PT  - JOURNAL ARTICLE
AU  - Andreas K. Buck
AU  - Götz Ulrich Grigoleit
AU  - Sabrina Kraus
AU  - Andreas Schirbel
AU  - Michael Heinsch
AU  - Niklas Dreher
AU  - Takahiro Higuchi
AU  - Constantin Lapa
AU  - Heribert Hänscheid
AU  - Samuel Samnick
AU  - Hermann Einsele
AU  - Sebastian E. Serfling
AU  - Rudolf A. Werner
TI  - C-X-C Motif Chemokine Receptor 4–Targeted Radioligand Therapy in Patients with Advanced T-Cell Lymphoma
AID  - 10.2967/jnumed.122.264207
DP  - 2023 Jan 01
TA  - Journal of Nuclear Medicine
PG  - 34--39
VI  - 64
IP  - 1
4099  - http://jnm.snmjournals.org/content/64/1/34.short
4100  - http://jnm.snmjournals.org/content/64/1/34.full
SO  - J Nucl Med2023 Jan 01; 64
AB  - C-X-C motif chemokine receptor 4 (CXCR4)–targeted radioligand therapy (RLT) has already been applied to advanced blood cancers, such as multiple myeloma or diffuse large B-cell lymphoma. We present a series of patients with advanced T-cell lymphoma (TCL) who were scheduled for CXCR4-directed therapy as a conditioning regimen, followed by hematopoietic stem cell transplantation (HSCT). Methods: Four patients with advanced, heavily pretreated, and relapsed TCL (2 men, 2 women; median age, 50 y) without suitable alternative therapeutic options underwent CXCR4-directed PET and pretherapeutic dosimetry. We then conducted CXCR4-targeted RLT in combination with allogeneic (3/4, 75%) or autologous (1/4, 25%) HSCT. One patient also underwent radioimmunotherapy targeting CD66 to enhance therapeutic efficacy. We investigated safety, best response, progression-free survival, and overall survival. Results: Pretherapeutic dosimetry indicated lymphoma-absorbed doses of up to 33.2 Gy from CXCR4-targeted RLT. Except for 1 patient who developed tumor lysis syndrome along with transient grade 3 kidney failure, no acute toxicity, allergic reactions, or other adverse events were recorded during therapy. One patient developed septicemia and subsequently died 16 d after RLT, whereas engraftment was achieved in the remaining 3 patients (75%). During follow-up, a partial response was recorded in 1 of 3 patients (33.3%) and a complete metabolic response in the other two (66.7%, with 1 patient also receiving additional radioimmunotherapy). Median progression-free survival was 7 mo (range, 4–25 mo). After a median follow-up of 54 mo (range, 4–56 mo), 3 patients were still alive at the date of censoring. Conclusion: For advanced, heavily pretreated TCL, CXCR4-directed RLT may serve as an effective conditioning therapy before HSCT and can cause substantial antilymphoma activity, leading to a remarkable response in selected cases.