The FP7 project MITIGATE will develop a closed-loop molecular environment for minimally invasive treatment of patients with metastatic Gastrointestinal Stromal Tumours (GIST).

The MITIGATE consortium representing three European universities, three research organisations and four SMEs will pursue the ultimate goal to develop new protocols and guidelines to effectively diagnose and treat patients with metastatic GIST resistant to current treatment.
Currently, there are no dedicated and specific procedures available for GIST imaging. The MITIGATE project has developed a novel approach for the radiopharmaceutical preparation of 68Ga-labelled peptides. This approach is used to produce a PET diagnostic agent for GIST imaging under the name NeoBOMB1.

The NeoBOMB1 peptide binds with high affinity to the Gastrin Releasing Peptide Receptors (GRPR) overexpressed in GIST tumours and can be efficiently labelled with the metallic positron emitter Gallium 68 (68Ga). This radionuclide has attracted interest and it is being increasingly employed as a radionuclide for PET imaging, thanks to its radiochemical characteristics (68 min half-life, high positron emission yield) and the large availability of 68Ge/68Ga generators, which makes its production independent from cyclotrons. The advantages of such a tracer and its innovative aspects are the following:

- The 68Ga-labelled NeoBOMB1 is a molecular PET imaging probe that targets a specific class of receptors (GRPR), overexpressed on GIST cancer cells (as compared to 18F-FDG, for example, whose uptake is based on a metabolic process)
- The novel approach guarantees a straightforward, reproducible and accessible radiolabelling procedure, allowing for direct reconstitution of the NeoBOMB1 peptide with the Gallium-68 solution obtained from commercially available generators, without the need of additional steps for product purification.

In addition to the PET-based approach, MITIGATE is also developing quantitative imaging with novel functional magnetic resonance imaging (fMRI) protocols for the assessment of drug resistance. Using these fMRI protocols it is possible to characterise TKI-sensitive and TKI-resistance GIST tumours. The developed protocols are based on T2w, DCE, CEST, DWI and 23Na X-MRI imaging.
GOAL OF THIS SURVEY

The goal of this short survey (5 minutes) is to assess the end-user community and their interest in the products developed by MITIGATE.

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* 1. Where are you working?

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* 2. What is your institution’s current imaging technique used to detect and diagnose GIST tumours?

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* 3. Is your method able to discriminate between Imatinib-sensitive and –resistant GIST tumours?

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* 4. Would you be interested in an MRI procedure able to distinguish between Imatinib-sensitive and –resistant tumours?

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* 5. Would you be interested in a radiopharmaceutical PET imaging agent (a specific peptide) able to detect GIST tumours?

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* 6. What would be an acceptable price level for your institution for PET analysis of GIST tumours?

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* 7. Would you be interested in a ready-to-use kit for direct and easy radiolabelling of tracer peptides at the time of imaging?

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* 8. If yes, what would you pay for such a kit?

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* 9. Do you have a MR system with Multi Nuclei Option?

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* 10. Are you using or planning to use 23Na MRI in your institution?

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* 11. If you are interested in learning more about the MITIGATE project and would like to receive our annual newsletter, please enter your contact details below.

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* 12. Do you have any general comments or remarks?

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