Open Access Article
This Open Access Article is licensed under a
Creative Commons Attribution 3.0 Unported Licence

Picolinamide-functionalized macrocyclic chelators for 203/212Pb theranostic radiotracers

Bradley E. Osborne*ab, Christina Siakalliab, Ryan K. Browna, Andrew J. P. Whitea, Claudia Roccoc, Dominik Weissc, Estefanía Delgado-Pinard, Enrique García-Españad, Jane K. Sosabowskie, Michelle T. Mab and Nicholas J. Long*a
aDepartment of Chemistry, Imperial College London, Molecular Sciences Research Hub, White City Campus, London, W12 0BZ, UK. E-mail: n.long@imperial.ac.uk; b.osborne18@imperial.ac.uk
bSchool of Biomedical Engineering and Imaging Sciences, King's College London, 4th Floor Lambeth Wing and St Thomas’ Hospital, London, SE1 7EH, UK
cDepartment of Earth Science and Engineering, Imperial College London, South Kensington Campus, London, SW7 2BP, UK
dInstitute of Molecular Sciences, Universitat de València, València, Spain
eCentre for Cancer Biomarkers and Biotherapeutics, Barts Cancer Institute, Queen Mary University of London, London, UK

Received 13th May 2026 , Accepted 9th June 2026

First published on 11th June 2026


Abstract

Picolinamide-functionalized macrocyclic ligands represent a promising class of chelators for 203/212Pb-based theranostic applications, offering a dual role in both diagnostic imaging and targeted radiotherapy. In this study, two 18-membered diazacrown ligands, K22_PicAm and the novel NPK_PicAm, were synthesized and complexed with both non-radioactive Pb2+ and radiotherapeutic 212Pb2+. Structural characterization via NMR spectroscopy and X-ray diffraction confirmed the formation of a single, highly rigid, symmetric [Pb(K22_PicAm)]2+ species. Density Functional Theory (DFT) and Natural Bond Orbital (NBO) analysis indicated stereochemically inactive 6s2 lone pairs in the Pb2+ complexes, leading to holodirected geometries. UV-vis spectroscopy and potentiometric titrations showed both ligands form highly stable Pb2+ complexes, with complete binding by K22_PicAm and NPK_PicAm between pH 4 and 9. Radiolabelling studies with 212Pb demonstrated near-quantitative radiochemical conversion within 15 minutes. These results establish picolinamide-bearing macrocycles as promising candidates for the development of next-generation, targeted 203/212Pb theranostic agents and support their further exploration in radiopharmaceutical research.


Introduction

Lead(II)-based (Pb2+) radiopharmaceuticals have gained significant interest in oncology due to their unique properties, offering a promising dual role in both diagnostic imaging and targeted radiotherapy.1–3 Theranostic “look and treat” radiopharmaceuticals use pairs of radionuclides that are incorporated into the same or similar molecular architectures that target receptors selectively expressed on the surface of tumour cells. Indeed, these molecular pharmaceuticals have transformed treatment outcomes for many cancer patients, particularly in neuroendocrine and prostate cancer.4,5 The first diagnostic radiopharmaceutical enables tumour imaging using either Positron (β+) Emission Tomography (PET), or Single Photon Computed Tomography (SPECT), selecting patients who are eligible for the second, systemic therapeutic radiopharmaceutical, which emits cytotoxic alpha- (α), beta- (β), or Auger particles.6–9 Either same-element isotope pairs (“true theranostics”) or different-element isotope pairs can be employed.10,11 For example, receptor-targeted peptide derivatives incorporating the PET radionuclide, gallium-68 (68Ga, t1/2 = 68 minutes) are used to stratify patients for companion receptor-targeted radiotherapies containing β-emitting lutetium-177 (177Lu, t1/2 = 6.65 days).12 Same-element isotope pairs, such as lead-203 (203Pb, t1/2 = 51.9 hours) and lead-212 (212Pb, t1/2 = 10.6 hours) are appealing as they enable a “true” molecular match, with the diagnostic agent having an identical chemical structure to the radiotherapeutic agent. 203Pb is a suitable SPECT radionuclide; significantly, therapeutic 212Pb emits both β-particles, and an α-particle via the decay of its daughter nuclide bismuth-212 (212Bi, t1/2 = 60.6 minutes).2,13–17 Preclinical studies with 203Pb- and 212Pb-based radiopharmaceuticals have demonstrated promising tumour targeting and therapeutic efficacy in pancreatic, melanoma, prostate, ovarian, and breast cancer models.18–29 Notably, 212Pb-radiopharmaceuticals are now advancing through early-phase clinical trials, showing favourable biodistribution and safety profiles in prostate, ovarian, and breast cancer.30–35

Chelators are critical to radiometal-based radiopharmaceuticals, as their resulting complexes need to possess sufficient thermodynamic and kinetic stability to deliver payload to diseased tissue in vivo.36,37 DOTAM (TCMC, Fig. 1) is cited as the “gold-standard” for Pb2+-based radiopharmaceuticals: its intermediate Lewis basic amides are more suitable for Pb2+ coordination compared to the analogous carboxylates of the prevalently used chelator, DOTA (Fig. 1).36,38,39 Alongside DOTA and DOTAM, which are prevalently used in radiopharmaceuticals, several families of macrocyclic chelators have also been investigated for the complexation of Pb2+ radionuclides.40–46 In particular, macropa (Fig. 1), an 18-membered macrocyclic chelator with picolinic acid pendant arms,47 has demonstrated exceptional selectivity and radiochemical labelling efficiency with Pb2+.44,48 We hypothesized that substituting the picolinic acid pendant arms with picolinamide groups would further enhance the kinetic inertness and thermodynamic stability of the Pb2+ complexes. Although not yet reported for radiopharmaceutical purposes, K22_PicAm (Fig. 1) was first used for the complexation of Eu2+ to investigate its size-discrimination ability and redox stabilisation.49 Here, we report the synthesis and characterisation of novel Pb2+ complexes of K22_PicAm, including a radiolabelled 212Pb2+ complex. We additionally report a novel nitrophenyl analogue of K22_PicAm, NPK_PicAm (Scheme 1), as a potential precursor to enable functionalisation of K22_PicAm with biomolecules (e.g. peptides) for targeting receptors of cancer cells, via the nitrophenyl motif.50


image file: d6qi01035k-f1.tif
Fig. 1 The structures of the chelators discussed in this work.

image file: d6qi01035k-s1.tif
Scheme 1 The synthesis of chelators K22_PicAm and NPK_PicAm. Reaction conditions: (i) methyl 6-(chloromethyl)picolinate, Na2CO3, MeCN, reflux, silica gel chromatography; (ii) NH3(aq) (35 wt%), 0 to 25 °C, reverse-phase chromatography.

Results and discussion

Synthesis of the chelators

K22_PicAm was synthesised in 21% yield from commercially available Kryptofix®22 by following a previously reported procedure51 (Scheme 1). NPK_PicAm was synthesised in a similar manner to K22_PicAm in two steps. Refluxing compound 2[thin space (1/6-em)]52 in anhydrous acetonitrile with 2.1 equivalents of methyl 6-(chloromethyl)picolinate, and 4 equivalents of sodium carbonate gave compound 3 as an orange oil. NPK_PicAm was obtained by aminolysis of 3, as a yellow solid in 38% yield after purification.

Solution-state structures of Pb2+ complexes

Pb2+ complexes were synthesised by the addition of 1.1 eq. of Pb(OAc)2·3H2O to a solution of the chelator in an aqueous NH4OAc solution (pH 4.5) at room temperature. After stirring for 15 minutes, the mixture was purified via reverse-phase chromatography, and the desired complexes characterised via NMR and MS (Fig. S13–S17, S19, S20, S24 and S25, SI). These complexation conditions were repeated in MeOD to record the complete reaction system and to assess the behaviour of the Pb2+ complexes in solution (Fig. 2). The 1H NMR spectrum of [Pb(K22_PicAm)]2+ is characteristic of a single highly rigid C2 symmetric species, evidenced by the presence of well-resolved aliphatic proton resonances, in contrast to other polyether complexes which are known to exhibit dynamic and fluxional behaviour.43,53 Further, geminal AB type splitting patterns are observed for all methylene and ethylene protons in the Pb2+ complex. The presence of a single, highly rigid species suggests that this complex could possess the requisite stability that is critical for in vivo applications. The 207Pb NMR spectrum of the complex [Pb(K22_PicAm)]2+ displays a single signal at −2289 ppm (Fig. 3 and Fig. S19, SI), versus Pb(NO3)2, which is within the range of macrocyclic crown systems with carboxylic acid and amide pendant arms reported previously (−2076 to −2299 ppm).40,41 Pb2+ complexation experiments with NPK_PicAm were undertaken by reacting 1 eq. of Pb2+ with 1 eq. of NPK_PicAm at 25 °C. 1H NMR, HRMS (ES-TOF+) and HPLC analyses (Fig. S20, S25, S29 and S30, SI) indicated the formation of a single product, consistent with the formation of [Pb(NPK_PicAm)]2+. The 1H NMR spectrum of [Pb(NPK_PicAm)]2+ was more complex than that of [Pb(K22_PicAm)]2+ (Fig. 2) due to the relative lower symmetry of the former, which arises from the incorporation of a nitrophenyl group. However, compared to [Pb(K22_PicAm)]2+, similar patterns in chemical shift changes were observed upon coordination of NPK_PicAm to Pb2+. HRMS (ES-TOF+) analysis showed the expected m/z signals for a complex of formula [Pb(NPK_PicAm)]2+. HPLC analysis showed the formation of a single Pb-bound species, with a retention time distinct to that of the free ligand.
image file: d6qi01035k-f2.tif
Fig. 2 1H NMR spectra of K22_PicAm, and [Pb(K22_PicAm)]2+, recorded in MeOD (400 MHz, 298 K).

image file: d6qi01035k-f3.tif
Fig. 3 207Pb{1H} NMR spectrum of [Pb(K22_PicAm)]2+, recorded in D2O (84 MHz, 298 K).

X-ray crystal structure of the [Pb(K22_PicAm)]2+ complex

Single crystals of [Pb(K22_PicAm)]-2PF6 suitable for X-ray diffraction studies (Fig. 4 and Fig. S41, Table S2, SI) were obtained. Bond distances and angles of the Pb2+ coordination environments are listed in Table 1 and Table S3, SI. Compound [Pb(K22_PicAm)]-2PF6 crystallizes in the tetragonal I4/m space group, with the crystal containing two non-coordinated PF6 anions. The Pb2+ metal ion in [Pb(K22_PicAm)]-2PF6 is ten-coordinated by the chelator, which binds through the two N and four O donor atoms of the macrocycle, two pyridyl N atoms, and two amide O atoms.47 The macrocyclic Pb–N and Pb–O distances (Table 1 and Table S3, SI) range from 2.89 to 3.05 Å, whereas pyridyl Pb–N distances (2.61 to 2.68 Å) are shorter. Amide Pb–O distances are shorter again (2.53 to 2.60 Å). The structure of [Pb(K22_PicAm)]-2PF6 displays shorter bond lengths involving donor atoms of the picolinamide pendant arms, whereas the donor atoms of the macrocyclic unit fall within a longer bond length range. This indicates that the donor atoms of the picolinamide pendant arms provide the strongest interactions with the Pb2+ ion. A similar trend in bond lengths was reported for the Pb2+ complex of macropa, in which the shortest bonds were observed between picolinate N and O donor atoms and Pb, with longer bond distances – similar to those observed here for [Pb(K22_PicAm)]-2PF6 – reported between macrocyclic N and O donors and Pb.47,48 An alternative trend in coordination of Pb2+ to multidentate macrocyclic chelators has also been reported, in which donor atoms of the macrocycle form stronger interactions with the Pb2+ metal ion compared to donor atoms of the pendant arms. This type of coordination has been observed in the Pb2+ complexes of the cyclen derivatives DOTA, DOTAM and THP-12-ane-N4, along with other azacrown macrocycles,39,41,54–56 although these structures are all considered to be hemidirected.
image file: d6qi01035k-f4.tif
Fig. 4 The structure of the cationic complex present in the crystal of [Pb(K22_PicAm)]-2PF6. Thermal ellipsoids are drawn at the 50% probability level. Hydrogen atoms and both PF6 anions are omitted for clarity.
Table 1 Bonding distances (Å) of the Pb2+ coordination environments in the X-ray structure of [Pb(K22_PicAm)]-2PF6 shown in Fig. 4
  [Pb(K22_PicAm)]-2PF6
Pb(1)–O(26) 2.534(4)
Pb(1)–O(35) 2.604(4)
Pb(1)–N(30) 2.613(5)
Pb(1)–N(21) 2.679(5)
Pb(1)–N(10) 2.890(5)
Pb(1)–O(7) 2.891(4)
Pb(1)–O(16) 2.910(4)
Pb(1)–O(13) 2.925(4)
Pb(1)–O(4) 3.015(4)
Pb(1)–N(1) 3.045(5)


DFT calculations

Having the electronic configuration [Xe]4f145d106s2, Pb2+ is one of the post-transition metal elements that exhibits the “inert pair effect”.57 The resulting lone pair of electrons are stereochemically active or inactive. Such Pb2+ complexes are termed as holodirected (inactive lone pair, even donor atom distribution) or hemidirected (active lone pair, uneven distribution of donor atoms), with the latter exhibiting lower stability under certain conditions.58 Hemidirected complexes are favoured by low coordination numbers, and hard and charged donor atoms, whereas holodirected complexes prefer high coordination numbers and soft donor atoms.59 Natural Bond Orbital (NBO) analysis can quantify the 6s2 lone pair character of Pb2+ complexes by analysing electron density distribution, orbital interactions, and hybridisation. If the lone pair has significant s-character with minimal 6p orbital mixing, it is likely to be stereochemically inactive, favouring holodirected geometry. Using DFT, NBO analysis of [Pb(K22_PicAm)]2+ and [Pb(NPK_PicAm)]2+ indicates that the Pb2+ lone pair is stereochemically inactive in both complexes due to the insignificant 6p contribution (0.59% and 0.60% respectively) to the 6s2 lone pair (Fig. S42–S45 and Table S5, S6, SI), signifying both complexes are holodirected. Initial geometries for K22_PicAm and NPK_PicAm and their respective Pb2+ complexes were taken from the crystal structure of macropa with modification of picolinate arms to picolinamide arms and the addition of a nitrophenyl group in the macrocyclic ring.48 The optimized structures of the Pb2+ complexes are consistent with the X-ray crystal structure [Pb(K22_PicAm)]-2PF6 in which there is no distinct void in the Pb2+ coordination sphere, indicative of a stereochemically inactive lone pair, supporting the presence of a holodirected complex.

Protonation constants and thermodynamic stability of the Pb2+ complexes

To investigate the properties and affinity of the new ligands for Pb2+, potentiometry and UV-Vis spectroscopy were used to determine the protonation constants (Ki) and the Pb2+ stability constants (KPbL) (Table 2). Consistent with previous reports,49 we find that potentiometric measurements resolve only two protonation constants for the systems studied. The second protonation constant (log[thin space (1/6-em)]KH2) determined in this study is in good agreement with literature values, while some variation is observed for the first constant (log[thin space (1/6-em)]KH1), which we attribute to differences in ionic strength and electrolyte. Comparison with the NPK_PicAm, for which potentiometric measurements provided well-defined constants (Table 2), supports the assigned value for the first protonation constant of K22_PicAm (log[thin space (1/6-em)]KH1 = 8.30). The observed UV-Vis absorption spectra suggest the presence of two different protonation processes. At acidic pH, the absorption spectrum displays a band centred at 270 nm, with shoulders at 262 and 276 nm. Upon gradual addition of NaOH(aq), the band broadens slightly and absorbance decreases until pH 5.6, followed by an increase in absorbance until pH 9.0, when a plateau is reached (Fig. S37, SI). The decrease in absorbance in acidic pH might correspond to the deprotonation of the pyridine nitrogen atoms while the increase in absorption correspond possibly to deprotonation of the tertiary ammonium groups of the macrocycle.60 While our observed UV-Vis trends are consistent with multiple protonation sites, the combined spectroscopic, potentiometric and literature data support a model in which the dominant observable equilibria correspond to the tertiary amine groups of the macrocyclic ring.41,54
Table 2 Protonation and Pb2+ complex formation constants for the ligands K22_PicAm and NPK_PicAm (L)
  Reaction K22_PicAm NPK_PicAm
a Determined by potentiometric titration in 0.15 M NaCl at 25 °C in this study.b Determined from spectroscopic titration data and using protonation constants obtained in this study.c Determined by potentiometric titration in 0.1 M KCl at 25 °C in a study reported by Regueiro–Figueroa et al.49d Calculated from spectroscopic titration data obtained in this study and using protonation constants reported in the literature.49 pPb corresponds to the negative logarithm of the equilibrium concentration of uncomplexed Pb2+ in the presence of the ligand at pH 7.4.
Log[thin space (1/6-em)]KH1 H+ + L ⇆ HL+ 7.90(2)a 7.08c 7.82(1)a
Log[thin space (1/6-em)]KH2 H+ + HL+ ⇆ H2L2+ 6.43(1)a 6.40c 5.422(7)a
Log[thin space (1/6-em)]KPbL Pb2+ + L ⇆ [PbL]2+ 14.19(2)b 13.28d 11.68(4)a
Log[thin space (1/6-em)]KPbLOH Pb2+ + L ⇆ [PbL(OH)]+ + H+     0.97(4)a
pPb   14.5 14.0 12.1


Potentiometric measurements indicate that complex formation occurs predominantly in a pH range where competition from protons is minimal, making the extraction of reliable stability constants (log[thin space (1/6-em)]KPbL) from these data challenging. Therefore, spectroscopic titrations were performed using solutions containing Pb2+ and K22_PicAm in a 0.9[thin space (1/6-em)]:[thin space (1/6-em)]1.0 molar ratio, titrated with aqueous NaOH starting from pH < 2 (Fig. S38, SI). Pb2+ complex formation is observed at low pH (approx. 2, see Fig. S38, SI). Absorption at 276 nm increases progressively with a maximum at pH 3.6, indicating quantitative formation of [Pb(K22_PicAm)]2+ ([PbL]2+). At pH above 10, absorbance slightly increases suggesting the formation of a minor hydroxide species [PbL(OH)]+. To determine the stability constant for the Pb-L complexes, a chemical model was developed using protonation constants derived from potentiometric measurements conducted during this study and a previous study.49 The spectrophotometric experimental titration data was fitted using the software program HypSpec.61 We find for the formation of a [PbL]2+ species log[thin space (1/6-em)]KPbL values ranging from 13.28 to 14.19, indicating quantitative complexation of lead at pH 7.4.

Both ligands achieve quantitative Pb2+ binding under mildly acidic conditions (pH 3–5) and K22_PicAm exhibits a higher apparent stability compared to NPK_PicAm and pPb for NPK_PicAm is two logarithmic units lower.

The incorporation of a rigidifying and electron-withdrawing nitrophenyl group into the macrocyclic backbone results in an expected decrease in thermodynamic stability. The speciation diagrams (Fig. 5) indicate that under the conditions tested here, all Pb2+ in solution is bound to the chelator, either K22_PicAm and NPK_PicAm, above pH ≈ 4 and below pH ≈ 9. Notably, this pH range is well aligned with conditions commonly employed for 203Pb/212Pb radiolabelling, and the efficient complex formation observed in this work is consistent with the results shown in the 212Pb labelling discussed below.


image file: d6qi01035k-f5.tif
Fig. 5 Speciation diagrams of the system Pb2+-L. (A) K22_PicAm; (B) NPK_PicAm.

Lead-212 radiolabelling studies

Radiolabelling reactions of K22_PicAm and NPK_PicAm with [212Pb]Pb2+ were undertaken. In these reactions, a solution of [212Pb]Pb(OAc)2 (∼1 MBq) was added to a solution of chelator and reacted for 15 minutes at either 37 °C or 95 °C, with the final reaction containing the pertinent chelator at a concentration of 1 mM, 100 µM, 50 µM, 10 µM or 5 µM, at pH 5.5, in 0.5 M NaOAc buffer. Radiochemical conversions (RCCs) were assessed using radio-iTLC and are summarised in Table S1, SI. Upon heating at 95 °C for 15 minutes, K22_PicAm produced near quantitative RCCs across all chelator concentrations (Fig. 6A). At 37 °C, and a chelator concentration of 100 µM, a RCY of 88% was achieved, and at a chelator concentration of 10 µM a RCC of 66% was achieved. Comparatively, for NPK_PicAm a steady decrease in RCC values was observed as the chelator concentration was decreased (Fig. 6B). At a chelator concentration of 1 mM (10−3 M), NPK_PicAm achieved a RCC value of 85%, whereas at a lower chelator concentration of 5 µM (5 × 10−6 M) a RCC value of 23% was achieved. Due to the lower RCC observed for NPK_PicAm at high temperature, we did not investigate [212Pb]Pb2+ labelling with NPK_PicAm at lower temperatures. These preliminary findings underscore the potential of the K22_PicAm ligand system as a foundation for developing Pb2+-based bifunctional chelators, paving the way for future structural refinements tailored to a broad spectrum of biological targeting vectors.
image file: d6qi01035k-f6.tif
Fig. 6 The radiochemical conversion (RCC) values for [212Pb]Pb2+ labelling with (A) K22_PicAm at chelator concentrations 1 mM to 5 µM over 15 minutes at 37 °C and 95 °C, and (B) NPK_PicAm at chelator concentrations 1 mM to 5 µM over 15 minutes at 95 °C.

Conclusions

In summary, we report two 18-membered diazacrown macrocyclic chelators bearing picolinamide pendant arms, K22_PicAm and NPK_PicAm for 212Pb radiopharmaceuticals. Structural NMR and X-ray diffraction studies show that [Pb(K22_PicAm)]2+ forms a single, highly rigid, symmetric species, and UV-Vis spectrophotometric and potentiometric titrations showed that both K22_PicAm and NPK_PicAm form highly stable Pb2+ complexes. Radiolabelling each of these chelators with 212Pb2+ achieved near-quantitative radiochemical conversion within 15 minutes at high temperatures.

As metallic radionuclides, such as 212Pb, with therapeutically efficacious decay profiles become available for clinical application, chelator technologies such as K22_PicAm and NPK_PicAm are critical to enable their therapeutic application, to benefit patients. Recent first-in-human translational studies of radiotherapeutic 212Pb agents highlight the significant potential of K22_PicAm and NPK_PicAm chelators as chemical platforms for the development of 203/212Pb-based theranostic agents. Further functionalisation of these chelators with receptor-targeted motifs will transform the K22_PicAm scaffold into a precision-guided tool for application as a molecular theranostic agent in combination with lead radionuclides.

Author contributions

BEO synthesised the compounds, performed the analyses, carried out the radiolabelling, and DFT calculations. X-ray crystallography was performed by RKB. Potentiometric titrations were performed by CS. UV-Vis spectrophotometric titrations were performed by ED-P and EG-E. MTM and NJL supervised the project, and all the authors contributed to the writing of the manuscript.

Conflicts of interest

There are no conflicts to declare.

Data availability

All the relevant research data is contained with the manuscript and supplementary information (SI). Supplementary information is available. See DOI: https://doi.org/10.1039/d6qi01035k.

No databases have been used and no references to such databases are contained in the manuscript or SI.

CCDC 2432138 contains the supplementary crystallographic data for this paper.62

Acknowledgements

This research was supported by the EPSRC programme for Next Generation Molecular Imaging and Therapy with Radionuclides (EP/S019901/1, “MITHRAS”) and Cancer Research UK (C63178/A24959).

References

  1. J. C. dos Santos, M. Schäfer, U. Bauder-Wüst, W. Lehnert, K. Leotta, A. Morgenstern, K. Kopka, U. Haberkorn, W. Mier and C. Kratochwil, Development and dosimetry of 203Pb/212Pb-labelled PSMA ligands: bringing “the lead” into PSMA-targeted alpha therapy?, Eur. J. Nucl. Med. Mol. Imaging, 2019, 46, 1081–1091 CrossRef CAS PubMed.
  2. R. G. Li, V. Y. Stenberg and R. H. Larsen, An Experimental Generator for Production of High-Purity 212Pb for Use in Radiopharmaceuticals, J. Nucl. Med., 2023, 64, 173–176 CrossRef CAS PubMed.
  3. H. S. Chong, H. A. Song, X. Ma, D. E. Milenic, E. D. Brady, S. Lim, H. Lee, K. Baidoo, D. Cheng and M. W. Brechbiel, Novel bimodal bifunctional ligands for radioimmunotherapy and targeted MRI, Bioconjugate Chem., 2008, 19, 1439–1447 CrossRef CAS PubMed.
  4. J. Strosberg, G. El-Haddad, E. Wolin, A. Hendifar, J. Yao, B. Chasen, E. Mittra, P. L. Kunz, M. H. Kulke, H. Jacene, D. Bushnell, T. M. O'Dorisio, R. P. Baum, H. R. Kulkarni, M. Caplin, R. Lebtahi, T. Hobday, E. Delpassand, E. Van Cutsem, A. Benson, R. Srirajaskanthan, M. Pavel, J. Mora, J. Berlin, E. Grande, N. Reed, E. Seregni, K. Öberg, M. Lopera Sierra, P. Santoro, T. Thevenet, J. L. Erion, P. Ruszniewski, D. Kwekkeboom and E. Krenning, Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors, N. Engl. J. Med., 2017, 376, 125–135 CrossRef CAS PubMed.
  5. O. Sartor, J. de Bono, K. N. Chi, K. Fizazi, K. Herrmann, K. Rahbar, S. T. Tagawa, L. T. Nordquist, N. Vaishampayan, G. El-Haddad, C. H. Park, T. M. Beer, A. Armour, W. J. Pérez-Contreras, M. DeSilvio, E. Kpamegan, G. Gericke, R. A. Messmann, M. J. Morris and B. J. Krause, Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer, N. Engl. J. Med., 2021, 385, 1091–1103 CrossRef CAS PubMed.
  6. T. I. Kostelnik and C. Orvig, Radioactive Main Group and Rare Earth Metals for Imaging and Therapy, Chem. Rev., 2019, 119, 902–956 CrossRef CAS PubMed.
  7. S. L. Pimlott and A. Sutherland, Molecular tracers for the PET and SPECT imaging of disease, Chem. Soc. Rev., 2010, 40, 149–162 RSC.
  8. D. E. Milenic and M. W. Brechbiel, Targeting of Radio-Isotopes for Cancer Therapy, Cancer Biol. Ther., 2004, 3, 361–370 CrossRef CAS PubMed.
  9. L. Filippi, A. Chiaravalloti, O. Schillaci, R. Cianni and O. Bagni, Theranostic approaches in nuclear medicine: current status and future prospects, Expert Rev. Med. Devices, 2020, 17, 331–343 CrossRef CAS.
  10. N. H. Álvarez, D. Bauer, J. Hernández-Gil and J. S. Lewis, Recent Advances in Radiometals for Combined Imaging and Therapy in Cancer, ChemMedChem, 2021, 16, 2909–2941 CrossRef PubMed.
  11. C. Miller, J. Rousseau, C. F. Ramogida, A. Celler, A. Rahmim and C. F. Uribe, Implications of physics, chemistry and biology for dosimetry calculations using theranostic pairs, Theranostics, 2022, 12, 232–259 CrossRef CAS PubMed.
  12. S. R. Banerjee, V. Kumar, A. Lisok, J. Chen, I. Minn, M. Brummet, S. Boinapally, M. Cole, E. Ngen, B. Wharram, C. Brayton, R. F. Hobbs and M. G. Pomper, 177Lu-labeled low-molecular-weight agents for PSMA-targeted radiopharmaceutical therapy, Eur. J. Nucl. Med. Mol. Imaging, 2019, 46, 2545–2557 CrossRef CAS PubMed.
  13. B. L. McNeil, A. K. H. Robertson, W. Fu, H. Yang, C. Hoehr, C. F. Ramogida and P. Schaffer, Production, purification, and radiolabeling of the 203Pb/212Pb theranostic pair, EJNMMI Radiopharm. Chem., 2021, 6, 6 CrossRef.
  14. T. Rold, N. Okoye, E. Devanny, A. Berendzen, T. Dresser, T. Quinn and T. Hoffman, Pb-203/Pb-212 Evaluation as Theranostic Pair for Prostate Cancer Detection, Monitoring, and Treatment, J. Nucl. Med., 2020, 61, 229 Search PubMed.
  15. D. Máthé, K. Szigeti, N. Hegedus, I. Horváth, D. S. Veres, B. Kovács and Z. Szucs, Production and in vivo imaging of 203Pb as a surrogate isotope for in vivo, 212Pb internal absorbed dose studies, Appl. Radiat. Isot., 2016, 114, 1–6 CrossRef PubMed.
  16. K. Yong and M. W. Brechbiel, Towards translation of 212Pb as a clinical therapeutic; getting the lead in!, Dalton Trans., 2011, 40, 6068–6076 RSC.
  17. B. J. B. Nelson, J. Wilson, M. K. Schultz, J. D. Andersson and F. Wuest, High-yield cyclotron production of 203Pb using a sealed 205Tl solid target, Nucl. Med. Biol., 2023, 116–117, 108314 CrossRef CAS.
  18. L. L. Chappell, E. Dadachova, D. E. Milenic, K. Garmestani, C. Wu and M. W. Brechbiel, Synthesis, characterization, and evaluation of a novel bifunctional chelating agent for the lead isotopes 203Pb and 212Pb, Nucl. Med. Biol., 2000, 27, 93–100 CrossRef CAS PubMed.
  19. V. Boudousq, L. Bobyk, M. Busson, V. Garambois, M. Jarlier, P. Charalambatou, A. Pèlegrin, S. Paillas, N. Chouin, F. Quenet, P. Maquaire, J. Torgue, I. Navarro-Teulon and J.-P. Pouget, Comparison between Internalizing Anti-HER2 mAbs and Non-Internalizing Anti-CEA mAbs in Alpha-Radioimmunotherapy of Small Volume Peritoneal Carcinomatosis Using 212Pb, PLoS One, 2013, 8, e69613 CrossRef CAS PubMed.
  20. Y. Miao, M. Hylarides, D. R. Fisher, T. Shelton, H. Moore, D. W. Wester, A. R. Fritzberg, C. T. Winkelmann, T. Hoffman and T. P. Quinn, Melanoma Therapy via Peptide-Targeted α-Radiation, Clin. Cancer Res., 2005, 11, 5616–5621 Search PubMed.
  21. Y. Miao, S. D. Figueroa, D. R. Fisher, H. A. Moore, R. F. Testa, T. J. Hoffman and T. P. Quinn, 203Pb-Labeled α-Melanocyte–Stimulating Hormone Peptide as an Imaging Probe for Melanoma Detection, J. Nucl. Med., 2008, 49, 823 Search PubMed.
  22. J. Yang, J. Xu, L. Cheuy, R. Gonzalez, D. R. Fisher and Y. Miao, Evaluation of a Novel Pb-203-Labeled Lactam-Cyclized Alpha-Melanocyte-Stimulating Hormone Peptide for Melanoma Targeting, Mol. Pharm., 2019, 16, 1694–1702 CrossRef CAS PubMed.
  23. T. A. R. Stallons, A. Saidi, I. Tworowska, E. S. Delpassand and J. J. Torgue, Preclinical Investigation of 212Pb-DOTAMTATE for Peptide Receptor Radionuclide Therapy in a Neuroendocrine Tumor Model, Mol. Cancer Ther., 2019, 18, 1012–1021 CrossRef CAS PubMed.
  24. B. Kasten, J. Fan, S. Ferrone, K. Zinn and D. Buchsbaum, Targeted radioimmunotherapy of triple negative breast cancer with CSPG4-specific 212Pb-labeled monoclonal antibody., J. Nucl. Med., 2016, 57, 114 Search PubMed.
  25. B. Kasten, J. Fan, S. Ferrone, K. Zinn and D. Buchsbaum, Targeted radioimmunotherapy of triple negative breast cancer with CSPG4-specific 212Pb-labeled monoclonal antibody., J. Nucl. Med., 2016, 57, 114 Search PubMed.
  26. B. B. Kasten, A. Gangrade, H. Kim, J. Fan, S. Ferrone, C. R. Ferrone, K. R. Zinn and D. J. Buchsbaum, 212Pb-labeled B7-H3-targeting antibody for pancreatic cancer therapy in mouse models, Nucl. Med. Biol., 2018, 58, 67–73 CrossRef CAS PubMed.
  27. B. B. Kasten, R. C. Arend, A. A. Katre, H. Kim, J. Fan, S. Ferrone, K. R. Zinn and D. J. Buchsbaum, B7-H3-targeted 212Pb radioimmunotherapy of ovarian cancer in preclinical models, Nucl. Med. Biol., 2017, 47, 23–30 CrossRef CAS PubMed.
  28. I. Quelven, J. Monteil, M. Sage, A. Saidi, J. Mounier, A. Bayout, J. Garrier, M. Cogne and S. Durand-Panteix, 212Pb α-Radioimmunotherapy Targeting CD38 in Multiple Myeloma: A Preclinical Study, J. Nucl. Med., 2020, 61, 1058 Search PubMed.
  29. M. Li, D. Liu, D. Lee, S. Kapoor, K. N. Gibson-Corley, T. P. Quinn, E. A. Sagastume, S. L. Mott, S. A. Walsh, M. R. Acevedo, F. L. Johnson and M. K. Schultz, Enhancing the Efficacy of Melanocortin 1 Receptor-Targeted Radiotherapy by Pharmacologically Upregulating the Receptor in Metastatic Melanoma, Mol. Pharm., 2019, 16, 3904–3915 CrossRef CAS.
  30. R. F. Meredith, J. J. Torgue, T. A. Rozgaja, E. P. Banaga, P. W. Bunch, R. D. Alvarez, J. M. J. Straughn, M. C. Dobelbower and A. M. Lowy, Safety and Outcome Measures of First-in-Human Intraperitoneal α Radioimmunotherapy With 212Pb-TCMC-Trastuzumab, Am. J. Clin. Oncol., 2018, 41, 716–721 CrossRef CAS PubMed.
  31. R. Meredith, J. Torgue, S. Shen, D. R. Fisher, E. Banaga, P. Bunch, D. Morgan, J. Fan and J. M. Straughn, Dose Escalation and Dosimetry of First-in-Human α Radioimmunotherapy with 212Pb-TCMC-Trastuzumab, J. Nucl. Med., 2014, 55, 1636 CrossRef CAS.
  32. R. F. Meredith, J. Torgue, M. T. Azure, S. Shen, S. Saddekni, E. Banaga, R. Carlise, P. Bunch, D. Yoder and R. Alvarez, Pharmacokinetics and Imaging of 212Pb-TCMC-Trastuzumab After Intraperitoneal Administration in Ovarian Cancer Patients, Cancer Biother. Radiopharm., 2013, 29, 12–17 CrossRef PubMed.
  33. E. S. Delpassand, I. Tworowska, R. Esfandiari, J. Torgue, J. Hurt, A. Shafie and R. Núñez, Targeted α-Emitter Therapy with 212Pb-DOTAMTATE for the Treatment of Metastatic SSTR-Expressing Neuroendocrine Tumors: First-in-Humans Dose-Escalation Clinical Trial, J. Nucl. Med., 2022, 63, 1326–1333 CrossRef CAS PubMed.
  34. M. R. Griffiths, D. A. Pattison, M. Latter, K. Kuan, S. Taylor, W. Tieu, T. Kryza, D. Meyrick, B. Q. Lee, A. Hansen, S. E. Rose and S. G. Puttick, First-in-Human 212Pb-PSMA–Targeted α-Therapy SPECT/CT Imaging in a Patient with Metastatic Castration-Resistant Prostate Cancer, J. Nucl. Med., 2024, 65(4), 664 CrossRef PubMed.
  35. K. Berner, E. Hernes, M. Kvassheim, M.-E. Revheim, J. Bastiansen, S. Selboe, C. L. Bakken, S. R. Grønningsæter, Ø.S Bruland, R. H. Larsen, L. Bouzelmat, V. L. Jardine and C. Stokke, First-in-Human Phase 0 Study of AB001, a Prostate-Specific Membrane Antigen–Targeted 212Pb Radioligand, in Patients with Metastatic Castration-Resistant Prostate Cancer, J. Nucl. Med., 2025, 66(5), 732–738 CrossRef CAS PubMed.
  36. E. W. Price and C. Orvig, Matching chelators to radiometals for radiopharmaceuticals, Chem. Soc. Rev., 2014, 43, 260–290 RSC.
  37. M. W. Brechbiel, Bifunctional Chelates for Metal Nuclides, Q. J. Nucl. Med. Mol. Imaging, 2008, 52, 166–173 CAS.
  38. R. G. Pearson, Hard and Soft Acids and Bases, J. Am. Chem. Soc., 1963, 85, 3533–3539 CrossRef CAS.
  39. R. D. Hancock, J. H. Reibenspies and H. Maumela, Structural Effects of the Lone Pair on Lead(II), and Parallels with the Coordination Geometry of Mercury(II). Does the Lone Pair on Lead(II) Form H-Bonds? Structures of the Lead(II) and Mercury(II) Complexes of the Pendant-Donor Macrocycle DOTAM (1,4,7,10-Tetrakis(carbamoylmethyl)-1,4,7,10-tetraazacyclododecane), Inorg. Chem., 2004, 43, 2981–2987 CrossRef CAS PubMed.
  40. C. Harriswangler, B. L. McNeil, I. Brandariz, L. Valencia, D. Esteban-Gómez, C. F. Ramogida and C. Platas-Iglesias, Incorporation of Carboxylate Pendant Arms into 18-Membered Macrocycles: Effects on [nat/203Pb]Pb(II) Complexation, Chem. – Eur. J., 2024, 30, e202400434 CrossRef CAS PubMed.
  41. C. Harriswangler, B. L. McNeil, I. Brandariz-Lendoiro, F. Lucio-Martínez, L. Valencia, D. Esteban-Gómez, C. F. Ramogida and C. Platas-Iglesias, Exploring the use of rigid 18-membered macrocycles with amide pendant arms for Pb(II)-based radiopharmaceuticals, Inorg. Chem. Front., 2024, 11, 1070–1086 RSC.
  42. M. L. Grieve, P. R. W. J. Davey, P. V. Bernhardt, C. M. Forsyth and B. M. Paterson, Rapid and stable complexation of the α-generators bismuth-212 and lead-212 with a tetraazamacrocyclic chelator bearing thiosemicarbazone pendant arms, Inorg. Chem. Front., 2024, 7307–7323 RSC.
  43. B. L. McNeil, K. J. Kadassery, A. W. McDonagh, W. Zhou, P. Schaffer, J. J. Wilson and C. F. Ramogida, Evaluation of the Effect of Macrocyclic Ring Size on [203Pb]Pb(II) Complex Stability in Pyridyl-Containing Chelators, Inorg. Chem., 2022, 61, 9638–9649 CrossRef CAS PubMed.
  44. P. Randhawa, K. J. Kadassery, B. L. McNeil, S. N. MacMillan, L. Wharton, H. Yang, J. J. Wilson and C. F. Ramogida, The H2Sx, macropa Series: Increasing the Chemical Softness of H 2 macropa with Sulfur Atoms to Chelate Radiometals [213Bi]Bi3+ and [203Pb]Pb2+ for Radiopharmaceutical Applications, Inorg. Chem., 2024, 63, 21177–21193 CrossRef CAS PubMed.
  45. M. Tosato, P. Randhawa, L. Lazzari, B. L. McNeil, M. Dalla Tiezza, G. Zanoni, F. Mancin, L. Orian, C. F. Ramogida and V. D. Marco, Tuning the Softness of the Pendant Arms and the Polyazamacrocyclic Backbone to Chelate the 203 Pb/212 Pb Theranostic Pair, Inorg. Chem., 2024, 63, 1745–1758 CrossRef CAS PubMed.
  46. J. L. Lange, P. R. W. J. Davey, M. T. Ma, J. M. White, A. Morgenstern, F. Bruchertseifer, P. J. Blower and B. M. Paterson, An octadentate bis(semicarbazone) macrocycle: a potential chelator for lead and bismuth radiopharmaceuticals, Dalton Trans., 2020, 49, 14962–14974 RSC.
  47. R. Ferreirós-Martínez, D. Esteban-Gómez, É. Tóth, A. de Blas, C. Platas-Iglesias and T. Rodríguez-Blas, Macrocyclic Receptor Showing Extremely High Sr(II)/Ca(II) and Pb(II)/Ca(II) Selectivities with Potential Application in Chelation Treatment of Metal Intoxication, Inorg. Chem., 2011, 50, 3772–3784 CrossRef PubMed.
  48. M. K. Blei, L. Waurick, F. Reissig, K. Kopka, T. Stumpf, B. Drobot, J. Kretzschmar and C. Mamat, Equilibrium Thermodynamics of Macropa Complexes with Selected Metal Isotopes of Radiopharmaceutical Interest, Inorg. Chem., 2023, 62, 20699–20709 CrossRef CAS PubMed.
  49. M. Regueiro-Figueroa, J. L. Barriada, A. Pallier, D. Esteban-Gómez, A. de Blas, T. Rodríguez-Blas, É. Tóth and C. Platas-Iglesias, Stabilizing Divalent Europium in Aqueous Solution Using Size-Discrimination and Electrostatic Effects, Inorg. Chem., 2015, 54, 4940–4952 CrossRef CAS PubMed.
  50. A. Frei, A. Rigby, T. T. C. Yue, G. Firth, M. T. Ma and N. J. Long, To chelate thallium(I) – synthesis and evaluation of Kryptofix-based chelators for 201Tl, Dalton Trans., 2022, 51, 9039–9048 RSC.
  51. A. Roca-Sabio, M. Mato-Iglesias, D. Esteban-Gómez, É. Tóth, A. de Blas, C. Platas-Iglesias and T. Rodríguez-Blas, Macrocyclic Receptor Exhibiting Unprecedented Selectivity for Light Lanthanides, J. Am. Chem. Soc., 2009, 131, 3331–3341 CrossRef CAS PubMed.
  52. K. J. Kadassery and J. J. Wilson, WO/2022/251496, 2022.
  53. A. Swidan and C. L. B. Macdonald, Polyether complexes of groups 13 and 14, Chem. Soc. Rev., 2016, 45, 3883–3915 RSC.
  54. C. Harriswangler, B. L. McNeil, I. Brandariz, L. Valencia, D. Esteban-Gómez, C. F. Ramogida and C. Platas-Iglesias, Incorporation of Carboxylate Pendant Arms into 18-Membered Macrocycles: Effects on [nat/203Pb]Pb(II) Complexation, Chem. – Eur. J., 2024, 30(28), e202400434 CrossRef CAS PubMed.
  55. J. W. Nugent, H. S. Lee, J. H. Reibenspies and R. D. Hancock, Spectroscopic, structural, and thermodynamic aspects of the stereochemically active lone pair on lead(II): Structure of the lead(II) dota complex, Polyhedron, 2015, 91, 120–127 CrossRef CAS.
  56. R. D. Hancock, M. Salim Shaikjee, S. M. Dobson and J. C. A. Boeyens, The Stereochemical activity or non-activity of the ‘Inert’ pair of electrons on lead(II) in relation to its complex stability and structural properties. Some considerations in ligand design, Inorg. Chim. Acta, 1988, 154, 229–238 CrossRef CAS.
  57. N. V. Sidgwick and H. M. Powell, Bakerian Lecture: Stereochemical types and valency groups, Proc. R. Soc. London, Ser. A, 1940, 176, 153–180 CAS.
  58. L. Shimoni-Livny, J. P. Glusker and C. W. Bock, Lone Pair Functionality in Divalent Lead Compounds, Inorg. Chem., 1998, 37, 1853–1867 CrossRef CAS.
  59. C. Harriswangler, A. Freire-García, S. Argibay-Otero, A. Rodríguez-Rodríguez, J. M. Rodríguez, D. Esteban-Gómez, E. M. Vázquez-López and C. Platas-Iglesias, Structural effects of the Pb2+ 6s2 lone pair activity: Eccentricity, Coord. Chem. Rev., 2025, 529, 216434 CrossRef CAS.
  60. H. H. G. Jellinek and J. R. Urwin, Ultraviolet Absorption Spectra and Dissociation Constants of Picolinic, Isonicotinic Acids and their Amides, J. Phys. Chem., 1954, 58, 548–550 CrossRef CAS.
  61. P. Gans, A. Sabatini and A. Vacca, Investigation of equilibria in solution. Determination of equilibrium constants with the HYPERQUAD suite of programs, Talanta, 1996, 43, 1739–1753 CrossRef CAS PubMed.
  62. CCDC 2432138: Experimental Crystal Structure Determination, 2026,  DOI:10.5517/ccdc.csd.cc2mmv26.

This journal is © the Partner Organisations 2026
Click here to see how this site uses Cookies. View our privacy policy here.