[<sup>177</sup>Lu]Lu-AKIR001 for CD44v6-Positive Pancreatic Cancer: Preclinical Efficacy and Combination Strategies.

Gustafsson, Amanda; Svedberg, Hedvig; Rinne, Sara S; Bertilsson, Filippa; Selvaraju, Ram Kumar; Lundgren Mortensen, Anja C; Lindskog, Cecilia; Nestor, Marika · J Nucl Med · 2026

basic_science · Level V

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Abstract

Pancreatic ductal adenocarcinoma (PDAC) is highly aggressive, with a 5-y survival rate of less than 5% for patients with advanced disease. CD44v6 is frequently overexpressed in the malignancy, representing a promising therapeutic target. Here, we evaluated the efficacy of [<sup>177</sup>Lu]Lu-AKIR001, a CD44v6-targeting radiopharmaceutical, alone and combined with chemotherapy for the treatment of PDAC. <b>Methods:</b> CD44v6 expression, radioligand binding, and chemotherapy sensitivity were assessed in PDAC cell lines. Mice bearing PDAC xenografts received [<sup>177</sup>Lu]Lu-AKIR001, chemotherapy, or a combination of the two modalities. Toxicity was determined by body weight monitoring and hematologic and organ analyses. <b>Results:</b> Three of the 4 cell lines expressed CD44v6. In vivo, tumor uptake exceeded 100 %IA/g. Tumor growth inhibition was activity-dependent, with complete remissions detected after the administration of 12 MBq of [<sup>177</sup>Lu]Lu-AKIR001 (40%) and 4 MBq of [<sup>177</sup>Lu]Lu-AKIR001 combined with paclitaxel (14%). <b>Conclusion:</b> [<sup>177</sup>Lu]Lu-AKIR001 demonstrated activity-dependent therapeutic potential in mice bearing PDAC xenografts. Combination therapy with paclitaxel indicated potential synergistic benefit, but further investigation and optimization are warranted.