title: Therapeutic response and side effects of repeated radioligand therapy with 177Lu-PSMA-DKFZ-617 of castrate-resistant metastatic prostate cancer.
abstract: Prostate-specific membrane antigen (PSMA) is highly expressed on prostate epithelial cells and strongly up-regulated in prostate cancer (PC), making it an optimal target for the treatment of metastasized PC. Radioligand therapy (RLT) with 177Lu-PSMA-DKFZ-617 (Lu-PSMA) is a targeted therapy for metastatic PC. In this study, we retrospectively analyzed the side effects and the response rate of 24 hormone and/or chemorefractory PC patients with a mean age of 75.2 years (range: 64-82) with distant metastases and progressive disease according to the PSA level, who were treated with Lu-PSMA. Median PSA was 522 ng/ml (range: 17-2360). Forty-six cycles of Lu-PSMA were performed. Of the 24 patients, 22 received two cycles. Eight weeks after the first cycle of Lu-PSMA therapy 79.1% experienced a decline in PSA level. Eight weeks after the second cycle of Lu-PSMA therapy 68.2% experienced a decline in PSA relative to the baseline value. Apart from two cases of grade 3 anemia, there was no relevant hemato- or nephrotoxicity (grade 3 or 4). These results confirmed that Lu-PSMA is a safe treatment option for metastatic PC patients and has a low toxicity profile. A positive response to therapy in terms of decline in PSA occurs in about 70% of patients.
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Hojjat
authors.initials: H
authors.lastname: Ahmadzadehfar
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Eppard
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kürpig
authors.affiliation: Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Fimmers
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Yordanova
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Carl Diedrich
authors.initials: CD
authors.lastname: Schlenkhoff
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Gärtner
authors.affiliation: Department of Urology, University Hospital Bonn, Bonn, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Rogenhofer
authors.affiliation: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Essler
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004151:Dipeptides / Q000008:administration & dosage*; D006573:Heterocyclic Compounds, 1-Ring / Q000008:administration & dosage*; D006801:Humans; D008187:Lutetium / Q000008:administration & dosage / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds / Q000008:administration & dosage*; D010455:Peptides / Q000008:administration & dosage*; D000072078:Positron Emission Tomography Computed Tomography; D017430:Prostate-Specific Antigen; D064129:Prostatic Neoplasms, Castration-Resistant / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D011868:Radioisotopes / Q000008:administration & dosage / Q000737:chemistry; D019275:Radiopharmaceuticals / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: C000603664:177Lu-DKFZ-617; C000610110:Pluvicto; D004151:Dipeptides; D006573:Heterocyclic Compounds, 1-Ring; D009942:Organometallic Compounds; D010455:Peptides; D011868:Radioisotopes; D019275:Radiopharmaceuticals; D008187:Lutetium; D017430:Prostate-Specific Antigen
keywords: 177Lu; PSA; PSMA; prostate cancer; radioligand therapy