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99mTc-HYNIC-IL2 is an investigational radiopharmaceutical imaging agent developed by the Mayo Clinic for the non-invasive visualization of tumor-infiltrating lymphocytes (TILs). The agent consists of recombinant human interleukin-2 (IL-2) conjugated with hydrazinonicotinamide (HYNIC) and labeled with the radionuclide technetium-99m (99mTc), utilizing tricine as a coligand. It specifically targets the IL-2 receptor (CD25) expressed on activated T lymphocytes. In clinical pilot studies, 99mTc-HYNIC-IL2 scintigraphy is being evaluated in patients with stage IV metastatic melanoma undergoing immunotherapy with checkpoint inhibitors (such as ipilimumab or pembrolizumab). The primary goal is to differentiate between true tumor progression and inflammatory pseudoprogression by assessing the presence and changes in TIL density within metastatic lesions.
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