Prostate specific membrane antigen targeted radioligand therapy of metastatic castration-resistant prostate cancer using Lu-177 PSMA-617: safety, efficacy and dosimetry in comparison with Lu-177 PSMA I&T

2016 ◽  
Author(s):  
Harshad R. Kulkarni ◽  
Aviral Singh ◽  
Christiane Schuchardt ◽  
Karin Niepsch ◽  
Richard P. Baum
Keyword(s):  
Prostate Cancer ◽  
Prostate Specific Membrane Antigen ◽  
Castration Resistant Prostate Cancer ◽  
Radioligand Therapy ◽  
Castration Resistant ◽  
Specific Membrane

scholarly journals Explorative analysis of a predictive score for patients with metastatic, castration resistant prostate cancer undergoing radioligand therapy with [177Lu]Lu-labeled prostate-specific membrane antigen

2020 ◽  
Author(s):  
Kai Huang ◽  
Imke Schatka ◽  
Julian M.M. Rogasch ◽  
Randall L. Lindquist ◽  
Maria De Santis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Specific Antigen ◽  
Significant Risk ◽  
Predictive Score ◽  
Prostate Specific Membrane Antigen ◽  
Castration Resistant Prostate Cancer ◽  
Radioligand Therapy ◽  
Castration Resistant ◽  
Specific Membrane

Abstract Background: Up to 60% of patients with metastatic, castration-resistant prostate cancer (mCRPC) treated with [177Lu]Lu-labeled prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) achieve partial biochemical response with a decrease of >50% in prostate-specific antigen (PSA) levels. The remaining fraction of patients, however, do not respond to RLT. The aim of this explorative analysis was to identify pretherapeutic factors for the prediction of response. Methods: 46 patients (age = 68 years [53-87]) with mCRPC who consecutively underwent RLT with [177Lu]Lu-PSMA (median applied activity = 6 GBq [2.9-6.2]) were included and analysed retrospectively. Association of different clinical and laboratory factors and parameters from pretherapeutic 68Gallium-PSMA positron emission tomography (PET) with the outcome of RLT was tested (Fisher’s test). Outcome was defined as PSA changes 8 weeks after the second RLT (partial response [PR], PSA decrease >50%; progressive disease [PD], PSA increase ≥25%; stable disease [SD], others). Significant risk factors were combined in a predictive score.Results: Median pretherapeutic PSA was 79 ng/ml. Thirty percent of the patients showed a post-treatment PR (median: 73% PSA decrease), 35% SD (median: 17% PSA decrease) and 35% PD (median: 42% PSA increase). Significant predictors for PD were alkaline phosphatase (ALP) >135 U/l (p=0.030), PSA >200 ng/ml (p=0.036), and maximum standardized uptake value (SUVmax) of the “hottest lesion” in pretherapeutic PET <45 (p=0.005). The predictive score including PSA, ALP, and SUVmax could separate 2 distinct groups of patients: ≤2 risk factors (81% PR or SD, 19% PD) and 3 risk factors (10% PR or SD, 90% PD). Conclusion: The presented predictive score allowed a pretherapeutic estimate of the expected response to RLT. This is hypothesis generating. Prospective trials are needed to test these predictive risk factors

scholarly journals Explorative analysis of a score predicting the therapy response of patients with metastatic, castration resistant prostate cancer undergoing radioligand therapy with 177Lu-labeled prostate-specific membrane antigen

2020 ◽  
Author(s):  
Kai Huang ◽  
Imke Schatka ◽  
Julian M. M. Rogasch ◽  
Randall L. Lindquist ◽  
Maria De Santis ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Predictive Factors ◽  
Specific Antigen ◽  
Standardized Uptake Value ◽  
Predictive Score ◽  
Prostate Specific Membrane Antigen ◽  
Castration Resistant Prostate Cancer ◽  
Radioligand Therapy ◽  
Castration Resistant ◽  
Specific Membrane

Abstract Objective Up to 60% of patients with metastatic, castration-resistant prostate cancer (mCRPC) treated with 177Lu prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) achieves a partial biochemical response with a decrease of > 50% in prostate-specific antigen (PSA) levels. The remaining fractions, however, do not respond to RLT. The aim of this explorative analysis was to identify pre-therapeutic factors for the prediction of response. Methods 46 patients [age = 68 years (50–87)] with mCRPC who consecutively underwent RLT with 177Lu PSMA [median applied activity = 6 GBq (2.9–6.2)] were included and analysed retrospectively. The association of different clinical and laboratory factors and parameters from pre-therapeutic 68Ga PSMA positron emission tomography (PET) with the outcome of RLT was tested (Fisher’s test). Outcome was defined as PSA changes 8 weeks after second RLT [partial response (PR), PSA decrease > 50%; progressive disease (PD), PSA increase ≥ 25%; stable disease (SD), others]. Significant predictive factors were combined in a predictive score. Results 30% showed a post-treatment PR (median 73% PSA decrease), 35% SD (median 17% PSA decrease) and 35% PD (median 42% PSA increase). Significant predictors for PD were alkaline phosphatase (ALP) > 135 U/l (p = 0.002), PSA > 200 ng/ml (p = 0.036), and maximum standardized uptake value (SUVmax) of the “hottest lesion” in pre-therapeutic PET < 45 (p = 0.005). The predictive score including PSA, ALP and SUVmax could separate 2 distinct groups of patients: ≤ 2 predictive factors (19% PD) and 3 predictive factors (90% PD). Conclusion The presented predictive score allowed a pre-therapeutic estimate of the expected response to 2 cycles of RLT. As our study was retrospective, prospective trials are needed for validation.

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