Article Figures & Data
Figures
- FIGURE 1.
Waterfall plots of PSA, lactate dehydrogenase (LDH), and ALP response after TAT using 225Ac-PSMA-I&T. A and B describe PSA changes after 8 wk and best PSA response after first TAT cycle. C and D describe best LDH and ALP response after median of 2 TAT cycles.
- FIGURE 2.
A 79-y-old mCRPC patient (patient 11) with lymphatic and bone metastases. Patient received 2 cycles of 177Lu-PSMA RLT (cumulative activity, 10.5 GBq) after failure of docetaxel and showed initial response. However, disease progression was observed in January 2019 after 2 additional 177Lu-PSMA RLT cycles (cumulative activity, 12 GBq), and patient was admitted for 225Ac-PSMA-I&T TAT. PSA follow-up and PSMA PET showed impressive response after 2 cycles (cumulative activity, 13.4 MBq). Unfortunately, patient developed grade 3 leukocytopenia, and TAT could not be continued. Disease progression was observed in November 2019 after best supportive care (BSC).
Tables
Characteristic Value Patients 14 (100%) Age (y) Median 75 (64–80) ≥75 8 (57%) ECOG performance score ≤1 11 (79%) 2 3 (21%) PSA at start of 225Ac-PSMA-I&T (ng/mL) 112 (20.5–818) Hemoglobin at start of 225Ac-PSMA-I&T (g/dL) 10.3 (5.6–12.5) Platelets at start of 225Ac-PSMA-I&T (g/L) 246 (72–412) ALP at start of 225Ac-PSMA-I&T (U/L) (reference range, 40−130) 143 (67–695) Site of metastases before 225Ac-PSMA-I&T Bone (any) 13 (93%) Bone (superscan pattern) 5 (36%) Lymph node 10 (71%) Visceral metastasis 3 (21%) Liver 1 (7%) Lung 3 (21%) Other organs 1 (7%) Therapy before start of 225Ac-PSMA-I&T Prostatectomy 9 (64%) Radiation therapy 12 (86%) Prostate or locoregional lymph nodes 10 (71%) Distant (nonregional lymph nodes, bone) 6 (43%) Androgen deprivation therapy 14 (100%) Abiraterone OR enzalutamide 11 (79%) Abiraterone AND enzalutamide 4 (29%) Docetaxel 11 (79%) Docetaxel AND cabazitaxel 1 (7%) 177Lu-PSMA RLT 11 (79%) 223Ra-dichloride 2 (14%) ECOG = eastern cooperative oncology group.
Qualitative data are number and percentage; continuous data are median and range.
- TABLE 2
Therapy-Related Hematologic and Renal Adverse Events After 225Ac-PSMA-I&T According to Common Terminology Criteria for Adverse Events, Version 5.0
Event Before TAT After TAT Gr. 1 Gr. 2 Gr. 3 Gr. 4 Gr. 1 Gr. 2 Gr. 3 Gr. 4 Hematologic Anemia 8 (57%) 4 (29%) 2 (14%) 3 (21%) 8 (57%) 3 (21%) — Thrombopenia 3 (21%) 1 (7%) — — 3 (21%) 3 (21%) — — Leukopenia 2 (14%) 1 (7%) — — 4 (28%) — 1 (7%) — Renal 1 (7%) — — — 1 (7%) 1 (7%) — — Gastrointestinal Xerostomia 6 (43%) 2 (14%) — ND 8 (57%) 5 (36%) — ND Dysgeusia — — — — 5 (36%) 1 (7%) — — Anorexia 9 (64%) — — — 7 (50%) 2 (14%) — — Nausea — — — — 4 (29%) 1 (7%) — — General Fatigue 10 (71%) 1 (7%) — — 6 (43%) 6 (43%) — — Weight loss NA NA NA NA 4 (29%) — — — Gr. = grade; ND = not defined; NA = not applicable.
Data are number and percentage.
Parameter Before 225Ac-PSMA-I&T TAT After 225Ac-PSMA-I&T TAT Hemoglobin (g/dL) 10.11 ± 1.94 9.15 ± 1.52 Platelets (g/L) 225.29 ± 99.11 190.00 ± 104.28 Leukocytes (g/L) 5.59 ± 1.92 4.89 ± 1.78 Sodium (mmol/L) 138.00 ± 2.66 137.69 ± 4.31 Potassium (mmol/L) 4.39 ± 0.65 4.15 ± 0.32 Calcium (mmol/L) 2.20 ± 0.08 2.27 ± 0.09 Creatinine (mg/dL) 0.96 ± 0.18 0.95 ± 0.37 eGFR (mL/min) 82.57 ± 17.42 79.57 ± 18.72 BUN (mg/dL) 41.36 ± 14.68 35.69 ± 10.85 ALT (U/L) 16.77 ± 6.92 20.14 ± 11.35 AST (U/L) 41.36 ± 31.56 49.69 ± 33.96 Albumin (g/dL) 4.05 ± 0.45 3.80 ± 0.66 Bilirubin (mg/dL) 0.35 ± 0.20 0.49 ± 0.35 ALP (U/L) 237.21 ± 188.85 409.64 ± 312.49 LDH (U/L) 505.14 ± 416.90 618.62 ± 551.64 eGFR = estimated glomerular filtration rate; BUN = blood urea nitrogen; ALT = alanine aminotransferase; AST = aspartate aminotransferase; LDH = lactate dehydrogenase.
Data are mean ± SD.
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