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68Ga-FZ-NRs is a novel, nectin-4-targeted radiopharmaceutical designed for positron emission tomography (PET) imaging. It consists of a bicyclic peptide ligand that binds covalently to Nectin-4, a cell surface protein highly overexpressed in urothelial carcinoma and other solid tumors. The covalent binding is achieved through a Sulfur(VI) Fluoride Exchange (SuFEx) bio-orthogonal strategy, which enhances tumor enrichment and retention compared to non-covalent ligands. Developed by researchers at Fudan University Shanghai Cancer Center, it serves as the diagnostic component of a theranostic pair, with 177Lu-FZ-NRs serving as the therapeutic counterpart for targeted radionuclide therapy. Clinical translation studies have demonstrated its ability to precisely localize lesions in patients with urothelial carcinoma with high tumor-to-muscle ratios.
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