Rapid liver and spleen
opsonization of systemically administered
nanoparticles (NPs) for in vivo applications remains
the Achilles’ heel of nanomedicine, allowing only a small fraction
of the materials to reach the intended target tissue. Although focusing
on diseases that reside in the natural disposal organs for nanoparticles
is a viable option, it limits the plurality of lesions that could
benefit from nanomedical interventions. Here we designed a theranostic
nanoplatform consisting of reactive oxygen (ROS)-generating titanium
dioxide (TiO2) NPs, coated with a tumor-targeting agent,
transferrin (Tf), and radiolabeled with a radionuclide (89Zr) for targeting bone marrow, imaging the distribution of the NPs,
and stimulating ROS generation for cell killing. Radiolabeling of
TiO2 NPs with 89Zr afforded thermodynamically
and kinetically stable chelate-free 89Zr-TiO2-Tf NPs without altering the NP morphology. Treatment of multiple
myeloma (MM) cells, a disease of plasma cells originating in the bone
marrow, with 89Zr-TiO2-Tf generated cytotoxic
ROS to induce cancer cell killing via the apoptosis
pathway. Positron emission tomography/X-ray computed tomography (PET/CT)
imaging and tissue biodistribution studies revealed that in
vivo administration of 89Zr-TiO2-Tf
in mice leveraged the osteotropic effect of 89Zr to selectively
localize about 70% of the injected radioactivity in mouse bone tissue.
A combination of small-animal PET/CT imaging of NP distribution and
bioluminescence imaging of cancer progression showed that a single-dose 89Zr-TiO2-Tf treatment in a disseminated MM mouse
model completely inhibited cancer growth at euthanasia of untreated
mice and at least doubled the survival of treated mice. Treatment
of the mice with cold Zr-TiO2-Tf, 89Zr-oxalate,
or 89Zr-Tf had no therapeutic benefit compared to untreated
controls. This study reveals an effective radionuclide sensitizing
nanophototherapy paradigm for the treatment of MM and possibly other
bone-associated malignancies.