High activity rhenium-186 hydroxyethylidene diphosphonate (HEDP) with autologous peripheral blood stem cell (PBSC) transplant: A novel treatment strategy in hormone refractory prostate cancer metastatic to bone

Abstract

4562 Background: Bone marrow is the dose-limiting organ for bone seeking radionuclide therapy of bone metastases from prostate cancer. This prospective phase 2 trial investigated the potential for improvement in disease control by using autologous peripheral blood stem cell transplant to permit administration of high activities of a bone seeking radionuclide, Rhenium-186 HEDP in patients with progressive hormone refractory prostate cancer. Methods: Eligible patients had histologically confirmed prostate cancer metastatic to the skeleton, rising PSA despite castrate testosterone levels, WHO PS 0–1, and minimal soft-tissue disease. Patients received between 4500 and 5000MBq of Rhenium-186 HEDP i.v. (approximately 4 times the dose normally used for palliation), followed 14 days later by the return of pre-harvested PBSCs. Response was assessed using PSA, survival, pain scores, and quality of life measurement. Results: Thirty-eight patients with a median age of 67 years (range 50–77), and a median PSA of 57 ng...