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[18F]AlF-NOTA-PCP2 is a hydrophilic, peptide-based radiopharmaceutical designed for positron emission tomography (PET) imaging of Programmed death-ligand 1 (PD-L1) expression. It consists of the PCP2 peptide conjugated to a NOTA chelator and labeled with aluminum [18F]fluoride. The tracer exhibits high affinity for PD-L1 (IC50 = 24.7 nM) and is used to noninvasively quantify PD-L1 status in tumors, particularly in head and neck cancer (HNC). Clinical studies have demonstrated its utility in predicting and monitoring response to PD-1/PD-L1 checkpoint inhibitors like pembrolizumab, where early reduction in tracer uptake correlates with therapeutic efficacy. It offers a dynamic alternative to static biopsies, accounting for PD-L1 expression heterogeneity.
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