Kambiz Rahbar1, Matthias Schmidt2, Alexander Heinzel3, Elisabeth Eppard4, Axel Bode5, Anna Yordanova4, Michael Claesener5, Hojjat Ahmadzadehfar4. 1. Department of Nuclear Medicine, University Hospital Muenster, Muenster, Germany rahbar@uni-muenster.de. 2. Department of Nuclear Medicine, University Hospital Cologne, Cologne, Germany. 3. Department of Nuclear Medicine, University Hospital Aachen, Aachen, Germany; and. 4. Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany. 5. Department of Nuclear Medicine, University Hospital Muenster, Muenster, Germany.
Abstract
UNLABELLED: 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 (177)Lu-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 (177)Lu-PSMA-617 (mean, 5.9 ± 0.5 GBq) were retrospectively analyzed. Data were collected at baseline and 8 wk after therapy. (68)Ga-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 (177)Lu-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.
UNLABELLED: 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 (177)Lu-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 (177)Lu-PSMA-617 (mean, 5.9 ± 0.5 GBq) were retrospectively analyzed. Data were collected at baseline and 8 wk after therapy. (68)Ga-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 (177)Lu-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.
Authors: Wolfgang P Fendler; Matthias Eiber; Mohsen Beheshti; Jamshed Bomanji; Francesco Ceci; Steven Cho; Frederik Giesel; Uwe Haberkorn; Thomas A Hope; Klaus Kopka; Bernd J Krause; Felix M Mottaghy; Heiko Schöder; John Sunderland; Simon Wan; Hans-Jürgen Wester; Stefano Fanti; Ken Herrmann Journal: Eur J Nucl Med Mol Imaging Date: 2017-06 Impact factor: 9.236
Authors: Clemens Kratochwil; Wolfgang Peter Fendler; Matthias Eiber; Richard Baum; Murat Fani Bozkurt; Johannes Czernin; Roberto C Delgado Bolton; Samer Ezziddin; Flavio Forrer; Rodney J Hicks; Thomas A Hope; Levant Kabasakal; Mark Konijnenberg; Klaus Kopka; Michael Lassmann; Felix M Mottaghy; Wim Oyen; Kambiz Rahbar; Heiko Schöder; Irene Virgolini; Hans-Jürgen Wester; Lisa Bodei; Stefano Fanti; Uwe Haberkorn; Ken Herrmann Journal: Eur J Nucl Med Mol Imaging Date: 2019-08-22 Impact factor: 9.236
Authors: Axel Bräuer; Lena Sophie Grubert; Wolfgang Roll; Andres Jan Schrader; Michael Schäfers; Martin Bögemann; Kambiz Rahbar Journal: Eur J Nucl Med Mol Imaging Date: 2017-06-17 Impact factor: 9.236
Authors: Andrei Fodor; Andrea Lancia; Francesco Ceci; Maria Picchio; Morten Hoyer; Barbara Alicja Jereczek-Fossa; Piet Ost; Paolo Castellucci; Elena Incerti; Nadia Di Muzio; Gianluca Ingrosso Journal: World J Urol Date: 2018-05-11 Impact factor: 4.226