Systemic Metabolic Radiopharmaceutical Therapy in the Treatment of Metastatic Bone Pain

Paes, Fabio M.; Serafini, Aldo N.

doi:10.1053/j.semnuclmed.2009.10.003

Cited by 138 publications

(109 citation statements)

References 85 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In patients with metastatic lesions, 50% to 65% of the injected radiopharmaceutical will be chemisorbed into the bone. Metastatic lesions can accumulate about 5 times more 153 Sm-EDTMP than healthy bone tissue (Paes and Serafini, 2010). Renal excretion is complete within 8 hours post radiopharmaceutical administration and less than 1% remains in the blood at 5 h post injection.…”

Section: Iiie 153 Sm-ethylenediaminetetramethylene Phosphonic Acid mentioning

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

View full text Add to dashboard Cite

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.

show abstract

Section: Iiie 153 Sm-ethylenediaminetetramethylene Phosphonic Acid mentioning

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

View full text Add to dashboard Cite

show abstract

“…Thirty consecutive analgesic refractory skeletal metastatic cancer patients who presented with multiple bone pains not fitting into a single field of radiotherapy corresponding to foci of intense osteoblastic activity on 99mTc MDP skeletal scintigraphy, good marrow reserve as evidenced by Hb greater than 9.0g/dL, total leucocyte count greater than 3500/mm 3 , platelet count greater than 1,00,000/mm 3 and estimated glomerular filtration rate (GFR) greater than 50mL/min referred for pain palliation with radiopharmaceuticals were recruited into the study after obtaining informed consent. Patients presenting with features of spinal cord compression, poor marrow reserve, those with GFR<50mL/min, pregnant women and nursing mothers were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…Total skeletal uptake ranges between 15% and 95%, depending on the skeletal tumour burden. 3 Sm-153 EDTMP targets hydroxyapatite at sites of increased osteoblastic activity, the tumour-to-normal bone ratio being 4:1-7:1. 6 In approximately 10% patients, "flare response" has been documented.…”

mentioning

confidence: 99%

Role of samarium-153-ethylene diamine tetramethylene phosphonate radionuclide bone pain palliation in patients with metastatic bone disease

Narayan

Manthri

Kannan

et al. 2017

jcsr

View full text Add to dashboard Cite

INTRODUCTIONBone metastasis is common in prostate, breast, lung and renal cancers and can lead to complications like fractures, hypercalcaemia and bone pain, as well as reduced performance status and quality of life.1 A multidisciplinary approach is required to treat bone pain and its complicating factors. Currently, the treatment of bone pain remains palliative with systemic treatment (analgesics, hormones, chemotherapy, steroids, and bisphosphonates) for diffuse bone metastases and local treatment (surgery, nerve blocks, and external beam radiation) for focal bone metastasis.2 Many of these treatments are limited in their efficacy or duration and have significant side effects that seriously limit the cancer patient's quality of life. ABSTRACTBackground: Bone pain is the most common symptom in advanced stages of malignancy and requires multidisciplinary approach for its treatment. Localized sites of involvement can be treated with surgery or external beam radiation, whereas radiopharmaceuticals, hormones, and chemotherapy are used to treat more diffuse bone involvement.

show abstract

“…These treatments, however, do not have direct tumouricidal effects and have demonstrated limited symptomatic relief. [3][4][5][6][7][8] Over the past several decades, bone-seeking radiopharmaceuticals have demonstrated their value in diagnosing and treating painful bone metastases.…”

Section: Molecular Radiotheragnostics In Prostate Cancermentioning

confidence: 99%

Molecular radiotheragnostics in prostate cancer

Dizdarevic

2017

Clinical Medicine

View full text Add to dashboard Cite

Two different molecular radio-theragnostic principles are applied in prostate cancer, providing a personalised management for those patients. Firstly, radiopharmaceuticals with the same or similar mechanism of action but different energy (gamma-γ, eg 99m Tc-diphosphonates or positron-β+, eg 18F-NaF emitting isotopes) can be used to identify patients with osteoblastic metastases for a treatment with bone seeking beta (β-) or alpha (α-) emitting radionuclides to deliver targeted molecular radiotherapy. IntroductionProstate cancer is the most common cancer in men, affecting approximately 1 in 9 males. It is also the second most common cause of cancer death in males in the UK, accounting for approximately 13% of all cancer deaths in males. 1 Almost all patients dying from prostate cancer today have castrationresistant prostate cancer (CRPC) and patients with CRPC have a 90-95% probability of developing bone metastases, which lead to severe morbidity -including bone pain, pathological fractures, spinal cord compression and haematological consequences of bone marrow infiltration. 2-5Because of the importance of bone metastases in overall disease progression and quality of life, bone targeted therapy constitutes an essential part of the treatment of CRPC. Clinically, management of bone metastases requires a multidisciplinary approach. Moderate bone pain is usually controlled by conventional analgesics, following the World Health Organization 'three step ladder'; localised pain could be treated effectively with ABSTRACT Molecular radiotheragnostics in prostate cancerexternal beam radiotherapy. However, a substantial amount of patients experience widespread multifocal bone metastases where the above measures become less useful. [3][4][5][6] Two classes of agents are specially targeting bone metastases in prostate cancer: targeting bone resorption and bone-seeking radiopharmaceuticals. Zoledronic acid is a bisphosphonate that delays skeletal-related events (SREs) by inhibiting osteoclast mediated bone resorption. Denosumab is a human monoclonal antibody against receptor activator of nuclear factor kappa-B ligand (RANKL), which has proven to be more effective than zolendronic acid for SRE prevention. These treatments, however, do not have direct tumouricidal effects and have demonstrated limited symptomatic relief.3-8 Over the past several decades, bone-seeking radiopharmaceuticals have demonstrated their value in diagnosing and treating painful bone metastases.In addition, a new radiolabelled theragnostic compound targeting prostate-specific membrane antigen (PSMA) has been developed to select patients and deliver irradiation to all tumour sites, including osseous, nodal and visceral metastases. Radiotheragnostic pathway for metastatic bone diseaseThe patient selection process for targeted bone therapy follows a theragnostic pathway, which involves the same theragnostic Key pointsProstate cancer is the most common cancer in men, leading to approximately 13% of cancer deaths in men Bone is the most common metastatic site ...

show abstract

Systemic Metabolic Radiopharmaceutical Therapy in the Treatment of Metastatic Bone Pain

Cited by 138 publications

References 85 publications

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

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

Role of samarium-153-ethylene diamine tetramethylene phosphonate radionuclide bone pain palliation in patients with metastatic bone disease

Molecular radiotheragnostics in prostate cancer

Contact Info

Product

Resources

About