lutetium-lu-177-dotatate and Prostatic-Neoplasms

We aimed first to evaluate the early oxidative stress following radionuclide therapy (RNT) with 177Lu-PSMA and 177Lu-DOTATATE and second to evaluate the protective effect of vitamin C on oxidative stress.. Prostate cancer and neuroendocrine tumor (NET) patients referred to therapy with 177Lu-PSMA and 177Lu-DOTATATE, respectively, were enrolled in this study. The patients divided into the control group underwent routine RNT without any intervention and the intervention group was asked to take effervescent tablets (500 mg) of vitamin C for two days prior to the RNT (three tablets per day). To measure oxidative stress, blood samples were taken immediately before treatment and 48 h after treatment, and the serums were separated and frozen. To evaluate oxidative stress, the serum levels of malondialdehyde (MDA) and glutathione (GSH) and the activity of glutathione reductase were measured before and two days after treatment.. In total, 61 RNT cycles were evaluated in 34 patients with age of 65 ± 2.83 (median ± SE) years (range of 27-99); this total included 20 (59%) prostate cancer patients [35 cycles (57.4%)] and 14 patients (41%) with NET [26 cycles (42.6%)]. Of the 61 evaluated cycles, 27 cycles were given in the control group and 34 cycles were given in the intervention group. The serum level of MDA was significantly increased after treatment compared to before treatment (P = 0.02) in the control group, while no significant change in the serum level of MDA was observed in the intervention group (P = 0.52). The serum level of GSH was insignificantly decreased after treatment compared to before treatment in the control group and slightly increased after treatment in the intervention group (P > 0.05). The serum level of glutathione reductase was insignificantly increased in all groups of patients after treatment (P > 0.05).. According to the results of this study, RNT with Lu-PSMA and Lu-DOTATATE may induce oxidative stress via the generation of free radicals and reactive oxygen species. Consumption of vitamin C prior to RNT may ameliorate this oxidative stress. These preliminary results have positive implications for clinical practice. Verification of these noteworthy results is needed and can be conducted with larger randomized controlled trials with longer time points.

Topics: Adult; Aged; Aged, 80 and over; Ascorbic Acid; Coordination Complexes; Female; Humans; Male; Middle Aged; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Oxidative Stress; Prostatic Neoplasms; Radiation-Protective Agents

 The aim of this study was to determine the probable cardiotoxicity following radionuclide therapy (RNT), specifically peptide receptor radionuclide therapy (PRRT) with .  Patients with prostate cancer and neuroendocrine tumours (NETs) referred for PRRT and RLT, respectively, were enrolled in this study. The cardiac profiles of the patients were evaluated by a cardiologist and a cardiac history was obtained from all patients. Also, troponin I was measured before and 48 hours after treatment..  In this retrospective study for assessment of RLT associated cardiotoxicity, 24 patients were evaluated with a median age of 64 years (27-99 years) including 13 NET patients and 11 prostate cancer patients. Patients were followed up for 4 to 31 months which no cardiovascular problem was observed. In evaluation of troponin I, 39 RNT cycles were evaluated. In all patients, the value of troponin I was in normal range. In all patients, the median values of serum troponin I before and after treatment were 0.2 ± 0.02 (range: 0.00-0.42) and 0.28 ± 0.02 (range: 0.00-0.46) ng/ml, respectively (p > 0.05). In the prostate cancer patients, the median values of serum troponin I before and after treatment were 0.26 ± 0.04 (0.04-0.42) and 0.30 ± 0.04 (0.00-0.41) ng/ml, respectively (p > 0.05). In the NET patients, the median values of serum troponin I before and after treatment were 0.18 ± 0.03 (0.00-0.42) and 0.17 ± 0.03 (0.00-0.46) ng/ml, respectively (p > 0.05)..  PRRT with.  Ziel dieser Studie war die Bestimmung der voraussichtlichen Kardiotoxizität nach Radionuklidtherapie (RNT), speziell der Peptidrezeptor-Radionuklidtherapie (PRRT) mit.  Patienten mit Prostatakrebs und neuroendokrinen Tumoren (NETs), die zur PRRT bzw. RLT überwiesen wurden, wurden in diese Studie eingeschlossen. Die kardialen Profile der Patienten wurden von einem Kardiologen beurteilt und von allen Patienten wurde eine kardiale Anamnese erhoben. Außerdem wurde Troponin I vor und 48 Stunden nach der Behandlung gemessen..  In dieser retrospektiven Studie zur Beurteilung der RLT-assoziierten Kardiotoxizität wurden 24 Patienten mit einem medianen Alter von 64 Jahren (27–99 Jahre) untersucht, darunter 13 NET-Patienten und 11 Prostatakrebspatienten. Die Patienten wurden für 4–31 Monate nachbeobachtet, wobei keine Herz-Kreislauf-Probleme beobachtet wurden. Bei der Bewertung von Troponin I wurden 39 RNT-Zyklen ausgewertet. Bei allen Patienten lag der Wert von Troponin I im Normalbereich. Bei allen Patienten lagen die medianen Werte von Serum-Troponin I vor und nach der Behandlung bei 0,2 ± 0,02 (Bereich: 0,00–0,42) bzw. 0,28 ± 0,02 (Bereich: 0,00–0,46) ng/ml (p > 0,05). Bei den Prostatakrebspatienten betrugen die medianen Werte von Serum-Troponin I vor und nach der Behandlung 0,26 ± 0,04 (0,04–0,42) bzw. 0,30 ± 0,04 (0,00–0,41) ng/ml (p > 0,05). Bei den NET-Patienten betrugen die Medianwerte von Serum-Troponin I vor und nach der Behandlung 0,18 ± 0,03 (0,00–0,42) bzw. 0,17 ± 0,03 (0,00–0,46) ng/ml (p > 0,05)..  PRRT mit

Topics: Cardiotoxicity; Humans; Male; Middle Aged; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Prostatic Neoplasms; Radioisotopes; Retrospective Studies

Lutetium-177 is an emerging radionuclide due its convenient chemical and nuclear properties. In this paper we describe the development and evaluation in Uruguay of the targeted 177Lu labelled radiopharmaceuticals EDTMP (for bone pain palliation) and DOTA-TATE (neuroendocrine tumors). We optimized the preparation of these 177Lu radiopharmaceuticals including radiolabelling, quality control methods, in vitro and in vivo stability and their therapeutic application in patients. Radiation dosimetry aspects of 177Lu are also included. Nine male patients with prostate cancer and four female patients with breast carcinoma with multiple bone metastatic lesions were treated with 177Lu-EDTMP. Four patients with gastroentheropancreatic neuroendocrine tumors (GEP-NET) and one patient with bronchial NET were treated with 1- 3 cycles with a cumulative dose of 4.44-22.2 GBq of 177Lu-DOTA-TATE. Scintigraphic images of the patients treated with 177Lu-EDTMP evidenced high and rapid uptake in bone metastasis, remaining after 7 days post administration. Images allow skeletal visualization with high definition and demonstrate increased uptake in bone metastases. For 177Lu-DOTA-TATE, partial remissions were obtained in 4 patients and the remaining patient did not show significant progression 3 months after the second cycle. No serious adverse effects were registered, even in two patients with confirmed renal disease and high risk for renal disease Dosimetry assessments confirm the predictive value of the personalized therapy with radiolabelled peptides. We found it is possible to accumulate high therapeutic doses in tumours in sequential administrations of 177Lu-DOTA-TATE, increasing the probability of biological response without significant impairment of the renal function in patients with risk factors. These results demonstrate the attractive therapeutic properties of these two 177Lu labelled agents and the feasibility of this metabolic therapy in regions far away from 177Lu producing countries.

Topics: Aged; Animals; Bone Neoplasms; Breast Neoplasms; Drug Stability; Female; Humans; Male; Mice; Middle Aged; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Organophosphorus Compounds; Pain; Prostatic Neoplasms; Quality Control; Radioisotopes; Radiometry; Radiopharmaceuticals; Uruguay