A Renal‐Clearable Activatable Molecular Probe for Fluoro‐Photacoustic and Radioactive Imaging of Cancer Biomarkers

Abstract In vivo simultaneous visualization of multiple biomarkers is critical to accurately diagnose disease and decipher fundamental processes at a certain pathological evolution, which however is rarely exploited. Herein, a multimodal activatable imaging probe (P‐ 125 I) is reported with activatable fluoro‐photoacoustic and radioactive signal for in vivo imaging of biomarkers (i.e., hepsin and prostate‐specific membrane antigen (PSMA)) associated with prostate cancer diagnosis and prognosis. P‐ 125 I contains a near‐infrared (NIR) dye that is caged with a hepsin‐cleavable peptide sequence and linked with a radiolabeled PSMA‐targeted ligand (PSMAL). After systemic administration, P‐ 125 I actively targets the tumor site via specific recognition between PSMA and PSMAL moiety and in‐situ generates of activated fluoro‐photoacoustic signal after reacting with hepsin to release the free dye (uncaged state). P‐ 125 I achieves precisely early detection of prostate cancer and renal clearance to alleviate toxicity issues. In addition, the accumulated radioactive and activated photoacoustic signal of probe correlates well with the respective expression level of PSMA and hepsin, which provides valuable foreseeability for cancer progression and prognosis. Thus, this study presents a multimodal activatable probe for early detection and in‐depth deciphering of prostate cancer.