Explorative analysis of a score predicting the therapy response of patients with metastatic, castration resistant prostate cancer undergoing radioligand therapy with 177Lu-labeled prostate-specific membrane antigen
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| Názov: | Explorative analysis of a score predicting the therapy response of patients with metastatic, castration resistant prostate cancer undergoing radioligand therapy with 177Lu-labeled prostate-specific membrane antigen |
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| Autori: | Kai Huang, Imke Schatka, Julian M. M. Rogasch, Randall L. Lindquist, Maria De Santis, Barbara Erber, Piotr Radojewski, Winfried Brenner, Holger Amthauer |
| Zdroj: | Ann Nucl Med |
| Informácie o vydavateľovi: | Springer Science and Business Media LLC, 2020. |
| Rok vydania: | 2020 |
| Predmety: | Male, Glutamate Carboxypeptidase II, Lu-177 PSMA, Lutetium, Ligands, Predictive score, 03 medical and health sciences, 0302 clinical medicine, Glutamate Carboxypeptidase II/metabolism [MeSH], Prostatic Neoplasms, Castration-Resistant/pathology [MeSH], Aged, 80 and over [MeSH], Aged [MeSH], Humans [MeSH], Neoplasm Metastasis [MeSH], Radioligand therapy, Treatment Outcome [MeSH], Retrospective Studies [MeSH], Middle Aged [MeSH], Antigens, Surface/metabolism [MeSH], Lutetium/therapeutic use [MeSH], Original Article, Male [MeSH], Radioisotopes/therapeutic use [MeSH], Metastatic castration-resistant prostate cancer, Prostatic Neoplasms, Castration-Resistant/radiotherapy [MeSH], Humans, Neoplasm Metastasis, Aged, Retrospective Studies, Aged, 80 and over, Radioisotopes, Middle Aged, Prostate-Specific Antigen, 3. Good health, Prostatic Neoplasms, Castration-Resistant, Treatment Outcome, Antigens, Surface, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit |
| Popis: | Objective Up to 60% of patients with metastatic, castration-resistant prostate cancer (mCRPC) treated with 177Lu prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) achieves a partial biochemical response with a decrease of > 50% in prostate-specific antigen (PSA) levels. The remaining fractions, however, do not respond to RLT. The aim of this explorative analysis was to identify pre-therapeutic factors for the prediction of response. Methods 46 patients [age = 68 years (50–87)] with mCRPC who consecutively underwent RLT with 177Lu PSMA [median applied activity = 6 GBq (2.9–6.2)] were included and analysed retrospectively. The association of different clinical and laboratory factors and parameters from pre-therapeutic 68Ga PSMA positron emission tomography (PET) with the outcome of RLT was tested (Fisher’s test). Outcome was defined as PSA changes 8 weeks after second RLT [partial response (PR), PSA decrease > 50%; progressive disease (PD), PSA increase ≥ 25%; stable disease (SD), others]. Significant predictive factors were combined in a predictive score. Results 30% showed a post-treatment PR (median 73% PSA decrease), 35% SD (median 17% PSA decrease) and 35% PD (median 42% PSA increase). Significant predictors for PD were alkaline phosphatase (ALP) > 135 U/l (p = 0.002), PSA > 200 ng/ml (p = 0.036), and maximum standardized uptake value (SUVmax) of the “hottest lesion” in pre-therapeutic PET p = 0.005). The predictive score including PSA, ALP and SUVmax could separate 2 distinct groups of patients: ≤ 2 predictive factors (19% PD) and 3 predictive factors (90% PD). Conclusion The presented predictive score allowed a pre-therapeutic estimate of the expected response to 2 cycles of RLT. As our study was retrospective, prospective trials are needed for validation. |
| Druh dokumentu: | Article Other literature type |
| Jazyk: | English |
| ISSN: | 1864-6433 0914-7187 |
| DOI: | 10.1007/s12149-020-01567-3 |
| DOI: | 10.17169/refubium-35185 |
| Prístupová URL adresa: | https://link.springer.com/content/pdf/10.1007/s12149-020-01567-3.pdf https://pubmed.ncbi.nlm.nih.gov/33351172 https://www.ncbi.nlm.nih.gov/pubmed/33351172 https://link.springer.com/content/pdf/10.1007/s12149-020-01567-3.pdf https://pubmed.ncbi.nlm.nih.gov/33351172/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7902572 https://link.springer.com/article/10.1007/s12149-020-01567-3 https://europepmc.org/article/PMC/PMC7902572 https://repository.publisso.de/resource/frl:6471492 https://refubium.fu-berlin.de/handle/fub188/35470 https://doi.org/10.17169/refubium-35185 https://doi.org/10.1007/s12149-020-01567-3 |
| Rights: | CC BY |
| Prístupové číslo: | edsair.doi.dedup.....37a1f37c1b6bfac2286db54aab8a92a7 |
| Databáza: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Objective Up to 60% of patients with metastatic, castration-resistant prostate cancer (mCRPC) treated with 177Lu prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) achieves a partial biochemical response with a decrease of > 50% in prostate-specific antigen (PSA) levels. The remaining fractions, however, do not respond to RLT. The aim of this explorative analysis was to identify pre-therapeutic factors for the prediction of response. Methods 46 patients [age = 68 years (50–87)] with mCRPC who consecutively underwent RLT with 177Lu PSMA [median applied activity = 6 GBq (2.9–6.2)] were included and analysed retrospectively. The association of different clinical and laboratory factors and parameters from pre-therapeutic 68Ga PSMA positron emission tomography (PET) with the outcome of RLT was tested (Fisher’s test). Outcome was defined as PSA changes 8 weeks after second RLT [partial response (PR), PSA decrease > 50%; progressive disease (PD), PSA increase ≥ 25%; stable disease (SD), others]. Significant predictive factors were combined in a predictive score. Results 30% showed a post-treatment PR (median 73% PSA decrease), 35% SD (median 17% PSA decrease) and 35% PD (median 42% PSA increase). Significant predictors for PD were alkaline phosphatase (ALP) > 135 U/l (p = 0.002), PSA > 200 ng/ml (p = 0.036), and maximum standardized uptake value (SUVmax) of the “hottest lesion” in pre-therapeutic PET p = 0.005). The predictive score including PSA, ALP and SUVmax could separate 2 distinct groups of patients: ≤ 2 predictive factors (19% PD) and 3 predictive factors (90% PD). Conclusion The presented predictive score allowed a pre-therapeutic estimate of the expected response to 2 cycles of RLT. As our study was retrospective, prospective trials are needed for validation. |
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| ISSN: | 18646433 09147187 |
| DOI: | 10.1007/s12149-020-01567-3 |