Ahmadzadehfar Hojjat, Zimbelmann Stefanie, Yordanova Anna, Fimmers Rolf, Kürpig Stefan, Eppard Elisabeth, Gaertner Florian C, Wei Xiao, Hauser Stefan, Essler Markus
Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany.
Oncotarget. 2017 Feb 25;8(33):55567-55574. doi: 10.18632/oncotarget.15698. eCollection 2017 Aug 15.
Radioligand therapy with Lu-PSMA-617 is an innovative and effective therapy for castrate-resistant metastatic prostate cancer patients. For patients with symptomatic bone metastases without visceral metastases, the guidelines recommend radionuclide therapy with Ra-dichloride as a single therapeutic agent or in combination with hormone therapy. The aim of this study was to evaluate the safety of repeated cycles of Lu-PSMA-617 after exposure to more cycles of Ra. Forty-nine patients were treated with three cycles of Lu-PSMA-617 divided into two groups subjected to a history of therapy with Ra. Group 1 included 20 patients, who had received therapy with Ra prior to Lu-PSMA-617 therapy. Group 2, which was the control group regarding hematotoxicity, comprised 29 patients without any history of a bone-targeted radionuclide therapy. No CTC 4° hematotoxicity was observed in the entire study population. There was no CTC 3° or CTC 4° leucopenia in either group. One and three patients from group 1 and 2, respectively, showed CTC 3° anemia. In group 1 there was significantly more CTC 2° anemia (50% vs. 6.9%) (p=0.008). One patient from group 1 (5%) showed a CTC 3° thrombocytopenia without any concurrent anemia, and two patients from group 2 (7%) showed a CTC 3° thrombocytopenia, one with CTC 3° anemia and one without any anemia. There were no significant differences between the two groups regarding leucopenia and thrombocytopenia. These results confirmed that performing repeated cycles of Lu-PSMA-617 after Ra seems to be safe with a very small probability of hematotoxicity.
用镥 - PSMA - 617进行放射性配体治疗是一种针对去势抵抗性转移性前列腺癌患者的创新且有效的治疗方法。对于有症状性骨转移但无内脏转移的患者，指南推荐使用二氯化镭进行放射性核素治疗，可作为单一治疗药物或与激素治疗联合使用。本研究的目的是评估在接受更多周期的镭治疗后重复使用镥 - PSMA - 617周期的安全性。49例患者接受了三个周期的镥 - PSMA - 617治疗，根据镭治疗史分为两组。第1组包括20例患者，他们在接受镥 - PSMA - 617治疗之前接受过镭治疗。第2组作为血液毒性的对照组，包括29例无骨靶向放射性核素治疗史的患者。在整个研究人群中未观察到4级血细胞毒性。两组均未出现3级或4级白细胞减少。第1组和第2组分别有1例和3例患者出现3级贫血。在第1组中，2级贫血明显更多（50%对6.9%）（p = 0.008）。第1组有1例患者（5%）出现3级血小板减少且无并发贫血，第2组有2例患者（7%）出现3级血小板减少，其中1例伴有3级贫血，1例无任何贫血。两组在白细胞减少和血小板减少方面无显著差异。这些结果证实，在镭治疗后进行重复周期的镥 - PSMA - 617治疗似乎是安全的，血液毒性发生概率非常小。
