Safety Profile and Therapeutic Efficacy of One Cycle of Lu177-PSMA in End-Stage Metastatic Castration-Resistant Prostate Cancer Patients with Low Performance Status

AbstractPurposeThe aim of this study was to evaluate safety and therapeutic efficacy of lutetium 177 prostate-specific membrane antigen (Lu-177-PSMA) in metastatic castration-resistant prostate cancer (mCRPC) patients with low performance status.MethodsTwenty-two patients already treated with anti-androgens and docetaxel were enrolled for one cycle of Lu-177-PSMA therapy. Haemoglobin, total leukocyte counts, platelets and serum creatinine for toxicity profile while prostate specific antigen (PSA), Eastern Cooperative Oncology Group (ECOG) performance status, visual analogue scale (VAS) and analgesic quantification scale (AQS) for therapeutic efficacy were recorded pre and 8  weeks post therapy. Wilcoxon signed-rank and ANOVA tests were used for statistical analysis.ResultsPartial response (PR), stable disease (SD) and progressive disease (PD) for PSA were seen in 5 (22.7%), 13 (59.1%) and 4 (18.2%) patients respectively treated with mean 6.88  GBq dose of Lu-177-PSMA. 8/22 (36.4%) patients showed ≥ 30% drop in PSA. Grade 3 haemoglobin toxicity was seen in 5/22 (22.7%) patients. No patient developed grade 4 haemoglobin toxicity. No patients had grade 3 or 4 leukocytopenia or thrombocytopenia. Wilcoxon signed-rank test showed statisti cal significant (P 
Source: Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research

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ConclusionsRadium-223 was generally well tolerated and there were no safety concerns. The adverseevents were mild and manageable. A decline in serum alkaline phosphatase was more frequent than a decline in the prostate-specific antigen. Monitoring changes in serum alkaline phosphatase dynamics may be useful.ResumenEl dicloruro de Ra223 es un radiofármaco emisor alfa que prolonga la supervivencia global en pacientes con cáncer de próstata resistente a la castración y metástasis óseas sintomáticas. Presentamos un análisis retrospectivo de 68 pacientes tratados.Mé...
Source: Revista Espanola de Medicina Nuclear e Imagen Molecular - Category: Nuclear Medicine Source Type: research
Conclusions: TANDEM-PLRT, concomitantly administering Ac-225 and Lu-177 PSMA-617, seems to be feasible, safe and effective in end-stage metastatic prostate cancer, refractory to Lu-177 PSMA. The administered radioactivity of Ac-225 PSMA can be lowered and the risk of dose-limiting toxicity (xerostomia, xerophthalmia etc.) be minimized. There might be a potential synergistic effect using two radionuclides with different emission characteristics.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Prostate Therapy I Source Type: research
Conclusions: We concluded that Lu177 PSMA therapy has adequate pain palliation in all end-stage mCRPC patients and it has the potential to become an effective therapeutic option in properly selected patients. Keywords: Lu177 PSMA, Safety, efficacy, mCRPC, Low-performance status
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Prostate Therapy I Source Type: research
Conclusions: Our findings show that 177Lu-PSMA-I&T therapy has early promising response rates and low toxicity in men with mCRPC who have progressed after conventional treatments in our local setting.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Prostate Therapy II Source Type: research
In conclusion, we identified a novel Bcl-2 inhibitor by QSAR screening, which exerted significant cytotoxic activity in breast cancer cells through inducing mitochondria-mediated apoptosis. Introduction Apoptosis is a process of cellular suicide through which unwanted or unhealthy cells are eliminated during organism development or cellular stress (Reed, 2002; Fernald and Kurokawa, 2013). Deregulated apoptosis is a characteristic of cancers (Doi et al., 2012; Roizen, 2012). The B-cell lymphoma-2 (Bcl-2) family is composed of pro- and anti-apoptotic proteins, plays pivotal role in the mitochondrial pathway of apoptosi...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
CONCLUSIONS: Lipegfilgrastim administered to patients with solid tumor/NHL undergoing chemotherapy in routine clinical practice showed similar effectiveness and safety compared to the pivotal trials. PMID: 30557099 [PubMed - as supplied by publisher]
Source: Current Medical Research and Opinion - Category: Research Tags: Curr Med Res Opin Source Type: research
Conclusions. This LuPSMA Phase II trial provides evidence of high response rates, pain reduction and low toxicity in men with mCRPC who progressed after conventional therapies. These compelling results indicate the need for randomised trials comparing LuPSMA to existing standard-of-care.
Source: Journal of Nuclear Medicine - Category: Nuclear Medicine Authors: Tags: Prostate: Therapy Source Type: research
ConclusionCombined treatment with rhenium-188-HEDP and docetaxel did not prolong PFS in patients with CRPC. The observed survival benefit in the per-protocol analysis warrants further studies in the combined treatment of chemotherapy and radiopharmaceuticals.
Source: European Journal of Nuclear Medicine and Molecular Imaging - Category: Nuclear Medicine Source Type: research
cute;nyi K, Rúzsa Á, Géczi L Abstract Radium-223 dichloride is an alpha-emitting radiopharmaceutical which significantly prolongs overall survival in patients with castration-resistant prostate cancer (CRPC) and symptomatic bone metastases. This was a retrospective analysis of the efficacy and safety of Radium-223 in the first 41 patients treated at a single center in Hungary. Radium-223 was given at a dose of 50 kBq/kg intravenously every 4 weeks for up to 6 cycles. Between 23rd July 2014 and 23rd February 2016, 41 patients were treated. Patient demographics, laboratory values,...
Source: Pathology Oncology Research - Category: Pathology Authors: Tags: Pathol Oncol Res Source Type: research
BACKGROUNDWe sought to identify potential clinical variables associated with outcomes after radium‐223 therapy in routine practice. METHODSConsecutive non‐trial mCRPC patients who received ≥1 dose of radium dichloride‐223 at four academic and one community urology‐specific cancer centers from May 2013 to June 2014 were retrospectively identified. Association of baseline and on‐therapy clinical variables with number of radium doses received and clinical outcomes including overall survival were analyzed using chi‐square statistics, cox proportional hazards, and Kaplan–Meier methods. Bone Scan Index (BSI)...
Source: The Prostate - Category: Urology & Nephrology Authors: Tags: Original Article Source Type: research
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