The Tyr Phenomenon: A Hypocalcemic Response in High-Volume Treatment Responders to 177 Lu-Prostate-Specific Membrane Antigen Therapy.

Autor:	Kumar S; Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia., Crumbaker M; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia., Harvey C; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia., Pathmanandavel S; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia., John N; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia.; St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia., Swiha MM; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia.; Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada., McDonald MM; Garvan Institute of Medical Research, Sydney, New South Wales, Australia.; School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia., Clifton-Bligh R; Department of Endocrinology, Royal North Shore Hospital, Sydney, New South Wales, Australia.; School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia., Lee A; Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia.; Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.; Genesis Care, Sydney, New South Wales, Australia; and., Bastick P; St. George Hospital, Sydney, New South Wales, Australia., Counter W; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia., Nguyen A; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia.; St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia., Emmett L; Department of Theranostics and Nuclear Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia; louise.emmett@svha.org.au.; St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia.; Garvan Institute of Medical Research, Sydney, New South Wales, Australia.
Jazyk:	angličtina
Zdroj:	Journal of nuclear medicine : official publication, Society of Nuclear Medicine [J Nucl Med] 2023 Sep; Vol. 64 (9), pp. 1412-1416. Date of Electronic Publication: 2023 Jun 22.
DOI:	10.2967/jnumed.123.265759
Abstrakt:	177 Lu-prostate-specific membrane antigen (PSMA) is an effective treatment for metastatic castration-resistant prostate cancer. Rarer treatment-related adverse events have not yet been described. Methods: We present case reviews of 2 men with a marked hypocalcemic osteosclerotic response to 177 Lu-PSMA-I&T therapy. A clinical dataset of 177 Lu-PSMA-I&T therapy was evaluated to estimate the incidence and clinical association with hypocalcemia. Results: Forty-one of the 127 men (32%) had a serum calcium drop, and 6 (5%) developed clinical hypocalcemia during 177 Lu-PSMA therapy. The baseline total tumor volume was significantly higher in those who developed hypocalcemia (median, 3,249 cm 3 [interquartile range, 1,856-3,852] vs. 465 [interquartile range 135-1,172]; P = 0.002). The mean prostate-specific antigen response in those with hypocalcemia was 78% (SD, 24%). Conclusion: Hypocalcemia may occur in response to 177 Lu-PSMA-I&T, particularly with both high-volume bone metastases and a significant prostate-specific antigen response, and may be severe, requiring corticosteroids. Further evaluation of 177 Lu-PSMA-induced hypocalcemia is required to better understand mechanisms, optimal treatments, and repercussions from any subsequent osteosclerotic response. (© 2023 by the Society of Nuclear Medicine and Molecular Imaging.)
Databáze:	MEDLINE
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