Add like
Add dislike
Add to saved papers

177 Lu-PSMA-617 radioligand therapy in metastatic castration-resistant prostate cancer patients with a single functioning kidney.

The aim of this study was to assess the safety, tolerability and effects on renal function as well as therapeutic efficacy of prostate-specific membrane antigen (PSMA) targeted radioligand therapy (PRLT) using lutetium-177 (177 Lu) labeled PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC) and a single functioning kidney before PRLT. Methods: Sixteen patients (age 53-78 y, mean age 64.7 ± 6.5 y) with a single functioning kidney received PRLT with 177 Lu-PSMA-617 between March 2015 and October 2018. All parameters of renal function (serum creatinine, blood urea nitrogen and electrolytes) were prospectively documented in a structured database and analyzed prior to each PRLT cycle and in follow-up. Renal function was further quantified by measuring TER using 99m Tc-MAG3 renal scintigraphy. Treatment-related adverse events (AEs) were graded according to the CTCAE v.5.0. Kaplan-Meier analysis was performed to obtain the progression-free survival and overall survival. Results: The median administered activity was 22.1 GBq (range 15.4-33.8 GBq). Calculated radiation-absorbed doses of kidney per cycle were 5.3 ± 2.1 Gy (0.81±0.32 Gy/GBq). Renal function was already impaired at baseline in 43.7% patients, including G1 renal impairment in 25.0% and G2 in 18.8%. G1 and G2 renal impairment, respectively, were present in 37.5% and 6.3% of the patients after the first PRLT cycle and in 31.3 % and 12.5% after the second cycle. No G3 or 4 nephrotoxicity was observed during or after treatment. There was no significant change in both tubular extraction rate (TER) and the ratio of to lower limit TER (TER/TERLoLi) after the last cycle of treatment (p>0.05). The median PFS was 8.1 months based on both EORTC and RECIST. The median overall survival has yet to be reached with a median follow-up time of 19.3 months (range 5.8-45.3 months). Conclusion: In patients with a single functioning kidney, 177 Lu-PSMA-617 radioligand therapy is feasible, seems to be effective and is very well tolerated without any signs of acute or subacute nephrotoxicity during a mean follow up of nearly 2 years (and up to 45.3 mo). Further long-term follow-up of this special patient group is warranted.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app