Process validation, current good manufacturing practice production, dosimetry, and toxicity studies of the carbonic anhydrase IX imaging agent [¹¹¹In]In-XYIMSR-01 for phase I regulatory approval

[¹¹¹In]In-XYIMSR-01 is a promising single-photon emission computed tomography (SPECT) imaging agent for identification of tumors that overexpress carbonic anhydrase IX. To translate [¹¹¹In]In-XYIMSR-01 to phase I trials, we performed animal toxicity and dosimetry studies, determined the maximum dose for human use, and completed the chemistry, manufacturing, and controls component of a standard regulatory application. The production process, quality control testing, stability studies, and specifications for sterile drug product release were based on United States Pharmacopeia chapters <823> and <825>, FDA 21 CFR Part 212. Toxicity was evaluated by using nonradioactive [^113/115In]In-XYIMSR-01 according to 21 CFR Part 58 guidelines. Organ Level INternal Dose Assessment/EXponential Modeling (OLINDA/EXM) was used to calculate the maximum single dose for human studies. Three process validation runs at starting radioactivities of ~800 MBq were completed with a minimum concentration of 407 MBq/ml and radiochemical purity of ≥99% at the end of synthesis. A single intravenous dose of 55 μg/ml of [^113/115In]In-XYIMSR-01 was well tolerated in male and female Sprague–Dawley rats. The calculated maximum single dose for human injection from dosimetry studies was 390.35 MBq of [¹¹¹In]In-XYIMSR-01. We have completed toxicity and dosimetry studies as well as validated a manufacturing process to test [¹¹¹In]In-XYIMSR-01 in a phase I clinical trial.