RT Journal Article
SR Electronic
T1 Predictors of Response to Radioligand Therapy of Metastatic Castrate-Resistant Prostate Cancer with <sup>177</sup>Lu-PSMA-617
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 312
OP 319
DO 10.2967/jnumed.116.178228
VO 58
IS 2
A1 Justin Ferdinandus
A1 Elisabeth Eppard
A1 Florian C. Gaertner
A1 Stefan Kürpig
A1 Rolf Fimmers
A1 Anna Yordanova
A1 Stefan Hauser
A1 Georg Feldmann
A1 Markus Essler
A1 Hojjat Ahmadzadehfar
YR 2017
UL http://jnm.snmjournals.org/content/58/2/312.abstract
AB Radioligand therapy (RLT) with 177Lu-PSMA-617 (PSMA is prostate-specific membrane antigen) is a novel targeted therapy for metastatic prostate cancer. In this study, we evaluated the effect of different pretherapeutic parameters on the therapeutic response measured by prostate-specific antigen (PSA) 2 mo after RLT. Methods: RLT was performed in 40 hormone-refractory patients with distant metastases and progressive disease (mean age, 71.4 y). 68Ga-PSMA-11 PET/CT was performed in all patients 1–2 wk before RLT. All patients were treated with a mean of 6 GBq. The SUVmax of tumor lesions was determined using region-of-interest analysis. Complete blood counts, renal and liver function assessments, previous therapies, pain medication, and SUVs were included in the analysis. PSA was assessed 2 mo after RLT. Results: In the univariate analysis, younger age, higher levels of γ-glutamyl transferase, lower pretherapeutic hemoglobin, a higher Gleason score, a higher number of platelets, higher C-reactive protein, regular need for pain medication, and higher lactate dehydrogenase had a negative impact on the therapeutic response; however, the multivariate analysis revealed that the most significant independent factors were the number of platelets and regular need for pain medication. The response was independent of the amount of PSMA uptake as well as previous therapies and other measured factors. Conclusion: A PSA decline of more than 50% was observed significantly more in patients without a regular need for analgesics.