Evaluation of Bifunctional, PSMA-Targeted Triazamacrocycle-Picolinates Compatible with the 18 F/ 44 Sc/ 177 Lu Isotope Triad

The development of matched diagnostic and therapeutic radiopharmaceuticals─theranostic pairs─has emerged as a promising strategy to advance personalized nuclear medicine. However, many current systems rely on chemically distinct elements such as the 68Ga3+/177Lu3+ pair, leading to inconsistencies in the pharmacokinetics. Here, we evaluate bifunctional chelator platforms derived of triazamacrocycle picolinates, capable of stably incorporating three clinically relevant isotopes 18F-, 44Sc3+, and 177Lu3+. mpatcn supported the formation of 18FScF, 44ScSc, and 177LuLu complexes when conjugated to a PSMA-targeting peptide (picaga-Met-hex-KuE). picaga-Met-hex-KuE displayed quantitative radiochemical yields and >95% formulation stability after 2 h. Biodistribution and metabolite analysis confirmed PSMA-targeting, minimal off-target uptake, and renal clearance for all picaga-Met-hex-KuE systems. Additionally, we demonstrate that a cartridge-based purification method formulates 18FScF(picaga-Met-hex-KuE) in >95% radiochemical purity with nondecay corrected yields of 32% in under 110 min. These results establish picaga-Met-hex-KuE as a lead scaffold for the 18F/44Sc/177Lu triad, enabling single-kit radiopharmaceutical preparation for theranostic applications.