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New marker shows which bladder cancer patients benefit from therapy

Johanna Trommer and Tobias Krönke are part of the HZDR team that developed the special molecular marker.  © HZDR/K.Zheynova
Johanna Trommer and Tobias Krönke are part of the HZDR team that developed the special molecular marker. © HZDR/K.Zheynova

Researchers at the Helmholtz-Zentrum Dresden-Rossendorf have developed a molecular marker to help doctors choose the right bladder cancer therapy. The radiotracer NECT-224 makes visible whether tumors carry a certain protein to which modern drugs can dock. In summer 2025, it was used successfully for the first time on a patient at Dresden University Hospital.

Not every cancer drug works equally well for every patient. Some tumors have certain structures on their surface, others do not. If this structure is missing, the therapy remains ineffective. Researchers at the Helmholtz-Zentrum Dresden-Rossendorf have now found a way to make these structures visible. Their molecular marker NECT-224 could help doctors select the right treatment for bladder cancer patients in the future.

The team developed a so-called radiotracer. This is a molecule that is labeled with a weak radioactive substance. It specifically docks onto cancer cells that carry a certain protein called nectin-4 on their surface. Special imaging, positron emission tomography, can then be used to identify where these cells are located in the body. "With NECT-224, we can reveal whether a tumor actually carries nectin-4 in order to assess whether the affected patient will respond to targeted therapies," explains Dr. Robert Wodtke from the HZDR Institute of Radiopharmaceutical Cancer Research.

First successful application at Dresden University Hospital

Nectin-4 plays a particularly important role in urothelial carcinomas, a common form of bladder cancer. Modern drugs use this protein as a target. They dock onto it and specifically switch off the tumor cells. The problem is that not every tumor produces sufficient quantities of nectin-4. Tumor metastases can even lose the protein. Until now, there has been no reliable method to determine whether and where the protein is present in the body without surgery.

The Dresden scientists chemically modified an already known drug molecule so that it is suitable for diagnostics. They used a bicyclic peptide for this purpose. These molecules are stable in the body and find their target very precisely. After extensive tests in cell cultures and animal models, NECT-224 was used for the first time in a patient at Dresden University Hospital in the summer of 2025. The images clearly showed the tumor disease.

From diagnosis to therapy

The research team is already working on improvements. In future, the marker should remain in the tumor tissue for longer. The scientists are also investigating whether NECT-224 is also suitable for new treatment strategies that combine diagnosis and therapy.

The development was part of the EU research project UroNec. In addition to the HZDR and Dresden University Hospital, the companies ROTOP Pharmaka from Dresden-Rossendorf and CUP Laboratorien Dr. Freitag from Radeberg are also involved. "The successful first use in humans was an important milestone for us and a strong sign that this tracer can offer real clinical added value," says Wodtke. The project is part of the nukliD radiopharmacy network, which aims to establish Dresden as a leading center in this field.

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