EANM procedure guidelines for radionuclide therapy with 177Lu-labelled PSMA-ligands (177Lu-PSMA-RLT) Guidelines


Authors: Kratochwil, C.; Fendler, W. P.; Eiber, M.; Baum, R.; Bozkurt, M. F.; Czernin, J.; Delgado Bolton, R. C.; Ezziddin, S.; Forrer, F.; Hicks, R. J.; Hope, T. A.; Kabasakal, L.; Konijnenberg, M.; Kopka, K.; Lassmann, M.; Mottaghy, F. M.; Oyen, W.; Rahbar, K.; Schöder, H.; Virgolini, I.; Wester, H. J.; Bodei, L.; Fanti, S.; Haberkorn, U.; Herrmann, K.
Title: EANM procedure guidelines for radionuclide therapy with 177Lu-labelled PSMA-ligands (177Lu-PSMA-RLT)
Abstract: Prostate-specific membrane antigen (PSMA) is expressed in most prostate cancers and can be identified by PSMA-ligand imaging, which has already become clinically accepted in several countries in- and outside Europe. PSMA-directed radioligand therapy (PSMA-RLT) with Lutetium-177 (177Lu-PSMA) is currently undergoing clinical validation. Retrospective observational data have documented favourable safety and striking clinical responses. Recent results from a prospective clinical trial (phase II) have been published confirming high response rates, low toxicity and reduction of pain in metastatic castration-resistant prostate cancer (mCRPC) patients who had progressed after conventional treatments. Such patients typically survive for periods less than 1.5 years. This has led some facilities to adopt compassionate or unproven use of this therapy, even in the absence of validation within a randomised-controlled trial. As a result, a consistent body of evidence exists to support efficacy and safety data of this treatment. The purpose of this guideline is to assist nuclear medicine specialists to deliver PSMA-RLT as an “unproven intervention in clinical practice”, in accordance with the best currently available knowledge. © 2019, Springer-Verlag GmbH Germany, part of Springer Nature.
Keywords: controlled study; unclassified drug; major clinical study; fatigue; drug efficacy; drug safety; side effect; cancer patient; follow up; prospective study; clinical practice; treatment indication; anemia; blood toxicity; nausea; randomized controlled trial; thrombocytopenia; validation study; retrospective study; patient identification; lymphocytopenia; prostate cancer; dosimetry; xerostomia; medical specialist; nuclear medicine; tracer; observational study; treatment contraindication; medical ethics; radioisotope therapy; medical expert; radiation protection; theranostics; castration resistant prostate cancer; lutetium; psma; salivary gland function; radionuclide therapy; human; male; article; prostate specific membrane antigen lu 177
Journal Title: European Journal of Nuclear Medicine and Molecular Imaging
Volume: 46
Issue: 12
ISSN: 1619-7070
Publisher: Springer  
Date Published: 2019-11-01
Start Page: 2536
End Page: 2544
Language: English
DOI: 10.1007/s00259-019-04485-3
PUBMED: 31440799
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 2 December 2019 -- Source: Scopus
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  1. Heiko Schoder
    546 Schoder
  2. Lisa   Bodei
    205 Bodei