Maman Adem
Department of Nuclear Medicine, Atatürk University, Faculty of Medicine, Erzurum, Turkey.
Eurasian J Med. 2023 Jun;55(2):109-113. doi: 10.5152/eurasianjmed.2023.0055.
Lutetium-177 prostate-specific membrane antigen-617 is a novel alternative therapeutic option in metastatic castration-resistant prostate cancer, especially useful for patients who do not respond to standard therapy methods. The aim of this study was to define the efficacy and safety profile of lutetium-177 prostate- specific membrane antigen-617 treatment in a group of patients with metastatic castration-resistant prostate cancer.
Study group included 34 men with metastatic castration-resistant prostate cancer (median, 69.6 ± 7.7 years) who were treated with lutetium-177 prostate-specific membrane antigen-617 therapy (22/34; 4 courses, 12/34; 2 courses). Patients were evaluated by physical examination, Eastern coop- erative oncology group performance status, gallium-68 prostate-specific membrane antigen positron emis- sion tomography/computed tomography, brief pain inventory-short form questionnaire, biochemical tests, and complete blood counts. Treatment response and adverse effects were examined by brief pain inventory scores, SUVmax values, biochemical tests, and complete blood counts. Independent variables were analyzed statistically (significance; P < .05).
The Eastern cooperative oncology group performance was grade 0 in 5/34 (14.7%), grade 1 in 25/34 (73.5%), and grade 2 in 4/34 (11.8%) patients. Distribution of patient numbers according to brief pain inven- tory scores (score: <1, scores: 1-4, and scores: 5-10) was 2, 10 and 22 at the beginning, 6, 16 and 12 after the second course, and 10, 10 and 2 after the fourth course of treatment, respectively. Serum prostate-specific antigen decreased in 15 of 22 patients (68%) (P < .05). Before and after the treatment, we found a substan- tial decrease in SUVmax values (22.3 vs. 11.8, P < .001) and brief pain inventory scores (score ≥ 5; 22/34 pts vs. 0/22 pts). The counts of white blood cells (P < .05), hemoglobin (P < .05), and thrombocytes (P = .001) were all significantly lower at the conclusion of the therapy. The most important adverse events were severe leukopenia (1/34 pts; 2.29 × 103/μL) and thrombocytopenia (3/34 pts; 32 000, 36 000, 32 000 106/L). Q1 Conclusion: We found that lutetium-177 prostate-specific membrane antigen-617 therapy is a promising treatment method for metastatic castration-resistant prostate cancer patients who are unresponsive to conventional therapy, according to our biochemical, positron emission tomography/computed tomography, and pain score outcomes.
镥-177前列腺特异性膜抗原-617是转移性去势抵抗性前列腺癌的一种新型替代治疗选择，对那些对标准治疗方法无反应的患者尤其有用。本研究的目的是确定镥-177前列腺特异性膜抗原-617治疗一组转移性去势抵抗性前列腺癌患者的疗效和安全性。
研究组包括34例转移性去势抵抗性前列腺癌男性患者（中位年龄，69.6±7.7岁），接受镥-177前列腺特异性膜抗原-617治疗（22/34；4个疗程，12/34；2个疗程）。通过体格检查、东部肿瘤协作组体能状态、镓-68前列腺特异性膜抗原正电子发射断层扫描/计算机断层扫描、简明疼痛量表简表问卷、生化检查和全血细胞计数对患者进行评估。通过简明疼痛量表评分、SUVmax值、生化检查和全血细胞计数检查治疗反应和不良反应。对自变量进行统计学分析（显著性；P<.05）。
东部肿瘤协作组体能状态评分为0级的患者有5/34（14.7%），1级的有25/34（73.5%），2级的有4/34（11.8%）。根据简明疼痛量表评分（评分：<1、评分：1-4、评分：5-10），患者数量分布在治疗开始时分别为2、10和22例，第二个疗程后分别为6、16和12例，第四个疗程后分别为10、10和2例。22例患者中有15例（68%）血清前列腺特异性抗原下降（P<.05）。治疗前后，我们发现SUVmax值（22.3对11.8，P<.001）和简明疼痛量表评分（评分≥5；22/34例患者对0/22例患者）有显著下降。治疗结束时，白细胞计数（P<.05）、血红蛋白（P<.05）和血小板计数（P=.001）均显著降低。最重要的不良事件是严重白细胞减少（1/34例患者；2.29×10³/μL）和血小板减少（3/34例患者；32000、36000、32000/10⁶/L）。结论：根据我们的生化、正电子发射断层扫描/计算机断层扫描和疼痛评分结果，我们发现镥-177前列腺特异性膜抗原-617治疗对于对传统治疗无反应的转移性去势抵抗性前列腺癌患者是一种有前景的治疗方法。
