Samarium for osteoblastic bone metastases and osteosarcoma.
Samarium-153 lexidronam (153Sm-EDTMP) is FDA approved for painful osteoblastic bone metastases that image on bone scan. 153Sm-EDTMP decay has a therapeutic beta-emission and a gamma-photon for bone scan imaging. Monitoring of osteosarcoma radiation treatment effectiveness was performed with bone, CT, MRI and PET/CT fusion imaging. Bone scan and PET/CT improved in 5 out of 9 and 16 out of 18 osteosarcoma sites, respectively. 153Sm-EDTMP targets multiple sites of disease, with a single administration. Side effects of 153Sm-EDTMP (0.5-2.5 mCi/kg) have been minimal and include transient thrombocytopenia and neutropenia. 153Sm-EDTMP can be combined with radiation therapy, bisphosphonates and/or chemotherapy to synergistically improve palliation. This article reviews the rationale, indications and monitoring of standard-dose samarium and investigational high-dose 153Sm-EDTMP treatment of cancer involving bone.
Anderson
Pete
P
Department of Pediatrics, University of Texas, MD Anderson Cancer Center, 1515 Holcombe Blvd., Unit 87, Houston, TX 77030-4009, USA. pmanders@mdanderson.org
D000818:Animals; D001859:Bone Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy / Q000556:secondary*; D004361:Drug Tolerance; D004335:Drug and Narcotic Control; D006801:Humans; D009942:Organometallic Compounds / Q000009:adverse effects / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*; D009943:Organophosphorus Compounds / Q000009:adverse effects / Q000737:chemistry / Q000493:pharmacokinetics / Q000627:therapeutic use*; D012516:Osteosarcoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy; D012493:Samarium / Q000009:adverse effects / Q000737:chemistry / Q000627:therapeutic use*
D009942:Organometallic Compounds; D009943:Organophosphorus Compounds; D012493:Samarium; C061972:samarium Sm-153 lexidronam