Abstract
BackgroundRadioligand therapy (RLT) with 177Lu-DKFZ-617 PSMA (Lu-PSMA) (prostate-specific membrane antigen) is a novel targeted therapy of metastatic prostate cancer. We analysed retrospectively the early side effects and the response rate in the first patients, who received a therapy with Lu-PSMA in our departments.MethodsRLT was performed in ten hormone- and/or chemo-refractory patients with distant metastases and progressive disease (mean age 73.5 years). 68Ga-PSMA HBED-CC PET/CT was performed in all patients prior to RLT. The median PSA level prior to the therapy was 298.5 ng/ml (range 5–853 ng/ml). All patients received CBC, renal and liver function tests the day before and 2 days after application (mean administered activity 5.6 GBq, range 4.1–6.1 GBq), followed by further tests every 2 weeks. All patients were contacted by telephone every week regarding side effects or any positive and negative changes.ResultsEight weeks after the therapy, seven patients (70 %) experienced a PSA decline, of whom six experienced more than 30 % and five more than 50 %. Three patients showed a progressive disease according to the PSA increase. No patient experienced any side effects immediately after injection of Lu-PSMA. Relevant hematotoxicity (grade 3 or 4) occurred 7 weeks after the administration in just one patient. The same patient showed a leucopenia grade 2. Two patients showed a disturbance of only 1 hematologic cell line, whereas one patient showed a reduction of grades 1 and 2 in leucocytes and thrombocytes, respectively. Six patients did not show any hematotoxicity during the 8 weeks after therapy. There was no relevant nephrotoxicity (grade 3 or 4).ConclusionsOur initial results indicate that RLT with Lu-PSMA is safe and seems to have low early side-effect profile. A relevant PSA decline was detected in 70 % of patients.
Highlights
Radioligand therapy (RLT) with 177Lu-DKFZ-617 Prostatespecific membrane antigen (PSMA) (Lu-PSMA) is a novel targeted therapy of metastatic prostate cancer
The PSMA expression levels are directly correlated to androgen independence, metastasis, and Prostate cancer (PCa) progression [10]; PSMA is an attractive target for diagnosis and therapy of metastasised prostate cancer
Ten hormone- and/or chemo-refractory patients with a mean age of 73.5 years underwent 68GaPSMA PET/CT followed by therapy with a mean of 5.6 GBq Lu-PSMA
Summary
Radioligand therapy (RLT) with 177Lu-DKFZ-617 PSMA (Lu-PSMA) (prostate-specific membrane antigen) is a novel targeted therapy of metastatic prostate cancer. We analysed retrospectively the early side effects and the response rate in the first patients, who received a therapy with Lu-PSMA in our departments. The PSMA expression levels are directly correlated to androgen independence, metastasis, and PCa progression [10]; PSMA is an attractive target for diagnosis and therapy of metastasised prostate cancer. We analysed retrospectively the early side effects and the response rate in the first patients, who received a therapy with 177Lu-DKFZ-617 PSMA (Lu-PSMA), in our departments as the last possible option [18]
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