Fluorodopa F-18
A tracer originally built to look at brain dopamine cells in suspected Parkinson's disease. Because certain hormone-producing tumours use the same chemical machinery, doctors also use it, off-label, to find those tumours -- especially adrenal gland tumours called pheochromocytoma.
Overview
Fluorodopa F 18 Injection was approved by FDA in 2019 (NDA 200655, sponsor The Feinstein Institutes for Medical Research) solely for PET imaging of dopaminergic nerve terminals in adults with suspected Parkinsonian syndromes; that is a neurological indication, not an oncological one, and it is the only indication on the US label. The recommended dose is 185 MBq (5 mCi) IV.
In oncology, 18F-FDOPA is used off-label, but with strong evidence and explicit guideline support: the 2019 EANM/SNMMI procedure standard for phaeochromocytoma and paraganglioma names 18F-FDOPA (alongside 123I-MIBG) as a first-line tracer, ahead of 68Ga-DOTATATE and 18F-FDG. In a prospective head-to-head study of 97 patients, FDOPA detected all 55 confirmed pheochromocytomas versus 25 of 55 for 68Ga-DOTATOC (sensitivity 100% vs 49%, p<0.0001), though DOTATATE-family tracers retain an edge for extra-adrenal and SDHx-related metastatic disease. FDOPA is also used, again off-label, in brain tumour imaging (glioma grading and recurrence, alongside FET) under joint EANM/EANO/RANO/SNMMI amino-acid PET guidelines.
A fluorinated analogue of L-DOPA that is taken up by the amino-acid transport system and converted by aromatic L-amino-acid decarboxylase (AADC) into a trapped dopamine analogue. Dopaminergic neurons take it up for the FDA-approved neurological indication; the same AADC pathway is highly active in cells of neural-crest and neuroendocrine origin, which is why the tracer also concentrates strongly in pheochromocytoma, paraganglioma and other well-differentiated neuroendocrine tumours.
1.Fluorodopa F-18 slips into a pocket on its target.
- Route
- Intravenous injection over 1 minute
- Schedule
- 185 MBq (5 mCi) in adults
Source: www.accessdata.fda.gov/drugsatfda_docs/label/2019/200655s000lbl.pdf. Doses are for orientation; the current label governs.
Approvals
| Region | Year | Indication |
|---|---|---|
| US | 2019 | PET imaging to visualise dopaminergic nerve terminals in the striatum in adults with suspected Parkinsonian syndromes (neurological indication; oncology use is off-label) |
Trials
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Latest papers
topQuery for this drug: (TITLE:"Fluorodopa F-18" OR ABSTRACT:"Fluorodopa F-18" OR TITLE:"18F-FDOPA" OR ABSTRACT:"18F-FDOPA" OR TITLE:"6-[18F]fluoro-L-DOPA" OR ABSTRACT:"6-[18F]fluoro-L-DOPA" OR TITLE:"Fluorodopa F 18 Injection" OR ABSTRACT:"Fluorodopa F 18 Injection") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Fluorodopa F-18, not a curated reading list.
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