1. Lutetium-177-PSMA-617 in low-volume hormone-sensitive metastatic prostate cancer
- Author
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Martin Gotthardt, J. Fred Verzijlbergen, Jean-Paul A. van Basten, Melline G.M. Schilham, James Nagarajah, Robert Jan Smeenk, Sandra Heskamp, J. Alfred Witjes, Steffie M. B. Peters, Tom W. J. Scheenen, Marcel J.R. Janssen, Inge M. van Oort, Maike J. M. Uijen, Jelle O. Barentsz, Niven Mehra, Michiel Sedelaar, Bastiaan M. Privé, Diederik M. Somford, Constantijn H.J. Muselaers, Annemarie Eek, Winald R. Gerritsen, Linda G W Kerkmeijer, Mark Konijnenberg, Patrik Zamecnik, and Radiology & Nuclear Medicine
- Subjects
Male ,Cancer Research ,medicine.medical_specialty ,Urology ,Pilot Projects ,Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9] ,urologic and male genital diseases ,030218 nuclear medicine & medical imaging ,Androgen deprivation therapy ,Heterocyclic Compounds, 1-Ring ,03 medical and health sciences ,Prostate cancer ,Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] ,0302 clinical medicine ,SDG 3 - Good Health and Well-being ,Urological cancers Radboud Institute for Molecular Life Sciences [Radboudumc 15] ,medicine ,Tumours of the digestive tract Radboud Institute for Molecular Life Sciences [Radboudumc 14] ,Humans ,Doubling time ,Dosimetry ,Prospective Studies ,Prospective cohort study ,Adverse effect ,Radioisotopes ,business.industry ,Other Research Radboud Institute for Health Sciences [Radboudumc 0] ,Androgen Antagonists ,Dipeptides ,Prostate-Specific Antigen ,medicine.disease ,Minimal residual disease ,Hormones ,Prostatic Neoplasms, Castration-Resistant ,Oncology ,030220 oncology & carcinogenesis ,Urological cancers Radboud Institute for Health Sciences [Radboudumc 15] ,Toxicity ,Quality of Life ,Radiopharmaceuticals ,business ,Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] - Abstract
Purpose: [177Lu]Lu-PSMA-617 radioligand therapy (177Lu-PSMA) is a novel treatment for metastatic castration-resistant prostate cancer (mCRPC), which could also be applied to patients with metastatic hormone-sensitive prostate cancer (mHSPC) with PSMA expression. In this prospective study (NCT03828838), we analyzed toxicity, radiation doses, and treatment effect of 177Lu-PSMA in pateints with low-volume mHSPC. Patients and Methods: Ten progressive patients with mHSPC following local treatment, with a maximum of ten metastatic lesions on [68Ga]Ga-PSMA-11 PET/diagnostic-CT imaging (PSMA-PET) and serum PSA doubling time Results: All patients received two cycles of 177Lu-PSMA without complications. No treatment-related grade III–IV adverse events were observed. According to dosimetry, none of the OAR reached threshold doses for radiation-related toxicity. Moreover, all target lesions received a higher radiation dose than the OAR. All 10 patients showed altered PSA kinetics, postponed androgen deprivation therapy, and maintained good quality of life. Half of the patients showed a PSA response of more than 50%. One patient had a complete response on PSMA-PET imaging until EOS and two others had only minimal residual disease. Conclusions: 177Lu-PSMA appeared to be a feasible and safe treatment modality in patients with low-volume mHSPC.
- Published
- 2021
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