Beyond Palliation: Therapeutic Applications Of 153Samarium-EDTMP

Wilky, Breelyn A.

doi:10.4172/2161-1459.1000131

Cited by 14 publications

(7 citation statements)

References 79 publications

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“…177 Lu-EDTMP is a relatively new beta and gamma emitting radiopharmaceutical, with suitable nuclear decay characteristics (T½ = 6.64 days, E β(max) = 498 keV, Eγ = 113 keV [6.4 %] and 208 keV [11 %]), mean tissue range = 0.23 mm) and the feasibility of large-scale production with adequate specific activity using moderate flux research reactors. 153 Sm-EDTMP is an older agent with favorable nuclear characteristic (T½ = 1.9 day, E β(max) = 810 ke , Eγ = 103 ke [28 %], mean tissue range = 0.6 mm) (10,14,17,18,19,20).…”

Section: Discussionmentioning

confidence: 99%

“…EDTMP is one of the most widely used ligands and forms stable complexes with 177 Lu and 153 Sm which can be concentrated specifically in the skeleton, in proportion to osteoblastic activity in the lesions. These radionuclides palliate the bone pain by destruction of inflammatory and malignant tumoral cells which secrete pain-inducing cytokines and prostaglandins (10,14,17,18,21).…”

Section: Discussionmentioning

confidence: 99%

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153Sm-EDTMP and 177Lu-EDTMP are equally safe and effective in pain palliation from skeletal metastases

Taheri¹,

Azizmohammadi²,

Ansari³

et al. 2018

Nuklearmedizin

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Summary Introduction: Bone pain from multifocal blastic or mixed lytic-blastic metastatic lesions can be effectively addressed with radiopharmaceuticals with high affinity for such foci. 153Sm-ethylene diamine tetramethylene phosphonic acid (153Sm-EDTMP) and 177Lu-ethylene diamine tetramethylene phosphonic acid) (177Lu-EDTMP) are two such radiopharmaceuticals. The aim of this study was to make a comparison of efficacy between 153Sm-EDTMP and 177Lu-EDTMP in terms of palliation of commonly encountered symptoms in cancer patients, functional status, and pain intensity as measured by Edmonton Symptom Assessment System (ESAS), Eastern Cooperative Oncology Group (ECOG) performance status, and numeric rating scale (NRS) respectively. This study was a double blind randomized clinical trial conducted in a setting of three university hospitals. Materials and Methods: In a randomized double-blind clinical trial 50 patients will with documented painful bone metastases of blastic or mixed lytic-blastic nature were randomly allocated into two groups; group receiving 153Sm-EDTMP and group receiving 177Lu-EDTMP. Radiopharmaceuticals were given at a dose of 37.0 MBq / kg body weight in both groups. Scores on ESAS, ECOG performance status and NRS were recorded before the intervention and following the intervention at 2, 4, 6, and 12 weeks. Hematologic toxicity was evaluated by monitoring hematologic parameters at the baseline and at 1, 3, 6, and 8 weeks after the intervention.Results: Fifty patients, 31 (62 %) females and 19 (38 %) males with the mean age of 66.08 ± 4.53 years were recruited. The baseline means and standard deviations for pain intensity as measured by the NRS were 8.4 ± 1.47 and 8.36 ± 1.43 in 153Sm-EDTMP- and 177Lu-EDTMP-treated subjects respectively. Patients of both groups showed significant alleviation of pain observed from the 2nd week (first follow up session) and continuing to the 12th week after treatment . No difference in response to the two radiopharmaceuticals were seen regarding their efficacy in pain alleviation (P < 1.0). Baseline “symptom distress scores” drawn from the ESAS-r in 153Sm-EDTMP- and 177Lu-EDTMP-treated groups were 5.5 ± 2.1 and 5.4 ± 2.1, respectively. The scores significantly improved in both groups with the most marked rate of improvement achieved within the first two weeks after treatment. The scores continued to improve until the 12th week of follow-up (P < 1.0, non-significant [ns]). Functional status as measured by ECOG performance status scores improved in both groups over the follow up period. Baseline scores on ECOG performance status in 153Sm-EDTMP- and 177Lu-EDTMP-treated groups were 2.5 ± 1.3 and 2.5 ± 1.3 (mean ± standard deviation). At 3 months post-treatment scores improved to 1.6 ± 0.6 and 1.6 ± 0.6 respectively (P < 1.0, n.s.). Conclusions: 153Sm-EDTMP and 177Lu-EDTMP are safe and effective radiopharmaceuticals in palliation of cancer pain from multiple skeletal metastases of blastic and mixed lyticblastic nature.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

153Sm-EDTMP and 177Lu-EDTMP are equally safe and effective in pain palliation from skeletal metastases

Taheri¹,

Azizmohammadi²,

Ansari³

et al. 2018

Nuklearmedizin

View full text Add to dashboard Cite

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“…Bone metastases occupy a nutrient-rich niche that enhances the treatment-resistance of disseminated PCa ( 128 ). Approved agents for palliative therapy of PCa patients with bone metastasis include beta-emitting particles such as strontium chloride ( 89 Sr-chloride) ( 129 ) and samarium-153-ethylene-diamine-tetra-methylene-phosphonate ( 153 Sm-EDTMP) ( 130 ). However, both options did not improve overall survival and demonstrated limited tolerability due to side effects on the bone marrow and hematopoietic system.…”

Section: Diagnostic Imaging Of Prostate Cancer Patients With Disseminmentioning

confidence: 99%

Metastatic Spread in Prostate Cancer Patients Influencing Radiotherapy Response

et al. 2021

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Radiotherapy and surgery are curative treatment options for localized prostate cancer (PCa) with a 5-year survival rate of nearly 100%. Once PCa cells spread into distant organs, such as bone, the overall survival rate of patients drops dramatically. The metastatic cascade and organotropism of PCa cells are regulated by different cellular subtypes, organ microenvironment, and their interactions. This cross-talk leads to pre-metastatic niche formation that releases chemo-attractive factors enforcing the formation of distant metastasis. Biological characteristics of PCa metastasis impacting on metastatic sites, burden, and latency is of clinical relevance. Therefore, the implementation of modern hybrid imaging technologies into clinical routine increased the sensitivity to detect metastases at earlier stages. This enlarged the number of PCa patients diagnosed with a limited number of metastases, summarized as oligometastatic disease. These patients can be treated with androgen deprivation in combination with local-ablative radiotherapy or radiopharmaceuticals directed to metastatic sites. Unfortunately, the number of patients with disease recurrence is high due to the enormous heterogeneity within the oligometastatic patient population and the lack of available biomarkers with predictive potential for metastasis-directed radiotherapy. Another, so far unmet clinical need is the diagnosis of minimal residual disease before onset of clinical manifestation and/or early relapse after initial therapy. Here, monitoring of circulating and disseminating tumor cells in PCa patients during the course of radiotherapy may give us novel insight into how metastatic spread is influenced by radiotherapy and vice versa. In summary, this review critically compares current clinical concepts for metastatic PCa patients and discuss the implementation of recent preclinical findings improving our understanding of metastatic dissemination and radiotherapy resistance into standard of care.

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“…In MM subjects who have diffused bone disease, systemic RT with compounds such as bone-seeking radionuclides [ 5 , 6 ] or treatments such as intensity modulated RT and helical tomography [ 7 , 8 ] have been employed. For instance, bone-seeking radionuclide treatment with radioactive samarium conjugated to a tetraphosphonate chelator has been utilized in myeloablative protocols for MM [ 9 , 10 , 11 , 12 ]. Moreover, the combinate use of RT with chemotherapeutic drugs such as bortezomib or thalidomide [ 13 , 14 , 15 ] has demonstrated good clinical effects with decreased radiotoxicity to normal tissues.…”

Section: Introductionmentioning

confidence: 99%

Radioprotective Agents and Enhancers Factors. Preventive and Therapeutic Strategies for Oxidative Induced Radiotherapy Damages in Hematological Malignancies

et al. 2020

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Radiation therapy plays a critical role in the management of a wide range of hematologic malignancies. It is well known that the post-irradiation damages both in the bone marrow and in other organs are the main causes of post-irradiation morbidity and mortality. Tumor control without producing extensive damage to the surrounding normal cells, through the use of radioprotectors, is of special clinical relevance in radiotherapy. An increasing amount of data is helping to clarify the role of oxidative stress in toxicity and therapy response. Radioprotective agents are substances that moderate the oxidative effects of radiation on healthy normal tissues while preserving the sensitivity to radiation damage in tumor cells. As well as the substances capable of carrying out a protective action against the oxidative damage caused by radiotherapy, other substances have been identified as possible enhancers of the radiotherapy and cytotoxic activity via an oxidative effect. The purpose of this review was to examine the data in the literature on the possible use of old and new substances to increase the efficacy of radiation treatment in hematological diseases and to reduce the harmful effects of the treatment.

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Beyond Palliation: Therapeutic Applications Of 153Samarium-EDTMP

Cited by 14 publications

References 79 publications

153Sm-EDTMP and 177Lu-EDTMP are equally safe and effective in pain palliation from skeletal metastases

153Sm-EDTMP and 177Lu-EDTMP are equally safe and effective in pain palliation from skeletal metastases

Metastatic Spread in Prostate Cancer Patients Influencing Radiotherapy Response

Radioprotective Agents and Enhancers Factors. Preventive and Therapeutic Strategies for Oxidative Induced Radiotherapy Damages in Hematological Malignancies

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