Clinical Evaluation of Ultrasound-Enhanced Radiotracer Uptake for Radioligand Therapy in Metastatic Prostate Cancer.

IF 1.7 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Cancer Biotherapy and Radiopharmaceuticals Pub Date : 2026-12-01 Epub Date: 2026-04-10 DOI:10.1177/10849785261431192

Yangbing Liang, Qingguo Wu, Yiwen Liang, Hanchu Ji

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引用次数: 0

Abstract

Background: Low-intensity pulsed ultrasound (LIPUS) may noninvasively enhance intratumoral delivery of radiopharmaceuticals, but clinical data are scarce. The authors prospectively evaluated whether adding LIPUS to prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) improves uptake and outcomes in metastatic prostate cancer while maintaining safety.

Methods: A total of 42 men with PSMA PET-positive metastatic prostate cancer received up to six cycles of ¹⁷⁷Lu-PSMA-617. Before each infusion, LIPUS (1 MHz, 0.5-2.0 W/cm², 10 min) was applied to one dominant metastasis. Baseline and postcycle-1 PSMA PET/CT measured percent change in SUV_max (ΔSUV_max) for the sonicated lesion versus a matched nonsonicated reference lesion. Patients were classified as high (ΔSUV_max ≥20%) or low enhancement. Prostate-specific antigen (PSA) response, progression-free survival (PFS), and toxicity were recorded.

Results: LIPUS was feasible in all patients without treatment interruptions. Sonicated lesions showed higher uptake (median ΔSUV_max + 32%) than reference lesions (+3%; p < 0.001). High-enhancement patients had more PSA_50 responses (71% vs. 33%) and longer PFS (11.5 vs. 5.3 months; hazard ratio 0.35). Adverse events were mainly Grades 1-2 local discomfort and typical ¹⁷⁷Lu-PSMA toxicities; no Grade ≥3 LIPUS-related events occurred.

Conclusions: US-enhanced RLT appears safe and can increase intratumoral radiotracer uptake, translating into improved biochemical control and PFS in metastatic prostate cancer.

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转移性前列腺癌放射配体治疗中超声增强示踪剂摄取的临床评价。

背景：低强度脉冲超声（LIPUS）可以无创地增强肿瘤内放射性药物的输送，但临床数据很少。作者前瞻性地评估了在前列腺特异性膜抗原（PSMA）放射配体治疗（RLT）中添加LIPUS是否能在保持安全性的同时改善转移性前列腺癌的摄取和预后。方法：共有42名PSMA pet阳性转移性前列腺癌患者接受了长达6个周期的177Lu-PSMA-617治疗。每次输注前，将LIPUS （1 MHz, 0.5-2.0 W/cm2, 10 min）应用于一个优势转移灶。基线和周期后1 PSMA PET/CT测量超声病变与匹配的非超声参考病变的SUVmax变化百分比（ΔSUVmax）。患者分为高增强（ΔSUVmax≥20%）和低增强。记录前列腺特异性抗原（PSA）反应、无进展生存期（PFS）和毒性。结果：LIPUS在所有患者中都是可行的，没有治疗中断。超声病变的摄取（中位ΔSUVmax + 32%）高于对照病变（+3%;p < 0.001）。高增强患者的PSA_50反应更多（71%对33%），PFS更长（11.5个月对5.3个月；风险比0.35）。不良事件主要为1-2级局部不适和典型的177Lu-PSMA毒性；未发生≥3级lipus相关事件。结论：us增强RLT似乎是安全的，并且可以增加肿瘤内放射性示踪剂的摄取，转化为改善转移性前列腺癌的生化控制和PFS。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Biotherapy and Radiopharmaceuticals 医学-核医学

CiteScore

7.80

自引率

2.90%

发文量

审稿时长

3 months

期刊介绍： Cancer Biotherapy and Radiopharmaceuticals is the established peer-reviewed journal, with over 25 years of cutting-edge content on innovative therapeutic investigations to ultimately improve cancer management. It is the only journal with the specific focus of cancer biotherapy and is inclusive of monoclonal antibodies, cytokine therapy, cancer gene therapy, cell-based therapies, and other forms of immunotherapies. The Journal includes extensive reporting on advancements in radioimmunotherapy, and the use of radiopharmaceuticals and radiolabeled peptides for the development of new cancer treatments.