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Cu-64 DOTA-trastuzumab is a radioimmunoconjugate (radioimmunoimaging agent) consisting of the recombinant humanized monoclonal antibody trastuzumab conjugated with the bifunctional macrocyclic chelating agent DOTA (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) and radiolabeled with the positron-emitting radioisotope copper-64 (Cu-64). Developed primarily at City of Hope, this diagnostic imaging agent targets human epidermal growth factor receptor 2 (HER2) with high affinity. Upon binding to HER2-expressing tumor cells, the Cu-64 radioisotope can be detected via positron emission tomography (PET) imaging, enabling non-invasive visualization, staging, and quantification of HER2-positive tumors. It is investigated as a diagnostic tool in HER2-positive breast cancer (including metastatic disease and brain metastases) and gastric cancer to predict patient response to HER2-targeted therapies such as trastuzumab emtansine (T-DM1) or trastuzumab deruxtecan.
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