000 units of Heparin through the right heart ventricle. Thereafter, 5 mL of OCT/PBS (50:50) were infused and tumors were excised and placed in OCT on dry ice. After full freezing, 10 m cryosections were cut, dried for 30 min and exposed to a high-resolution phosphor screen for 16 h. The screen was analyzed using a phosphor imager (Cyclone Plus, Perkin Elmer). The results are shown in Figure 7.