Development of Highly Potent Clinical Candidates for Theranostic Applications against Cholecystokinin‑2 Receptor Positive Cancers

Peptide receptor radionuclide therapy (PRRT) is a promising form of systemic radiation therapy designed to eradicate cancer. Cholecystokinin-2 receptor (CCK2R) is an important molecular target that is highly expressed in a range of cancers. This study describes the synthesis and in vivo characterization of a novel series of 177Lu-labeled peptides ([177Lu]­Lu-2b–4b) in comparison with the reference CCK2R-targeting peptide CP04 ([177Lu]­Lu-1b). [177Lu]­Lu-1b-4b showed high chemical purity (HPLC ≥ 94%), low Log D 7.4 (−4.09 to −4.55) with strong binding affinity to CCK2R (K D 0.097–1.61 nM), and relatively high protein binding (55.6–80.2%) and internalization (40–67%). Biodistribution studies of the novel 177Lu-labeled peptides in tumors (AR42J and A431-CCK2R) showed uptake one- to eight-fold greater than the reference compound CP04 at 1, 24, and 48 h. Rapid clearance and high tumor uptake and retention were established for [177Lu]­Lu-2b–4b, making these compounds excellent candidates for theranostic applications against CCK2R-expressing tumors.