Departments of Medical Oncology.
Radiation Oncology, Tulane University School of Medicine, New Orleans, Lousiana.
Pract Radiat Oncol. 2022 Jul-Aug;12(4):300-304. doi: 10.1016/j.prro.2022.01.008. Epub 2022 May 14.
Treatment options for men with metastatic castration-resistant prostate cancer are rapidly changing. In addition to novel anti-androgens and taxane-based chemotherapy, radiopharmaceuticals are having an increasing role. Although calcium-mimetic theranostics have been in use for years, newer approaches use molecularly targeted radiation therapy by conjugating isotopes to prostate-specific membrane antigen (PSMA) and in so doing directly target prostate cancer cells; Lutetium-PSMA-617 is perhaps the best-known member of this new class. Expanding our capacity to deliver targeted beta-emitters requires additional planning and equipment. Having delivered close to 200 doses of Lutetium-PSMA-617 at our center, we offer practical advice about patient selection, radiation safety, treatment administration, and toxicity monitoring. Although this blueprint is not the only way to expand a theranostics program beyond Radium-223, we offer our institutional experience with Lutetium-PSMA-617 as an example to programs seeking to expand their radiopharmaceutical programs. We must rise to meet the patient-driven demand for these innovative and effective therapies.
治疗转移性去势抵抗性前列腺癌的方法正在迅速变化。除了新型抗雄激素和紫杉烷类化疗药物外，放射性药物也发挥着越来越重要的作用。虽然钙模拟治疗剂已经使用多年，但新的方法是通过将同位素与前列腺特异性膜抗原（PSMA）结合，使用分子靶向放射疗法，直接靶向前列腺癌细胞；镥-PSMA-617 可能是这一新类别的最知名成员。为了扩大靶向β发射器的能力，需要额外的规划和设备。在我们中心，我们已经接近 200 例镥-PSMA-617 剂量的治疗，因此我们提供有关患者选择、辐射安全、治疗管理和毒性监测的实用建议。虽然这一蓝图并不是将镭-223 之外的治疗剂计划扩大的唯一方法，但我们提供了我们在使用镥-PSMA-617 方面的机构经验，以供寻求扩大放射性药物计划的项目参考。我们必须满足患者对这些创新和有效的治疗方法的需求。
