1. Salivary toxicity from PSMA-targeted radiopharmaceuticals: What we have learned and where we are going.
- Author
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Muniz M, Loprinzi CL, Orme JJ, Koch RM, Mahmoud AM, Kase AM, Riaz IB, Andrews JR, Thorpe MP, Johnson GB, Kendi AT, Kwon ED, Nauseef JT, Morgans AK, Sartor O, and Childs DS
- Subjects
- Humans, Male, Prostatic Neoplasms, Castration-Resistant drug therapy, Prostatic Neoplasms, Castration-Resistant radiotherapy, Lutetium therapeutic use, Radioisotopes adverse effects, Radioisotopes administration & dosage, Salivary Glands radiation effects, Salivary Glands drug effects, Dipeptides therapeutic use, Heterocyclic Compounds, 1-Ring therapeutic use, Radiopharmaceuticals therapeutic use, Antigens, Surface, Glutamate Carboxypeptidase II antagonists & inhibitors
- Abstract
Clinical trials of prostate-specific membrane antigen (PSMA) targeted radiopharmaceuticals have shown encouraging results. Some agents, like lutetium-177 [177Lu]Lu-PSMA-617 ([
177 Lu]Lu-PSMA-617), are already approved for late line treatment of metastatic castration-resistant prostate cancer (mCRPC). Projections are for continued growth of this treatment modality; [177 Lu]Lu-PSMA-617 is being studied both in earlier stages of disease and in combination with other anti-cancer therapies. Further, the drug development pipeline is deep with variations of PSMA-targeting radionuclides, including higher energy alpha particles conjugated to PSMA-honing vectors. It is safe to assume that an increasing number of patients will be exposed to PSMA-targeted radiopharmaceuticals during the course of their cancer treatment. In this setting, it is important to better understand and mitigate the most commonly encountered toxicities. One particularly vexing side effect is xerostomia. In this review, we discuss the scope of the problem, inventories to better characterize and monitor this troublesome side effect, and approaches to preserve salivary function and effectively palliate symptoms. This article aims to serve as a useful reference for prescribers of PSMA-targeted radiopharmaceuticals, while also commenting on areas of missing data and opportunities for future research., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)- Published
- 2024
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