177Lu-Labeled Agents for Neuroendocrine Tumor Therapy and Bone Pain Palliation in Uruguay
| Autor: | Gaudiano Javier, Henia Balter, Trindade Victoria, Hermida Juan, De Marco Eugenia, Oliver Patricia, Ferrando Rodolfo, Terán Mariella, Rodriguez Graciela, Paolino Andrea |
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| Rok vydání: | 2015 |
| Předmět: |
Pharmacology
Oncology medicine.medical_specialty EDTMP Cumulative dose business.industry Bone metastasis Neuroendocrine tumors medicine.disease Prostate cancer chemistry.chemical_compound chemistry In vivo Internal medicine medicine Radiology Nuclear Medicine and imaging medicine.symptom Nuclear medicine business Adverse effect Bone pain |
| Zdroj: | Current Radiopharmaceuticals. 9:85-93 |
| ISSN: | 1874-4710 |
| Popis: | Lutetium-177 is an emerging radionuclide due its convenient chemical and nuclear properties. In this paper we describe the development and evaluation in Uruguay of the targeted 177 Lu labelled radiopharmaceuticals EDTMP (for bone pain palliation) and DOTA-TATE (neuroendocrine tumors). We optimized the preparation of these 177 Lu radiopharmaceuticals including radiolabelling, quality control methods, in vitro and in vivo stability and their therapeutic application in patients. Radiation dosimetry aspects of 177 Lu are also included. Nine male patients with prostate cancer and four female patients with breast carcinoma with multiple bone metastatic lesions were treated with 177 Lu-EDTMP. Four patients with gastroentheropancreatic neuroendocrine tumors (GEP-NET) and one patient with bronchial NET were treated with 1- 3 cycles with a cumulative dose of 4.44-22.2 GBq of 177 Lu-DOTA-TATE. Scintigraphic images of the patients treated with 177 Lu-EDTMP evidenced high and rapid uptake in bone metastasis, remaining after 7 days post administration. Images allow skeletal visualization with high definition and demonstrate increased uptake in bone metastases. For 177 Lu-DOTA-TATE, partial remissions were obtained in 4 patients and the remaining patient did not show significant progression 3 months after the second cycle. No serious adverse effects were registered, even in two patients with confirmed renal disease and high risk for renal disease Dosimetry assessments confirm the predictive value of the personalized therapy with radiolabelled peptides. We found it is possible to accumulate high therapeutic doses in tumours in sequential administrations of 177 Lu-DOTA-TATE, increasing the probability of biological response without significant impairment ofthe renal function in patients with risk factors. These results demonstrate the attractive therapeutic properties of these two 177 Lu labelled agents and the feasibility of this metabolic therapy in regions far away from 177 Lu producing countries |
| Databáze: | OpenAIRE |
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