Penny Ross, Fongenie Benjamin, Davis Phillip, Sykes James
Blue Earth Diagnostics Ltd. The Oxford Science Park, Magdalen Centre, Robert Robinson Avenue, Oxford, OX4 4GA, UK.
Blue Earth Therapeutics Ltd. The Oxford Science Park, Magdalen Centre, Robert Robinson Avenue, Oxford, OX4 4GA, UK.
Am J Nucl Med Mol Imaging. 2024 Oct 15;14(5):337-344. doi: 10.62347/INCG3525. eCollection 2024.
BACKGROUND: High-affinity radiohybrid PSMA-targeting radiopharmaceutical F-flotufolastat (F-rhPSMA-7.3) is newly approved for diagnostic imaging of prostate cancer. Here, we conduct a post hoc analysis of two phase 3 studies to quantify F-flotufolastat uptake in a range of normal organs. METHODS: All 718 evaluable F-flotufolastat scans from LIGHTHOUSE and SPOTLIGHT were re-evaluated. Additionally, patients' medical records were reviewed and any patients with high tumor burden (PSA>20 ng/mL), altered biodistribution (e.g., chronic kidney disease), major anatomical changes to normal organs (e.g., nephrectomy), or any other history of cancer were excluded. A medical physicist defined volumes of interest over specific organs for evaluation of SUV and SUV per PERCIST 1.0 criteria. Normally distributed data are reported as mean (SD) and non-normally distributed data as median (IQR). The co-efficient of variation (CoV; calculated as SD/mean for normally distributed data and IQR/median for non-normally distributed data) was used to quantify variability of SUV metrics. RESULTS: In total, scans from 546 patients (244 primary, 302 recurrent) were eligible for this analysis. All organs were considered to be normally distributed except for the bladder and spleen. In the liver, the mean SUV was 6.7 (SD 1.7), CoV 26%, while the bladder median SUV was 10.6 (IQR 11.9), CoV 112%. The mean SUV in the liver was 8.2 (SD 2.1), CoV 26% and median SUV in the bladder was 16.0 (IQR 18.5), CoV 116%. CONCLUSIONS: Physiological F-flotufolastat uptake in normal organs was broadly consistent with other renally-cleared radiopharmaceuticals, which may have clinically significant implications when considering patient selection for radioligand therapy. Additionally, the bladder median SUV for F-flotufolastat was lower than that previously reported for Ga-PSMA-11 and F-DCFPyL.
背景:高亲和力放射性杂交前列腺特异性膜抗原(PSMA)靶向放射性药物F-氟托法司他(F-rhPSMA-7.3)新近被批准用于前列腺癌的诊断成像。在此,我们对两项3期研究进行事后分析,以量化F-氟托法司他在一系列正常器官中的摄取情况。 方法:对来自LIGHTHOUSE和SPOTLIGHT研究的所有718例可评估的F-氟托法司他扫描进行重新评估。此外,查阅了患者的病历,排除了任何肿瘤负荷高(前列腺特异性抗原>20 ng/mL)、生物分布改变(如慢性肾病)、正常器官主要解剖结构改变(如肾切除术)或有任何其他癌症病史的患者。一名医学物理学家在特定器官上定义感兴趣区,以根据PERCIST 1.0标准评估标准化摄取值(SUV)和SUV。正态分布数据报告为均值(标准差),非正态分布数据报告为中位数(四分位间距)。变异系数(CoV;正态分布数据计算为标准差/均值,非正态分布数据计算为四分位间距/中位数)用于量化SUV指标的变异性。 结果:总共546例患者(244例原发性,302例复发性)的扫描符合本分析条件。除膀胱和脾脏外,所有器官均被认为呈正态分布。在肝脏中,平均SUV为6.7(标准差1.7),CoV为26%,而膀胱的SUV中位数为10.6(四分位间距11.9),CoV为112%。肝脏中的平均SUV为8.2(标准差2.1),CoV为26%,膀胱中的SUV中位数为16.0(四分位间距18.5),CoV为116%。 结论:正常器官中F-氟托法司他的生理性摄取与其他经肾脏清除的放射性药物大致一致,在考虑放射性配体治疗的患者选择时可能具有临床重要意义。此外,F-氟托法司他的膀胱SUV中位数低于先前报道的镓-PSMA-11和F-DCFPyL的数值。
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