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62. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie

14. - 15.04.2016, Münster

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Therapeutic response and side effects of repeated radioligand therapy with 177Lu- PSMA-DKFZ-617 of castrate-resistant metastatic prostate cancer

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  • presenting/speaker H. Ahmadzadehfar - Universitätsklinikum Bonn, Nuklearmedizin, Bonn, Germany
  • E. Eppard - Universitätsklinikum Bonn, Nuklearmedizin, Bonn, Germany
  • S. Kürpig - Universitätsklinikum Bonn, Nuklearmedizin, Bonn, Germany
  • R. Fimmers - Universitätsklinikum Bonn, Biometrie, Bonn, Germany
  • A. Yordanova - Universitätsklinikum Bonn, Nuklearmedizin, Bonn, Germany
  • C.D. Schlenkhoff - Universitätsklinikum Bonn, Nuklearmedizin, Bonn, Germany
  • S. Rogenhofer - Universitätsklinikum Bonn, Urologie, Bonn, Germany
  • M. Essler - Universitätsklinikum Bonn, Nuklearmedizin, Bonn, Germany

Nordrhein-Westfälische Gesellschaft für Urologie. 62. Kongress der Nordrhein-Westfälischen Gesellschaft für Urologie. Münster, 14.-15.04.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocV4.6

doi: 10.3205/16nrwgu51, urn:nbn:de:0183-16nrwgu517

Published: February 25, 2016

© 2016 Ahmadzadehfar et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction: Prostate-specific membrane antigen (PSMA) is highly expressed on prostate epithelial cells and strongly up-regulated in prostate cancer, making it an optimal target for the treatment of metastasized prostate cancers. Radioligand therapy (RLT) with 177Lu- PSMA-DKFZ-617 (Lu-PSMA) is a novel targeted therapy of metastatic prostate cancer. In this study, we retrospectively analyzed the side effects and the response rate of 24 patients who received up to two cycles of therapy with Lu-PSMA in our department.

Methods: Twenty-four consecutive hormone and/or chemorefractory PCa patients with distant metastases and progressive disease according to the PSA level were treated with Lu-PSMA, Gleason-Score: 6-9; mean age: 75 y (64-82). 68Ga-PSMA PET was performed in all patients 1-2 weeks prior to RLT. Median PSA was 522 ng/ml (range: 17-2360). The salivary glands were protected with ice packs.

Results: Forty-six cycles of Lu-PSMA (mean of 6.0 GBq) were performed in 24 patients with a mean age of 75.2 years (range: 64-82). Twenty-two out of 24 patients received two cycles (at about an 8-week interval). Eight weeks after the first cycle of Lu-PSMA therapy 79.1% experienced a decline in PSA. Eight weeks after the second cycle of Lu-PSMA therapy 68.2% experienced a decline in PSA relative to the baseline value. Apart from two cases of grade 3 anemia, there was no relevant hemato- or nephrotoxicity (grade 3 or 4).

Conclusion: Lu-PSMA is a safe treatment option for metastatic prostate cancer patients and has a low toxicity profile. A positive response to therapy in terms of decline in PSA occurs in about 70% of patients.