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JZQ-B4 is a mesothelin (MSLN)-specific nanobody (VHH) developed as a carrier for targeted radiotherapy and imaging. Nanobodies typically exhibit rapid renal clearance and high kidney retention due to their small size, which can lead to dose-limiting radiation nephropathy. To address this, JZQ-B4 has been rationally engineered through fusion with albumin-binding nanobodies to extend its circulation half-life and modified with specific amino acid linkers to enhance renal clearance of the radiolabeled construct. It has been evaluated with various radioactive payloads, including Zirconium-89 (Zr89) for PET imaging and Lutetium-177 (Lu177) or Actinium-225 (Ac225) for beta/alpha-particle therapy. Preclinical studies conducted at the Houston Methodist Research Institute and Weill Cornell Medical College have demonstrated that these modifications significantly improve the tumor-to-kidney ratio, enhancing the efficacy of targeted radiotherapy in mesothelin-expressing tumor models.
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