Radioisotope therapy of bone metastases

Bączyk, Maciej

doi:10.5603/nmr.2011.00023

Cited by 10 publications

(8 citation statements)

References 36 publications

(48 reference statements)

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“…Several RCTs have been conducted with these agents, which demonstrated a slightly lower (but significant) benefit for 89 Sr than for 153 Sm (REF. 147) with 30–40% of patients achieving complete pain control and 40–50% achieving partial pain control 148 . Pain control was improved with the addition of bisphosphonates (50–65% achieved complete pain relief and 20–30% achieved partial pain relief) 148 .…”

Section: Managing Skeletal Complications Of Cancermentioning

confidence: 99%

“…147) with 30–40% of patients achieving complete pain control and 40–50% achieving partial pain control 148 . Pain control was improved with the addition of bisphosphonates (50–65% achieved complete pain relief and 20–30% achieved partial pain relief) 148 . 223 Ra was approved by the FDA in 2013 for use in patients with castrate-resistant prostate cancer with painful bone metastases.…”

Section: Managing Skeletal Complications Of Cancermentioning

confidence: 99%

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The best of both worlds — managing the cancer, saving the bone

et al. 2015

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In the context of breast cancer, the importance of the skeleton in the regulation of primary tumour development and as a site for subsequent metastasis is well characterized. Our understanding of the contributions made by the host bone and bone marrow cells increasingly demonstrates the extent of the interaction between tumour cells and normal host cells. As a result, the need to develop and utilize therapies that can impede the growth and/or function of tumour cells while sparing normal host bone and bone marrow cells is immense and expanding. The need for these new treatments is, however, superimposed on the orthopaedic management of patients’ quality of life, where pain control and continued locomotion are paramount. Indeed, the majority of the anticancer therapies used to date often result in direct or indirect damage to bone. Thus, although the bone microenvironment regulates tumour cell growth in bone, cells within the bone marrow niche also mediate many of the orthopaedic consequences of tumour progression as well as resistance to the antitumour effects of existing therapies. In this Review, we highlight the effects of existing cancer treatments on bone and the bone marrow microenvironment as well as the mechanisms mediating these effects and the current utility of modern orthopaedic interventions.

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Section: Managing Skeletal Complications Of Cancermentioning

confidence: 99%

Section: Managing Skeletal Complications Of Cancermentioning

confidence: 99%

The best of both worlds — managing the cancer, saving the bone

et al. 2015

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“…Therefore, they concluded that the type and size of metastases and the type of neoplasm are the main factors predicting effectiveness. In general, osteoblastic or mixed metastases have been claimed as an indication for radioisotope therapy, while osteolytic metastases require bisphosphonate treatment as a first line [23].…”

Section: Discussionmentioning

confidence: 99%

Therapeutic bone response of breast cancer recurrences on single sm-153 EDTMP treatment (+/- influence of statin intake)

Elzahry¹,

Sinzinger²,

Palumbo³

2018

Imaging-Medicine

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Purpose: Data comparing osteoblastic vs osteolytic recurrences of therapeutic response are still very limited. We aimed to answer this question in 164 female breast cancer patients (including 61 females on statin therapy) suffering from recurrent breast cancer who received a single dose of Sm-153 EDTMP for painful metastatic bone lesions. Methods: 164 female patients suffered from painful metastatic breast cancer with >1 up to 5 bone lesions, we evaluated the response of recurrences judged by CT as osteoblastic (BL), osteolytic (LY) or mixed (MI) showing up in bone scintigraphy to a single dose of 30 mci (1.1 GBq) 153 Sm-EDTMP. 116 females (70.03%) suffered from ductal, 37 (22.56%) from lobular, 10 (6.09%) from mixed and 1 (0.61%) from medullary cancer. Statin used by the 61 female patients were Simvastatin (20 or 40 mg/day orally), Atorvastatin (20 or 40 mg/day orally) and Rosuvastatin (20 mg/day orally). Results: Bone uptake and pain response did not show any difference between BL-, LY-and MI-recurrences. No correlation of pain response and its duration vs. uptake, type, number and extent of lesions, adhesion molecules (AM) and histology was seen. Out of 164 female cancer breast, females on statins exhibited a significantly (P-value<0.01) more pronounced decrease in adhesion molecules vs. non users. Conclusion: These findings indicate no significant difference in pain response between the different types of bone recurrences. Whether, the effect of statins on adhesion molecules is a direct drug effect or reflect on antitumoral action as well as, the influence on the extent of recurrences should be examined in prospective studies. KEYWORDS: therapeutic  bone response  breast cancer  recurrences  sm-153 EDTMP treatment  influence  statins intake.

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“…For example, the decay of 125 I has been shown to lead to the deposition of a very high dose (≈10 9 cGy/decaying atom) in the immediate vicinity (≈2 nm 3 ) of the decay site and a sharp and significant drop in the energy deposited (from ≈10 9 to ≈10 6 cGy) as a function of increasing distance (few nanometres) from the decaying 125 I atom (Kassis, 2011). For example, when 125 I is localized within the cytoplasm, the survival curve is of the low LET type and the number of decays needed to reduce survival is ≈80 times that of DNA-incorporated 125 I (Kassis, 2011 (Abbasi, 2012(Abbasi, , 2011Argyrou et al, 2013a;Bączyk, 2011;Bryan et al, 2009;Chakraborty et al, 2008;Daha et al, 2010;Das et al, 2009;Harrison et al, 2013;Lewington, 2005;Máthé et al, 2010;Neves et al, 2005;Nilsson et al, 2013bNilsson et al, , 2007Nilsson et al, , 2005aNilsson et al, , 2005bPandit-Taskar et al, 2014;Ramdahl et al, 2013;Sartor, 2004;Simón et al, 2012;Sivaprasad and Rajagopal, 2012;Tomblyn, 2012;Vigna et al, 2011;Volkert and Hoffman, 1999;Wang et al, 2011). Despite the growing number of radionuclides investigated for treatment of bone metastases, the use of 89 Sr and 153 Sm still accounts for the bulk of radiopharmaceutical bonetargeted therapeutics in the clinical context and the majority of the review articles available in the literature focus on those two radionuclides.…”

Section: Introductionmentioning

confidence: 99%

Palliative treatment of metastatic bone pain with radiopharmaceuticals: A perspective beyond Strontium-89 and Samarium-153

Liberal

Tavares

2016

Applied Radiation and Isotopes

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Purpose: The present review article aims to provide an overview of the available radionuclides for palliative treatment of bone metastases beyond 89 Sr and 153 Sm. In addition, it aims to review and summarize the clinical outcomes associated with the palliative treatment of bone metastases using different radiopharmaceuticals. Materials and Methods: A literature search was conducted on Science Direct and PubMed databases (1990 -2015). The following search terms were combined in order to obtain relevant results: "bone", "metastases", "palliative", "care", "therapy", "treatment", "radiotherapy", "review", "radiopharmaceutical", "phosphorus-32", "strontium-89", "yttrium-90", "tin-117m", "samarium-153", "holmium-166", "thulium-170", "lutetium-177", "rhenium-186", "rhenium-188" and "radium-223". Studies were included if they provided information regarding the clinical outcomes. Results and Conclusions: A comparative analysis of the measured therapeutic response of different radiopharmaceuticals, based on previously published data, suggests that there is a lack of substantial differences in palliative efficacy among radiopharmaceuticals. However, when the comparative analysis adds factors such as patient's life expectancy, radionuclides' physical characteristics (e.g. tissue penetration range and half-life) and health economics to guide the rational selection of a radiopharmaceutical for palliative treatment of bone metastases, 177 Lu and 188 Re-labeled radiopharmaceuticals appear to be the most suitable radiopharmaceuticals for treatment of small and medium/large size bone lesions, respectively.

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Radioisotope therapy of bone metastases

Cited by 10 publications

References 36 publications

The best of both worlds — managing the cancer, saving the bone

The best of both worlds — managing the cancer, saving the bone

Therapeutic bone response of breast cancer recurrences on single sm-153 EDTMP treatment (+/- influence of statin intake)

Palliative treatment of metastatic bone pain with radiopharmaceuticals: A perspective beyond Strontium-89 and Samarium-153

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