Misza pisze:Jako ciekawostka (potencjalnie ważna) jeszcze jedna informacja.
Zastrzegam tylko, że wiem na ten temat bardzo mało i proszę nie trzymać mnie za słowo. Od jednego z lekarzy słyszeliśmy (padło to jako jedna z opcji dalszego leczenia), że w CO Bydgoszcz niedługo (za 2/3 miesiące) ma pojawić się (niestety odpłatnie, duże kwoty) możliwość leczenia 177Lu-PSMA-617, czyli jednej z najnowszych metod celowanej walki z rakiem prostaty, która wydaje się przynosić doskonałe rezultaty. Koszta są bardzo duże, choć dobrze wiedzieć, że pojawia się kolejny nabój do walki.
Odplatne leczenie w panstwowym (?) szpitalu srodkiem, ktory jest ciagle w fazie badan?
German Multicenter Study Investigating 177Lu-PSMA-617 Radioligand Therapy in Advanced Prostate Cancer Patients
177Lu-labeled PSMA-617 is a promising new therapeutic agent for radioligand therapy (RLT) of patients with metastatic castration- resistant prostate cancer (mCRPC).
Initiated by the German Society of Nuclear Medicine, a retrospective multicenter data analysis was started in 2015 to evaluate efficacy and safety of 177Lu-PSMA-617 in a large cohort of patients.
Methods:
One hundred forty-five patients (median age, 73 y; range, 43–88 y) with mCRPC were treated with 177Lu-PSMA-617 in 12 therapy centers between February 2014 and July 2015 with 1–4 therapy cycles and an activity range of 2–8 GBq per cycle.
Toxicity was categorized by the common toxicity criteria for adverse events (version 4.0) on the basis of serial blood tests and the attending physician’s report.
The primary endpoint for efficacy was biochemical response as defined by a prostate-specific antigen decline $ 50% from baseline to at least 2 wk after the start of RLT.
Results:
A total of 248 therapy cycles were performed in 145 patients. Data for biochemical response in 99 patients as well as data for physician-reported and laboratory-based toxicity in 145 and 121 patients, respectively, were available.
The median follow-up was 16 wk (range, 2–30 wk).
Nineteen patients died during the observation period.
Grade 3–4 hematotoxicity occurred in 18 patients: 10%, 4%, and 3% of the patients experienced anemia, thrombocytopenia, and leukopenia, respectively. Xerostomia occurred in 8%.
The overall biochemical response rate was 45% after all therapy cycles, whereas 40% of patients already responded after a single cycle.
Elevated alkaline phosphatase and the presence of visceral metastases were negative predictors and the total number of therapy cycles positive predictors of biochemical response.
Conclusion:
The present retrospective multicenter study of 177Lu-PSMA-617 RLT demonstrates favorable safety and high efficacy exceeding those of other third-line systemic therapies in mCRPC patients.
Future phase II/III studies are warranted to elucidate the survival benefit of this new therapy in patients with mCRPC.
https://www.snmmi.org/files/FileDownloads/JNM 1-17 featured article_Lu-177-PSMA-617 Therapy.pdf
Caly artykul:
Artykul dot. nieduzej kohorty niemieckiej (24 pacjentow):
Bardzo interesujacy australijski artykul na temat Lutetu 177 PSMA:
W USA prowadzony jest obecnie nabor do badan klinicznych z uzyciem Lutetu 177:
Phase I Dose-escalation Study of Fractionated 177Lu-PSMA-617 for Progressive Metastatic CRPC
https://clinicaltrials.gov/ct2/show/NCT03042468
oraz
Lutetium-177 (Lu177) Prostate-Specific Antigen (PSMA)-Directed EndoRadiotherapy (PSMA-directed EndoRadiotherapy of Castration-resISTant Prostate Cancer (PERCIST): A Phase II Clinical Trial)
https://clinicaltrials.gov/ct2/show/NCT03042312