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Radioligand Therapy in Prostate Cancer Using PSMA Ligands

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Clinical Nuclear Medicine
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Abstract

Patients with metastatic castration-resistant prostate cancer (mCRPC) have limited therapeutic options. Following a theranostics strategy, targeting the prostate-specific membrane antigen (PSMA) by diagnostic and therapeutic radioisotopes is an evolving field in the management of mCRPC. Initial results of PSMA ligands that are conjugated with therapeutic radioisotopes show good efficacy and modest side effects. In this chapter, we present a historical outline and current clinical procedure guidelines for PSMA-targeted therapy regimes.

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References

  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2017. CA Cancer J Clin. 2017;67:7–30.

    Article  PubMed  Google Scholar 

  2. Mongiat-Artus P, Teillac P. Role of Luteinising Hormone Releasing Hormone (LHRH) agonists and hormonal treatment in the management of prostate cancer. Prostate Cancer Testosterone Suppr Levels Eligard®. 2005;4:4–13.

    CAS  Google Scholar 

  3. Parker C, Nilsson S, Heinrich D, et al. Alpha emitter Radium-223 and survival in metastatic prostate Cancer. N Engl J Med. 2013;369:213–23.

    Article  CAS  PubMed  Google Scholar 

  4. Bander NH, Milowsky MI, Nanus DM, Kostakoglu L, Vallabhajosula S, Goldsmith SJ. Phase I trial of 177lutetium-labeled J591, a monoclonal antibody to prostate-specific membrane antigen, in patients with androgen-independent prostate cancer. J Clin Oncol. 2005;23:4591–601.

    Article  CAS  PubMed  Google Scholar 

  5. Tagawa ST, Milowsky MI, Morris M, et al. Phase II study of Lutetium-177-labeled anti-prostate-specific membrane antigen monoclonal antibody J591 for metastatic castration-resistant prostate cancer. Clin Cancer Res. 2013;19:5182–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Vallabhajosula S. Radioimmunotherapy of prostate cancer using 90Y- and 177Lu-labeled J591 monoclonal antibodies: effect of multiple treatments on myelotoxicity. Clin Cancer Res. 2005;11:7195s–200s.

    Article  CAS  PubMed  Google Scholar 

  7. Zechmann CM, Afshar-Oromieh A, Armor T, et al. Radiation dosimetry and first therapy results with a (124)I/ (131)I-labeled small molecule (MIP-1095) targeting PSMA for prostate cancer therapy. Eur J Nucl Med Mol Imaging. 2014;41:1280–92.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Kratochwil C, Giesel FL, Eder M, et al. [177Lu]Lutetium-labelled PSMA ligand-induced remission in a patient with metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2015;42:987–8.

    Article  PubMed  Google Scholar 

  9. Ahmadzadehfar H, Rahbar K, Kürpig S, et al. Early side effects and first results of radioligand therapy with (177)Lu-DKFZ-617 PSMA of castrate-resistant metastatic prostate cancer: a two-Centre study. EJNMMI Res. 2015;5:114.

    PubMed  Google Scholar 

  10. Rahbar K, Bögeman M, Yordanova A, et al. Delayed response after repeated177Lu-PSMA-617 radioligand therapy in patients with metastatic castration resistant prostate cancer. Eur J Nucl Med Mol Imaging. 2017:243–6.

    Article  PubMed  Google Scholar 

  11. Scher HI, Halabi S, Tannock I, et al. Design and end points of clinical trials for patients with progressive prostate cancer and castrate levels of testosterone: recommendations of the prostate Cancer clinical trials working group. J Clin Oncol. 2008;26:1148–59.

    Article  PubMed  Google Scholar 

  12. Rahbar K, Ahmadzadehfar H, Kratochwil C, et al. German multicenter study investigating 177Lu-PSMA-617 Radioligand therapy in advanced prostate Cancer patients. J Nucl Med. 2017;58:85–90.

    Article  CAS  PubMed  Google Scholar 

  13. Ferdinandus J, Eppard E, Gaertner FC, et al. Predictors of response to Radioligand therapy of metastatic castrate-resistant prostate Cancer with 177Lu-PSMA-617. J Nucl Med. 2017;58:312–9.

    Article  CAS  PubMed  Google Scholar 

  14. Ahmadzadehfar H, Wegen S, Yordanova A, et al. Overall survival and response pattern of castration-resistant metastatic prostate cancer to multiple cycles of radioligand therapy using [(177)Lu]Lu-PSMA-617. Eur J Nucl Med Mol Imaging. 2017;44:1448–54.

    Article  CAS  PubMed  Google Scholar 

  15. Rahbar K, Bode A, Weckesser M, et al. Radioligand therapy with 177Lu-PSMA-617 as a novel therapeutic option in patients with metastatic castration resistant prostate Cancer. Clin Nucl Med. 2016;41:522–8.

    Article  PubMed  Google Scholar 

  16. Hofman MS, Violet J, Hicks RJ, et al. [177Lu]-PSMA-617 radionuclide treatment in patients with metastatic castration-resistant prostate cancer (LuPSMA trial): a single-Centre, single-arm, phase 2 study. Lancet Oncol. 2018;19:825–33.

    Article  CAS  PubMed  Google Scholar 

  17. Rahbar K, Boegemann M, Yordanova A, et al. PSMA targeted radioligand therapy in metastatic castration resistant prostate cancer after chemotherapy, abiraterone and/or enzalutamide. A retrospective analysis of overall survival. Eur J Nucl Med Mol Imaging. 2018;45:12–9.

    Article  CAS  PubMed  Google Scholar 

  18. Delker A, Fendler WP, Kratochwil C, et al. Dosimetry for 177Lu-DKFZ-PSMA-617: a new radiopharmaceutical for the treatment of metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2016;43:42–51.

    Article  CAS  PubMed  Google Scholar 

  19. Bräuer A, Grubert LS, Roll W, et al. 177Lu-PSMA-617 radioligand therapy and outcome in patients with metastasized castration-resistant prostate cancer. Eur J Nucl Med Mol Imaging. 2017;44:1663–70.

    Article  PubMed  Google Scholar 

  20. Yordanova A, Becker A, Eppard E, et al. The impact of repeated cycles of radioligand therapy using [(177)Lu]Lu-PSMA-617 on renal function in patients with hormone refractory metastatic prostate cancer. Eur J Nucl Med Mol Imaging. 2017;44:1473–9.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Kambiz Rahbar .

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Seifert, R., Rahbar, K. (2020). Radioligand Therapy in Prostate Cancer Using PSMA Ligands. In: Ahmadzadehfar, H., Biersack, HJ., Freeman, L., Zuckier, L. (eds) Clinical Nuclear Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-39457-8_40

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  • DOI: https://doi.org/10.1007/978-3-030-39457-8_40

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-39455-4

  • Online ISBN: 978-3-030-39457-8

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