RT Journal Article
SR Electronic
T1 C-X-C Motif Chemokine Receptor 4–Targeted Radioligand Therapy in Patients with Advanced T-Cell Lymphoma
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 34
OP 39
DO 10.2967/jnumed.122.264207
VO 64
IS 1
A1 Andreas K. Buck
A1 Götz Ulrich Grigoleit
A1 Sabrina Kraus
A1 Andreas Schirbel
A1 Michael Heinsch
A1 Niklas Dreher
A1 Takahiro Higuchi
A1 Constantin Lapa
A1 Heribert Hänscheid
A1 Samuel Samnick
A1 Hermann Einsele
A1 Sebastian E. Serfling
A1 Rudolf A. Werner
YR 2023
UL http://jnm.snmjournals.org/content/64/1/34.abstract
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.