Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT)
Year: 2023
Type: article
Abstract: Prostate-specific membrane antigen (PSMA) is expressed by the majority of clinically significant prostate adenocarcinomas, and patients with target-positive disease can easily be identified by PSMA PET imaging. Promising results with PSMA-targeted radiopharmaceutical therapy have already been obtained in early-phase studies using various combinations of targeting molecules and radiolabels. Definitive evidence of the safety and efficacy of [ 177 Lu]Lu-PSMA-617 in combination with standard-of-care has been demonstrated in patients with metastatic castration-resistant prostate cancer, whose disease had progressed after or during at least one taxane regimen and at least one novel androgen-axis drug. Preliminary data suggest that 177 Lu-PSMA-radioligand therapy (RLT) also has high potential in additional clinical situations. Hence, the radiopharmaceuticals [ 177 Lu]Lu-PSMA-617 and [ 177 Lu]Lu-PSMA-I&T are currently being evaluated in ongoing phase 3 trials. The purpose of this guideline is to assist nuclear medicine personnel, to select patients with highest potential to benefit from 177 Lu-PSMA-RLT, to perform the procedure in accordance with current best practice, and to prepare for possible side effects and their clinical management. We also provide expert advice, to identify those clinical situations which may justify the off-label use of [ 177 Lu]Lu-PSMA-617 or other emerging ligands on an individual patient basis.
Authors: Clemens Kratochwil, Wolfgang P. Fendler, Matthias Eiber, Michael S. Hofman, Louise Emmett, Jeremie Calais, Joseph R. Osborne, Amir Iravani, Phillip Koo, Liza Lindenberg, Richard P. Baum, Murat Fani Bozkurt, Roberto C. Delgado Bolton, Samer Ezziddin, Flavio Forrer, Rodney J. Hicks, Thomas A. Hope, Levent Kabasakal, Mark Konijnenberg, Klaus Kopka, Michael Lassmann, Felix M. Mottaghy, Wim J. G. Oyen, Kambiz Rahbar, Heiko Schoder, Irene Virgolini, Lisa Bodei, Stefano Fanti, Uwe Haberkorn, Ken Hermann
Institutions: University Hospital Heidelberg, Essen University Hospital, Deutsches Konsortium für Translationale Krebsforschung, University of Duisburg-Essen, TUM Klinikum, Technical University of Munich, The University of Melbourne, Peter MacCallum Cancer Centre, St Vincent's Hospital Sydney, University of California, Los Angeles, Weill Cornell Medicine, University of Washington, Banner MD Anderson Cancer Center, National Institutes of Health, Uniformed Services University of the Health Sciences, National Cancer Institute, Center for Cancer Research, Hacettepe University, Hospital San Pedro, Center for Biomedical Research of La Rioja, Universitätsklinikum des Saarlandes, Kantonsspital St. Gallen, St Vincent's Hospital Melbourne, University of California, San Francisco, UCSF Helen Diller Family Comprehensive Cancer Center, Istanbul University-Cerrahpaşa, Istanbul University, Erasmus MC, Helmholtz-Zentrum Dresden-Rossendorf, University Hospital Carl Gustav Carus, Nationales Centrum für Tumorerkrankungen Dresden, German Cancer Consortium (DKTK) Dresden, Technische Universität Dresden, Universitätsklinikum Würzburg, Maastricht University Medical Centre, RWTH Aachen University, Humanitas University, Radboud University Medical Center, Rijnstate Hospital, University Hospital Münster, Memorial Sloan Kettering Cancer Center, Innsbruck Medical University, Universität Innsbruck, IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola
Language: English
Subfield: Radiology, Nuclear Medicine and Imaging
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,990
Award: Cancer Center Support Grant
OpenAlex ID: W4378640167