Factors affecting 223Ra therapy: clinical experience after 532 cycles from a single institution

Etchebehere, Elba; Milton, Denái R.; Araujo, John C.; Swanston, Nancy; Macapinlac, Homer A.; Rohren, Eric M.

doi:10.1007/s00259-015-3185-4

Cited by 51 publications

(50 citation statements)

References 16 publications

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“…У пациентов, получавших радий-223 при начальном уровне ПСА> 10 нг/мл, отмечалось двукратное увеличе-ние риска прогрессирования [30]. Общее количество проведенных циклов терапии радием-223 также было связано с уменьшением уровней ЩФ и со значительным снижением боли.…”

Section: радий-223 способен индуцировать снижение не только костной щunclassified

“…Ретро-спективные данные свидетельствуют о том, что добавле-ние другого агента к радию-223 может улучшить борьбу с болезнью. Например, согласно новым данным, исполь-зование абиратерона в сочетании с радием-223 улучши-ло клинические исходы [30]. Таким образом, разрабаты-ваются и тестируются нетрадиционные схемы и терапев-тические комбинации.…”

Section: радий-223 способен индуцировать снижение не только костной щunclassified

See 1 more Smart Citation

Possibilities of Radium-223 Application in Therapy of Prostate Gland Cancer

Грицкевич¹,

Мишугин²,

Русаков³

2017

Med. sov.

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ОНКОУРОЛОГИЯ ВВЕДЕНИЕВ РФ РПЖ является одним из наиболее распростра-ненных онкологических заболеваний у мужчин, он зани-мает 2-е место после опухолей легких. Доля РПЖ в струк-туре онкозаболеваний составляет 14,4%. Стандарти-зированный показатель заболеваемости в 2015 г. соста-вил 40 на 100 тыс. мужчин. В РФ число мужчин, заболев-ших РПЖ в 2015 г., составило 38 812, тогда как в 2005 г. было выявлено 16 861. Рост заболеваемости за послед-ние 10 лет составил + 105,7%. Важно отметить, что при общем снижении смертности от всех онкозаболеваний смертность от рака простаты растет (в 2005 г. -8 192, а в 2015 г. -уже 11 987 случаев) [1].Хотя такие методы лечения, как радикальная простат-эктомия, дистанционная лучевая терапия и брахитерапия, позволяют излечить пациента, примерно у 35% больных будут развиваться отдаленные метастазы [2]. В таком слу-чае применяется андрогенная депривационная терапия (AДT). К сожалению, у многих, если не у всех, мужчин заболевание прогрессирует даже на фоне АДТ, что приво-дит к метастатическому кастрационно-резистентному РПЖ (мКРРПЖ) [3]. С начала этого столетия терапевтический подход при мКРРПЖ кардинально изменился из-за появления несколь-ких новых терапевтических агентов, которые значи тельно улучшили общую выживаемость (ОВ). Доцетаксел был пер-вым препаратом, демонстрирующим значительное преи-мущество перед митоксантроном в увеличении ОВ у пациентов с мКРРПЖ [4]. В течение нескольких лет дру-гие методы лечения не получали одобрения, но в 2010 г. новый таксан, кабазитаксел, показал улучшение ОВ у пациентов, которые ранее получали лечение доцетаксе-лом [5]. Более того, новая генерация антиандрогенов, таких как абиратерона ацетат и энзалутамид, продемон-стрировала преимущества в ОВ как у пациентов, не полу-чавших лечение, так и у пациентов, предварительно полу-чавших доцетаксел [6][7][8][9]. Наконец, было показано, что инновационный радиофармацевтический препарат радий-223 повышает выживаемость у пациентов с мКРРПЖ независимо от предыдущего лечения доцетак-селом [10].Таким образом, появление ряда агентов дает возмож-ность их последовательного использования с целью достижения более высокой ОВ. К сожалению, эффектив-ность этих новых видов терапии уменьшается при более

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Section: радий-223 способен индуцировать снижение не только костной щunclassified

Possibilities of Radium-223 Application in Therapy of Prostate Gland Cancer

Грицкевич¹,

Мишугин²,

Русаков³

2017

Med. sov.

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“…In an observational study on 110 patients at the MD Anderson Cancer Center based on clinical experience, the chemotherapy regimen used concurrent with 223 Ra was not associated with an increased risk of bone marrow failure, while this risk was increased with the concomitant use of EBRT (92).…”

Section: Association Sequence and Interactionsmentioning

confidence: 99%

Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer

Buroni

Persico

Pasi

et al. 2016

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Abstract. 223 Prostate cancer (PCa) is the most common malignancy in men (1). In patients affected by advanced PCa, defined as hormonesensitive disease since the tumor still requires androgen for growth, androgen deprivation therapy (ADT), including luteinizing hormone-releasing hormone (LHRH) agonists, antagonists and anti-androgens, represents the first-line treatment. Unfortunately some cancer cells develop resistance to ADT, indicating the progression of the disease to metastatic castration-resistant prostate cancer (mCRPCa). Such resistance to castration occurs in most patients (2) and, despite the approval of new therapeutic agents, mCRPCa remains a lethal disease (3). Nowadays the new therapeutic landscape for patients affected by mCRPCa aims to extend overall survival (OS) and includes cytotoxic, new-generation anti-androgens, immunotherapeutics and radiopharmaceuticals (4, 5).Bones are the preferred site of metastasis. Almost 90% of men who die from PCa have bone-metastatic disease (6), with a 5-year OS rate of 20%. Due to the fragility of bone with metastases, with the related risk of pain, fractures, spinal cord compression and hematological consequences, several drugs have been developed to treat the osseous involvement of this disease. In previous years, the optimal treatment aimed to relieve pain and reduce skeletal morbidity.Besides systemic therapies, bone-targeted agents that focus their activity on bone, such as bisphosphonates, monoclonal antibody and radiopharmaceuticals, have become available. The bisphosphonate zoledronic acid, the antibody to receptor activator of nuclear factor kappa-B ligand (RANKL) denosumab and radiopharmaceuticals [such as 89 Sr and 153 Sm-ethylene diamine tetramethylene phosphonate ( 153 Sm-EDTMP)], were approved for delaying skeletal-related events (SREs) and for the palliation of bone pain from mCRPCa. Radionuclide TherapyRadionuclide therapy is known to deliver ionizing radiation to tumor sites, thereby killing cancer cells (7). Bone-targeted radiopharmaceuticals localize their radiation to sites of high bone remodeling. 5719

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“…Ceci et al [17] discuss the use of PET for therapy monitoring in castration resistant prostate cancer. Of note, the success of nuclear medicine in prostate cancer is based not only on its diagnostic capabilities, but also on achieving a gain in overall survival as well as improvement of quality of life in bonemetastatic refractory prostate cancer patients treated with Radium 223 [18,19]. Etchebehere et al [20] review the use of Sodium Fluoride PET in this setting, using this probe for baseline tumor burden assessment and to monitor the effect of radium 223 .…”

mentioning

confidence: 99%

“…It is followed by a section including a practical guide to better understand molecularly targeted therapies, and a comprehensive review on the use of the EORTC PET response criteria as well as the PERCIST. The third section reviews therapy monitoring with 18 F-FDG, 18 F-or 11 C-Choline, 68 Ga-PSMA and Sodium Fluoride in solid tumors, while the fourth and last section reviews therapy monitoring in hematological malignancies.…”

mentioning

confidence: 99%

Therapy monitoring with PET in cancer patients: achievements, opportunities and challenges ahead for the PET community

Aide

Fanti

2017

Eur J Nucl Med Mol Imaging

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It has been 18 years since the first guidelines on PET response criteria were released [1] (with little supporting data at that time) and 15 years since the first successful use of PET for evaluation of a molecularly targeted therapy (imatinib) was published [2]. This latter study demonstrated the huge potential of PET imaging in assessing tumor response early after treatment initiation, at a time when conventional criteria based on size measurements (RECIST) were found to be unsatisfactorily. Since then, numerous studies using FDG PET as a surrogate marker to evaluate response to therapy have been published; PET Response Criteria In Solid Tumors (PERCIST) have been introduced [3,4] and data regarding repeatability of PET have been published, supporting the use of thresholds to discriminate between responders and non-responders [5,6]. Nonetheless, unfortunately, FDG PET is far from being a standard tool in clinical trials assessing new antineoplastic tools, but there have been indeed relevant progress.It is our pleasure to introduce this special issue of the EJNMMI dedicated to therapy monitoring with PET in cancer patients, in which the reader will find up-to-date information on the basis of tumor biology and new PET technologies for therapy assessment with FDG and other PET probes in solid tumors and in hematological tumors.We have divided the issue into four sections. The first section includes a recent update on PET technologies and two articles discussing the motivations and methodology for harmonization of PET data and the challenges faced when implementing PET in clinical trials. It is followed by a section including a practical guide to better understand molecularly targeted therapies, and a comprehensive review on the use of the EORTC PET response criteria as well as the PERCIST. The third section reviews therapy monitoring with 18 F-FDG, 18 F-or 11 C-Choline, 68 Ga-PSMA and Sodium Fluoride in solid tumors, while the fourth and last section reviews therapy monitoring in hematological malignancies.One might consider that the natural history of PET technologies and antineoplastic drugs is somewhat similar, both being characterized by continuous improvements and from time to time a major breakthrough. In this EJNMMI special issue, Van der Vos et al. [7] review hardware (digital PET) and software (advanced reconstruction algorithms) PET technological improvements, digital PET being expected as a major breakthrough by the PET community. While these advances give our community great opportunities such as a better staging capability thanks to an improvement in small lesions detectability, they also bring challenges in getting harmonized images/quantitative values in PET centers running different PET systems and in multicentre clinical trials, as reviewed by Aide et al. [8] in a paper also discussing the EANM response to this issue, namely the EARL accreditation program. Yet, harmonization of PET data is only one of the problems faced by the medical oncology and PET communities when trying to implement PET wi...

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Factors affecting 223Ra therapy: clinical experience after 532 cycles from a single institution

Abstract: Concomitant use of abiraterone and (223)Ra seems to have a beneficial effect, while the EBRT may increase the risk of BMF.

Cited by 51 publications

References 16 publications

Possibilities of Radium-223 Application in Therapy of Prostate Gland Cancer

Possibilities of Radium-223 Application in Therapy of Prostate Gland Cancer

Radium-223: Insight and Perspectives in Bone-metastatic Castration-resistant Prostate Cancer

Therapy monitoring with PET in cancer patients: achievements, opportunities and challenges ahead for the PET community

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