With binding functionality at each end, the bisPSMA conjugate molecule is designed to attach to two cancer cell receptor sites. This allows for two different binding possibilities.
The usually displayed mode of action is attachment at two positions on a single target cancer cell, leading to increased strength of binding and hence superior performance for both 64Cu and 67Cu products compared to monomer PSMA.
The alternative is that bisPSMA could link two different cancer cells via a single receptor site on each cell. This also would produce increased binding efficiency and statistically superior performance.
The linked mode of action would allow the theranostic product to destroy two targeted cancer cells from a single 67Cu radiation source.
To my knowledge both the cage structure and the bi-modal conjugate function are unique to radiochemical molecular design. It may have set a few other drug designers thinking though.
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