在终末期肾病患者中使用已获批准的 Lu-177 放射性药物:文献综述和拟议治疗算法

IF 4.3 3区 材料科学 Q1 ENGINEERING, ELECTRICAL & ELECTRONIC
Nikolaos A. Trikalinos, Hyun Kim, Anitha Vijayan, Maxwell Amurao, Vikas Prasad
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引用次数: 0

摘要

肽受体放射性核素疗法(PRRT)对神经内分泌肿瘤和转移性阉割耐药前列腺癌患者来说是一种非常有用的治疗方法,但由于会对肾功能产生不利影响,因此晚期肾病患者通常避免使用这种疗法。因此,对于血液透析(HD)患者使用 PRRT,目前还没有明确的指南。我们进行了一次文献综述,以查找有关接受了多他他酸镥177 (Lu177) 和 Y-90 PRRT 的血液透析患者的文献,并从制造商处获得了有关 Lu177 药代动力学和早期测试数据的信息。我们还阅读了北美神经内分泌肿瘤学会(NANETS)/欧洲神经内分泌肿瘤学会(ENETS)的最新建议。共纳入了 7 篇相关文献,涉及 15 名患者。患者接受了剂量调整后的分次PRRT治疗,通常在24小时内进行HD治疗。虽然数据有限,但没有发生任何可归因于放射性配体的即刻或长期严重不良事件。利用现有证据和多学科小组的意见,我们创建了一个机构工作流程。在多学科人员的精心指导下,可以为接受 HD 的患者提供剂量调整的 PRRT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of approved Lu-177 radiopharmaceuticals in patients with end-stage renal disease: A review of the literature and proposed treatment algorithm

Peptide receptor radionuclide therapy (PRRT) can be a very useful treatment for patients with neuroendocrine neoplasms and metastatic castration-resistant prostate cancer but it is routinely avoided in those with advanced kidney disease because it can adversely affect the renal function. Accordingly, no clear guidelines exist on the use of PRRT for patients on hemodialysis (HD). We performed a literature review to identify publications on HD patients who received PRRT with Lutetium-177 (Lu177) Dotatate and Y-90 and obtained information on Lu177 pharmacokinetics and early testing data from the manufacturer. We also perused the most recent North American Neuroendocrine Tumor Society (NANETS)/European Neuroendocrine Tumor Society (ENETS) recommendations. Seven relevant publications with a total of 15 patients were included. Patients received dose-adjusted fractions of PRRT with HD occurring usually within 24 h. There were no immediate or long-term serious adverse events attributed to the radioligand, although data was limited. Using available evidence and input from a multidisciplinary group, we have created an institutional workflow. Dose-adjusted PRRT can be offered to patients undergoing HD under careful, multidisciplinary supervision.

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CiteScore
7.20
自引率
4.30%
发文量
567
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