177Lu-前列腺特异性膜抗原治疗转移性Castion-耐药前列腺癌症和既往223Ra患者(RALU研究)。

IF 9.1 1区 医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Kambiz Rahbar, Markus Essler, Matthias Eiber, Christian la Fougère, Vikas Prasad, Wolfgang P Fendler, Philipp Rassek, Ergela Hasa, Helmut Dittmann, Ralph A Bundschuh, Kim M Pabst, Milena Kurtinecz, Anja Schmall, Frank Verholen, Oliver Sartor
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引用次数: 0

摘要

223Ra-二氯(223Ra)和177Lu-国家特异性膜抗原(PSMA)是用于转移性去势耐受性前列腺癌症(mCRPC)的经批准的治疗方法。在mCRPC患者中连续使用223Ra和177Lu PSMA的安全性和有效性尚未得到很好的描述。本研究旨在评估177Lu PSMA在既往接受223Ra治疗的mCRPC患者中的安全性和有效性。方法:镭→镥(RALU)研究是一项多中心、回顾性、医学图表综述。参与者接受了至少1 223Ra剂量,在随后的任何治疗系列中,至少接受了1 177Lu PSMA剂量。主要终点包括不良事件(AE)、严重AE、3-4级血液学AE和异常实验室值的发生率。次要终点包括总生存率、下一次治疗/死亡的时间以及血清前列腺特异性抗原和碱性磷酸酶水平与基线的变化。结果:数据来自133例患者。177Lu PSMA治疗前,56%(75/133)的患者接受了至少4种延长生命的治疗;所有患者接受223Ra(73%接受5-6次注射)。总体而言,27%(36/133)的患者接受了至少5次177Lu PSMA输注。79%(105/133)的患者报告了任何级别的治疗突发AE,30%(40/133)报告了严重AE。最常见的3-4级实验室异常是贫血(30%,40/133)和血小板减少症(13%,17/133)。中位总生存率为13.2 mo(95%置信区间,10.5-15.6 莫)从177Lu PSMA开始。结论:在这种现实环境中,在mCRPC的重度预处理患者中,223Ra和177Lu PSMA治疗在临床上是可行的,没有迹象表明177Lu-PSMA的安全性或有效性受损。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
177Lu-Prostate-Specific Membrane Antigen Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer and Prior 223Ra (RALU Study).

223Ra-dichloride (223Ra) and 177Lu-prostate-specific membrane antigen (PSMA) are approved treatments for metastatic castration-resistant prostate cancer (mCRPC). The safety and effectiveness of sequential use of 223Ra and 177Lu-PSMA in patients with mCRPC are not well described. This study aimed to evaluate 177Lu-PSMA safety and efficacy in patients with mCRPC previously treated with 223Ra. Methods: The radium→lutetium (RALU) study was a multicenter, retrospective, medical chart review. Participants had received at least 1 223Ra dose and, in any subsequent therapy line, at least 1 177Lu-PSMA dose. Primary endpoints included the incidence of adverse events (AEs), serious AEs, grade 3-4 hematologic AEs, and abnormal laboratory values. Secondary endpoints included overall survival, time to next treatment/death, and change from baseline in serum prostate-specific antigen and alkaline phosphatase levels. Results: Data were from 133 patients. Before 177Lu-PSMA therapy, 56% (75/133) of patients received at least 4 life-prolonging therapies; all patients received 223Ra (73% received 5-6 injections). Overall, 27% (36/133) of patients received at least 5 177Lu-PSMA infusions. Any-grade treatment-emergent AEs were reported in 79% (105/133) of patients and serious AEs in 30% (40/133). The most frequent grade 3-4 laboratory abnormalities were anemia (30%, 40/133) and thrombocytopenia (13%, 17/133). Median overall survival was 13.2 mo (95% CI, 10.5-15.6 mo) from the start of 177Lu-PSMA. Conclusion: In this real-world setting, 223Ra followed by 177Lu-PSMA therapy in heavily pretreated patients with mCRPC was clinically feasible, with no indication of impairment of 177Lu-PSMA safety or effectiveness.

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来源期刊
Journal of Nuclear Medicine
Journal of Nuclear Medicine 医学-核医学
CiteScore
13.00
自引率
8.60%
发文量
340
审稿时长
1 months
期刊介绍: The Journal of Nuclear Medicine (JNM), self-published by the Society of Nuclear Medicine and Molecular Imaging (SNMMI), provides readers worldwide with clinical and basic science investigations, continuing education articles, reviews, employment opportunities, and updates on practice and research. In the 2022 Journal Citation Reports (released in June 2023), JNM ranked sixth in impact among 203 medical journals worldwide in the radiology, nuclear medicine, and medical imaging category.
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