Rahbar, Kambiz ORCID: 0000-0002-4591-4055, Schmidt, Matthias, Heinzel, Alexander ORCID: 0000-0002-2430-4557, Eppard, Elisabeth ORCID: 0000-0002-4400-2070, Bode, Axel, Yordanova, Anna ORCID: 0000-0001-5881-2819, Claesener, Michael and Ahmadzadehfar, Hojjat (2016). Response and Tolerability of a Single Dose of Lu-177-PSMA-617 in Patients with Metastatic Castration-Resistant Prostate Cancer: A Multicenter Retrospective Analysis. J. Nucl. Med., 57 (9). S. 1334 - 1339. RESTON: SOC NUCLEAR MEDICINE INC. ISSN 1535-5667

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Abstract

Radiolabeled prostate-specific membrane antigen (PSMA) ligands represent a true theranostic concept for diagnosis and therapy in patients with relapsed or metastatic prostate cancer. The aim of this study was to evaluate the response to and tolerability of a single dose of Lu-177-PSMA-617 in a large cohort of patients with metastatic castration-resistant prostate cancer (mCRPC). Methods: The data of 82 consecutive patients (median age, 73 y; range, 43-87 y) with mCRPC who received a single dose of Lu-177-PSMA-617 (mean, 5.9 +/- 0.5 GBq) were retrospectively analyzed. Data were collected at baseline and 8 wk after therapy. Ga-68-PSMA-11 PET/CT was performed on all patients to verify sufficient PSMA expression. Bone, lymph node, liver, and lung metastases were present in 99%, 65%, 17%, and 11% of the patients, respectively. Tolerability and response were evaluated using hematologic parameters, renal scintigraphy, clinical data, and the prostate-specific antigen (PSA) level at baseline and 8 wk after therapy application. Results: Six patients died, and 2 patients dropped out because they were not willing to continue therapy and follow-up. The complete dataset of 74 patients was available for analysis. Forty-seven patients (64%) showed a PSA decline, including 23 (31%) with a decline by more than 50%. Thirty-five patients (47%) had stable disease: the change in their PSA level ranged from less than a 50% decline to less than a 25% rise. Seventeen patients (23%) had progressive disease: their PSA level rose by more than 25%. There were no significant changes in hemoglobin, white blood cells, creatinine, or tubular extraction rates indicative of toxicity. There was a significant but mild decrease in platelets; but the median value was still within the reference range. Conclusion: This retrospective multicenter analysis suggests that radioligand therapy with Lu-177-PSMA-617 is safe and well tolerated and has a considerable effect on PSA level. Therefore, it offers an additional therapeutic option for patients with mCRPC. These data may justify further prospective randomized studies to evaluate and prove the clinical benefit in terms of survival and quality of life.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Rahbar, KambizUNSPECIFIEDorcid.org/0000-0002-4591-4055UNSPECIFIED
Schmidt, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heinzel, AlexanderUNSPECIFIEDorcid.org/0000-0002-2430-4557UNSPECIFIED
Eppard, ElisabethUNSPECIFIEDorcid.org/0000-0002-4400-2070UNSPECIFIED
Bode, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Yordanova, AnnaUNSPECIFIEDorcid.org/0000-0001-5881-2819UNSPECIFIED
Claesener, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ahmadzadehfar, HojjatUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-264968
DOI: 10.2967/jnumed.116.173757
Journal or Publication Title: J. Nucl. Med.
Volume: 57
Number: 9
Page Range: S. 1334 - 1339
Date: 2016
Publisher: SOC NUCLEAR MEDICINE INC
Place of Publication: RESTON
ISSN: 1535-5667
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MONOCLONAL-ANTIBODY; RADIATION-DOSIMETRY; MEMBRANE ANTIGEN; PET/CT; PSMA; DIAGNOSIS; J591Multiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/26496

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