A recent phase II clinical trial has highlighted the potential of urokinase-type plasminogen activator receptor (uPAR) targeted positron emission tomography (PET) imaging in predicting the prognosis of patients with gliomas, the most common type of primary brain cancer. The study, published in EJNMMI Research, suggests that high uPAR expression, as detected by PET imaging, is associated with significantly poorer survival outcomes.
The investigator-initiated trial, conducted at Copenhagen’s Rigshospitalet, involved 24 patients with primary gliomas of varying grades. The study utilized 68Ga-NOTA-AE105 uPAR-PET/MR (uTRACE) to assess uPAR expression levels within the tumors. The primary objective was to determine the prognostic value of uPAR-PET and estimate the proportion of patients who might benefit from future uPAR-targeted radioligand therapy (uTREAT).
The results indicated that 67% of the patients had WHO grade 4 gliomas, 25% had grade 3, and 8% had grade 2. Notably, almost all (94%) of the grade 4 gliomas (glioblastomas) were uPAR-PET positive. With a median follow-up of 18.8 months, high uPAR expression was significantly correlated with worse overall survival (hazard ratio of 14.3, 95% CI: 1.8-112.3, P=0.011) and progression-free survival (hazard ratio of 26.5, 95% CI: 3.3-214.0, P=0.0021).
Clinical Implications
The study's findings suggest that uPAR-PET imaging could serve as a valuable tool in the management of brain tumors. According to the authors, "The majority of glioma patients and almost all with grade 4 gliomas displayed uPAR positive lesions," and "High uPAR expression is significantly correlated with worse survival outcomes for patients."
Curasight CEO Ulrich Krasilnikoff commented on the results, stating, "We are extremely excited about the completed phase II study in brain cancer and its clear results underscores the relevance of both uTRACE and uTREAT in brain cancer and in glioblastoma in particular...With regard to uTRACE, its ability to visualize glioma tumor tissue and to predict both survival and tumor progression, makes it an obvious tool in the management of brain tumors."
About Gliomas and Glioblastomas
Glioblastoma is an aggressive form of brain cancer with a poor prognosis. Approximately 65,000 patients are diagnosed with primary brain tumors annually in the US and EU, with over 30,000 of these being glioblastomas. The prognosis for glioblastoma patients is grim, with approximately 50% dying within 14 months and only 5% surviving beyond five years from diagnosis. These statistics highlight the urgent need for innovative and effective treatments.
Curasight's uPAR Theranostic Platform
Curasight is a clinical development company focused on exploiting its uTRACE and uTREAT theranostic platform, which targets the urokinase-type plasminogen activator receptor (uPAR). This technology aims to improve the diagnosis and treatment of various cancer types.
