PT  - JOURNAL ARTICLE
AU  - Sabine Maurer
AU  - Peter Herhaus
AU  - Romina Lippenmeyer
AU  - Heribert Hänscheid
AU  - Malte Kircher
AU  - Andreas Schirbel
AU  - H. Carlo Maurer
AU  - Andreas K. Buck
AU  - Hans-Jürgen Wester
AU  - Hermann Einsele
AU  - Götz-Ulrich Grigoleit
AU  - Ulrich Keller
AU  - Constantin Lapa
TI  - Side Effects of CXC-Chemokine Receptor 4–Directed Endoradiotherapy with Pentixather Before Hematopoietic Stem Cell Transplantation
AID  - 10.2967/jnumed.118.223420
DP  - 2019 Oct 01
TA  - Journal of Nuclear Medicine
PG  - 1399--1405
VI  - 60
IP  - 10
4099  - http://jnm.snmjournals.org/content/60/10/1399.short
4100  - http://jnm.snmjournals.org/content/60/10/1399.full
SO  - J Nucl Med2019 Oct 01; 60
AB  - The chemokine receptor CXC-chemokine receptor 4 (CXCR4) is a transmembrane receptor involved in survival, proliferation, and dissemination of different cancers, including hematopoietic malignancies. Relapsed or refractory hematopoietic cancers are frequently resistant to conventional therapy, and novel highly active strategies are urgently needed. CXCR4-directed endoradiotherapy constitutes a highly promising targeted therapeutic concept. Here, we investigated the adverse effects of this novel treatment approach. Methods: Twenty-two patients with heavily pretreated lymphoproliferative or myeloid malignancies were treated with 177Lu- or 90Y-pentixather—a CXCR4-directed therapeutic radioligand—before conventional conditioning therapy followed by autologous or allogeneic hematopoietic stem cell transplantation. Twenty-five CXCR4-directed endoradiotherapies were administered to those patients. Adverse events occurring between endoradiotherapy and the start of conventional conditioning therapy were retrospectively analyzed and graded for the estimation of the safety profile. Results: CXCR4-directed endoradiotherapy with pentixather showed a favorable toxicity profile. As expected, the hematopoietic system was most affected, with all subjects developing cytopenias. Except for 1 acute kidney failure, grade 3, due to tumor lysis syndrome, overall nephro- and hepatotoxicity was low. Other higher-grade adverse events were either transient and resolved or easily manageable. Conclusion: Therapy with radiolabeled pentixather appears to be well tolerated and easily applicable when preceding conventional conditioning regimens for hematopoietic stem cell transplantation.