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**131i-tm601** is a synthetic radiolabeled peptide drug developed for the targeted treatment and imaging of tumors, particularly high-grade gliomas and other brain cancers. It consists of TM601, a synthetic version of chlorotoxin—a 36-amino-acid peptide originally isolated from the venom of the giant Israeli scorpion (Leiurus quinquestriatus)—covalently linked to radioactive iodine (Iodine-131). The drug selectively binds to tumor cells expressing Annexin A2 and matrix metalloproteinase 2 (MMP2), both overexpressed in various malignancies but not in normal tissues. Upon binding, it delivers localized beta radiation to tumor cells while sparing healthy tissue. In addition to its cytotoxic effect via radiation, TM601 exhibits antiangiogenic activity by inhibiting MMP2-mediated processes involved in tumor growth and metastasis. Early clinical trials demonstrated that it can cross the blood-brain barrier when administered intravenously or directly into tumor cavities, with promising safety profiles and evidence of selective tumor uptake[1][5][7][9].
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