Prolonged survival in secondary glioblastoma following local injection of targeted alpha therapy with (213)Bi-substance P analogue.
Prolonged survival in secondary glioblastoma following local injection of targeted alpha therapy with (213)Bi-substance P analogue.
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DOI：
10.1007/s00259-018-4015-2
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发表时间：
2018-07
影响因子：
9.1
通讯作者：
Morgenstern A
中科院分区：
文献类型：
--
作者：
Krolicki L;Bruchertseifer F;Kunikowska J;Koziara H;Królicki B;Jakuciński M;Pawlak D;Apostolidis C;Mirzadeh S;Rola R;Merlo A;Morgenstern A
多形性胶质母细胞瘤（GBM）是最常见的恶性脑肿瘤，主要表现为原发性新发肿瘤，较少表现为继发性神经胶质肿瘤。 GBM已被证明过度表达NK-1受体，P物质可用作靶向治疗的配体。 Alpha 发射器，例如213Bi 在短距离内沉积高能量，可以选择性照射肿瘤细胞，同时不伤害邻近的神经元结构。迄今为止，在华沙医科大学已接受靶向 α 疗法治疗的 50 名不同亚型的神经胶质瘤患者中，我们在此报告了 9 名继发性 GBM 患者的数据。手术、化疗和放疗后，复发性 GBM 通过腔内注射 1-6 剂 0.9-2.3 GBq 213Bi-DOTA-[Thi8,Met(O2)11]-P 物质 (213Bi-DOTA-SP) 进行治疗，间隔 2 个月。将 68Ga-DOTA-[Thi8,Met(O2)11]-物质 P (68Ga-DOTA-SP) 与治疗剂量共同注射，以使用 PET/CT 评估生物分布。通过 MRI 监测治疗反应。活动范围为 1.4 至 9.7（中位数 5.8）GBq 213Bi-DOTA-SP 的治疗耐受性良好，仅有轻微的短暂不良反应，主要是由于短暂的全灶水肿反应引起的头痛。开始 α 疗法后的中位无进展生存期和总生存期分别为 5.8 个月和 16.4 个月。自首次诊断起的中位总生存时间为 52.3 个月。在治疗开始后，九名患者中有两名分别存活 39 个月和 51 个月。使用 213Bi-DOTA-SP 对继发性 GBM 进行靶向 α 疗法安全且耐受性良好，可能会发展成为继发性 GBM 的一种有前途的新型治疗选择。
Glioblastoma multiforme (GBM), the most common malignant brain tumor, mainly manifests as a primary de novo and less frequently as a secondary glial neoplasm. GBM has been demonstrated to overexpress the NK-1 receptor and substance P can be used as a ligand for targeted therapy. Alpha emitters, e.g. 213Bi, that deposit their high energy within a short range allow the selective irradiation of tumor cells while sparing adjacent neuronal structures. Among 50 glioma patients of different subtypes that have to date been treated with targeted alpha therapy at the Medical University Warsaw, we report here the data on nine patients with secondary GBM. Following surgery, chemo- and radiotherapy, recurrent GBM was treated by intracavitary injection of 1–6 doses of 0.9–2.3 GBq 213Bi- DOTA-[Thi8,Met(O2)11]-substance P (213Bi-DOTA-SP) in 2-month intervals. 68Ga-DOTA-[Thi8,Met(O2)11]-substance P (68Ga-DOTA-SP) was co-injected with the therapeutic doses to assess biodistribution using PET/CT. Therapeutic response was monitored with MRI. Treatment with activities ranging from 1.4 to 9.7 (median 5.8) GBq 213Bi- DOTA-SP was well tolerated with only mild transient adverse reactions, mainly headaches due to a transient perfocal edema reaction. The median progression free survival and overall survival time following the initiation of alpha therapy was 5.8 and 16.4 months, respectively. The median overall survival time from the first diagnosis was 52.3 months. Two out of nine patients are still alive 39 and 51 months, respectively, after the initiation of the therapy. Targeted alpha therapy of secondary GBM with 213Bi-DOTA-SP is safe and well tolerated and may evolve as a promising novel therapeutic option for secondary GBM.
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影响因子：
158.5
作者：
Stupp, R;Mason, WP;Ryan, G
通讯作者：
Ryan, G
影响因子：
2.3
作者：
Morgenstern, Alfred;Bruchertseifer, Frank;Apostolidis, Christos
通讯作者：
Apostolidis, Christos
影响因子：
45.3
作者：
Park, John K.;Hodges, Tiffany;Black, Peter McL.
通讯作者：
Black, Peter McL.
影响因子：
15.9
作者：
Carpentier, Alexandre;Metellus, Philippe;Carpentier, Antoine F.
通讯作者：
Carpentier, Antoine F.
影响因子：
3.9
作者：
Minniti, Giuseppe;Salvati, M.;Giangaspero, F.
通讯作者：
Giangaspero, F.