Patient-Specific Dosimetry in Radioligand Therapy (RLT) for Metastatic Prostate Cancer Using 177Lu-DKFZ-PSMA-617

Mahmoudi, Elahe; Pirayesh, Elahe; Deevband, Mohammad Reza; Amoui, Mahasti; Rad, Mehrdad Ghorbani; Ghorbani, Mahdi

doi:10.1007/s13139-021-00713-7

Cited by 4 publications

(2 citation statements)

References 23 publications

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“…It should be noted that the pre-treatment PSMA SUVmax of the tumors selected for dosimetry was relatively low (< 10.0) in 5 out of 24 assessed lesions in our study. However, as only [ 177 Lu]Ludotadipep was used in this study, and considering the wide variability of inter- and intra-patient tumor PSMA expression, dosimetry profiles, and dosimetry computation methods [ 30 31 32 ] it would be injudicious to directly compare the reported tumor absorbed dose values of various PSMA-targeting compounds were directly compared. Full therapeutic efficacy can only be appreciated after long-term clinical outcome data are available.…”

Section: Discussionmentioning

confidence: 99%

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [¹⁷⁷Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Ha,

Park

et al. 2024

Korean J Radiol

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Objective 177 Lutetium [Lu] Ludotadipep is a novel prostate-specific membrane antigen targeting therapeutic agent with an albumin motif added to increase uptake in the tumors. We assessed the biodistribution and dosimetry of [ 177 Lu]Ludotadipep in patients with metastatic castration-resistant prostate cancer (mCRPC). Materials and Methods Data from 25 patients (median age, 73 years; range, 60–90) with mCRPC from a phase I study with activity escalation design of single administration of [ 177 Lu]Ludotadipep (1.85, 2.78, 3.70, 4.63, and 5.55 GBq) were assessed. Activity in the salivary glands, lungs, liver, kidneys, and spleen was estimated from whole-body scan and abdominal SPECT/CT images acquired at 2, 24, 48, 72, and 168 h after administration of [ 177 Lu]Ludotadipep. Red marrow activity was calculated from blood samples obtained at 3, 10, 30, 60, and 180 min, and at 24, 48, and 72 h after administration. Organ- and tumor-based absorbed dose calculations were performed using IDAC-Dose 2.1. Results Absorbed dose coefficient (mean ± standard deviation) of normal organs was 1.17 ± 0.81 Gy/GBq for salivary glands, 0.05 ± 0.02 Gy/GBq for lungs, 0.14 ± 0.06 Gy/GBq for liver, 0.77 ± 0.28 Gy/GBq for kidneys, 0.12 ± 0.06 Gy/GBq for spleen, and 0.07 ± 0.02 Gy/GBq for red marrow. The absorbed dose coefficient of the tumors was 10.43 ± 7.77 Gy/GBq. Conclusion [ 177 Lu]Ludotadipep is expected to be safe at the dose of 3.7 GBq times 6 cycles planned for a phase II clinical trial with kidneys and bone marrow being the critical organs, and shows a high tumor absorbed dose.

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Section: Discussionmentioning

confidence: 99%

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [¹⁷⁷Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Ha,

Park

et al. 2024

Korean J Radiol

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“…Consequently, [ 177 Lu]Lu-PSMA-617 was approved using fixed standard treatment activities, and patient individual dosimetry is not mandatory for in-label use. Comparable dosimetry estimates have also been obtained in several academically driven dosimetry studies covering various in-house formulations of [ 177 Lu]Lu-PSMA-617 (e.g., with different specific activities GBq/mmol) [22,23,31,36,61,70,[87][88][89][90][106][107][108][109][110][111][112][113][114][115][116][117][118][119][120][121][122] (Annex Table -5). Similar absorbed doses to organs-at-risk have also been approximated when using [ 177 Lu]Lu-PSMA-I&T [75,81,98,[123][124][125][126] (Annex Table-5).…”

Section: Dosimetrymentioning

confidence: 97%

Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT)

Kratochwil

Fendler

Eiber

et al. 2023

Eur J Nucl Med Mol Imaging

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Prostate-specific membrane antigen (PSMA) is expressed by the majority of clinically significant prostate adenocarcinomas, and patients with target-positive disease can easily be identified by PSMA PET imaging. Promising results with PSMA-targeted radiopharmaceutical therapy have already been obtained in early-phase studies using various combinations of targeting molecules and radiolabels. Definitive evidence of the safety and efficacy of [177Lu]Lu-PSMA-617 in combination with standard-of-care has been demonstrated in patients with metastatic castration-resistant prostate cancer, whose disease had progressed after or during at least one taxane regimen and at least one novel androgen-axis drug. Preliminary data suggest that 177Lu-PSMA-radioligand therapy (RLT) also has high potential in additional clinical situations. Hence, the radiopharmaceuticals [177Lu]Lu-PSMA-617 and [177Lu]Lu-PSMA-I&T are currently being evaluated in ongoing phase 3 trials. The purpose of this guideline is to assist nuclear medicine personnel, to select patients with highest potential to benefit from 177Lu-PSMA-RLT, to perform the procedure in accordance with current best practice, and to prepare for possible side effects and their clinical management. We also provide expert advice, to identify those clinical situations which may justify the off-label use of [177Lu]Lu-PSMA-617 or other emerging ligands on an individual patient basis.

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Theranostics as an Emerging Integrated Imaging and Therapies in Precision Oncology

Taleuzzaman,

Chauhan,

Singh

et al. 2024

Nanotheranostics for Diagnosis and Therapy

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Patient-Specific Dosimetry in Radioligand Therapy (RLT) for Metastatic Prostate Cancer Using 177Lu-DKFZ-PSMA-617

Cited by 4 publications

References 23 publications

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [¹⁷⁷Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [¹⁷⁷Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT)

Theranostics as an Emerging Integrated Imaging and Therapies in Precision Oncology

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Patient-Specific Dosimetry in Radioligand Therapy (RLT) for Metastatic Prostate Cancer Using 177Lu-DKFZ-PSMA-617

Cited by 4 publications

References 23 publications

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [177Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [177Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT)

Theranostics as an Emerging Integrated Imaging and Therapies in Precision Oncology

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Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [¹⁷⁷Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer

Dosimetric Analysis of a Phase I Study of PSMA-Targeting Radiopharmaceutical Therapy With [¹⁷⁷Lu]Ludotadipep in Patients With Metastatic Castration-Resistant Prostate Cancer