Therapeutic efficiency of rhenium-188-HEDP in human prostate cancer skeletal metastases

Abstract

Rhenium-188-HEDP (Re generator, it is convenient for clinical therapeutic use with a short physical half-life of 16.9 h and a maximal b-energy of 2.1 MeV. We investigated the effect of 188 Re-HEDP on pain relief, analgesic intake and impairment of bone marrow function in 27 patients with bone metastases induced from prostate cancer. All patients were interviewed using a standardised set of questions before, and after therapy for 12 weeks. The patients were treated with 2700 -3459 MBq of 188 Re-HEDP. Blood samples were taken weekly for 12 weeks, and a blood count was performed. Patients described an improvement on the Karnofsky performance scale from 7477 to 8579% 12 weeks after therapy (P ¼ 0.001). The pain score showed a maximum decrease from 44718 to 27720% in the third to the eight week after therapy (P ¼ 0.009). Seventy-six percent of the patients described a pain relief without increase of analgesic intake. Twenty percent of the patients could discontinue their analgesics and were pain free. Mean platelet count decreased from (286775) * 10 3 ml À1 to (215792) * 10 3 ml À1, and mean leucocyte count from (7.771.5) * 10 3 ml À1 to (6.071.9) * 10 3 ml À1 in the second to the fourth week after therapy. The maximal differences between the values of platelets and leucocytes before and after therapy were not statistically significant (P ¼ 0.021 and 0.094). In conclusion, 188Re-HEDP is an effective radiopharmaceutical used in the palliative treatment of metastatic bone pain in prostate cancer and shows minimal bone marrow toxicity.

The benefit of bone-seeking radiopharmaceuticals in the treatment of metastatic bone pain

“…There are single reports using 131 I-BDP3 (Eisenhut et al 1986) and yttrium-90 (Kutzner et al 1982). More recently, 117m Sn-DTPA (Atkins et al 1995) 188 Re-HEDP (Palmedo et al 2000;Liepe et al 2003b) and 188 Re-DMSA (Blower et al 2000) have been reported to be effective for bone pain palliation, but these agents were used only in clinical studies.…”

Synthesis and structural characterization of the novel unusual oxido-bridged rhenium complex with Re atoms in two different coordination environments

“…As recently Re 186 /Re 188 is also used e.g. in palliative treatment of bone metastases [24], similar applications may be expected for the rhenium analogues. The authors reporting the analogous picoline technetium complex [22] did not provide accurate structure parameters, but solved the oxidation state problem in a later report, completing physicochemical properties characterization for [XL 4 Tc-O-TcX 4 L] (X = Cl/Br, L = pyridine, 4-picoline, 3,5-lutidine) complexes.…”

“…The Re1-Cl cis bond lengths are comparable (2.376(2)-2.385(2) Å). For comparison, in trans-ReCl 4 (py) 2 the Re IV -Cl bond length is 2.330 (1) Å, whereas Morrow[24] reported for K4 [Re 2 OCl 10 ] all Re-Cl bond lengths of 2.38(2) Å. The four pyridine ligands around the "Re III " centre are distributed in a propeller-like fashion.…”

The role of electron-emitting radiopharmaceuticals in the palliative treatment of metastatic bone pain and for radiosynovectomy: applications of conversion electron emitter Tin-117m

“…However, the average beta energy is considerably higher than that of samarium-153, and consequently the range is longer so that, at least theoretically, it is less sparing of the bone marrow. However, dosimetry from Re-188-HEDP, a much higher energy beta emitter, was shown to be within acceptable limits (Liepe et al, 2003). The dose ratio of bone to marrow is not particularly favorable for Re-186 and the compound is less stable in vivo than the other radiopharmaceuticals under discussion (Maxon et al, 1990;de Klerk et al, 1992).…”