EANM procedure guidelines for radionuclide therapy with 177Lu-labelled PSMA-ligands (177Lu-PSMA-RLT)
EANM procedure guidelines for radionuclide therapy with 177Lu-labelled PSMA-ligands (177Lu-PSMA-RLT)
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DOI：
10.1007/s00259-019-04485-3
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发表时间：
2019-11-01
影响因子：
9.1
通讯作者：
Herrmann, Ken
中科院分区：
文献类型：
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作者：
Kratochwil, Clemens;Fendler, Wolfgang Peter;Herrmann, Ken
前列腺特异性膜抗原（PSMA）在大多数前列腺癌中表达，可以通过PSMA配体成像来识别，这已经在欧洲内外的几个国家被临床接受。目前，使用镥-177 （Lutetium-177 - psma）的psma定向放射配体治疗（PSMA-RLT）正在进行临床验证。回顾性观察数据证明了良好的安全性和显著的临床反应。最近发表的一项前瞻性临床试验（II期）结果证实，在常规治疗后进展的转移性去势抵抗性前列腺癌（mCRPC）患者中，高反应率、低毒性和疼痛减轻。这类患者的生存期通常不到1.5年。这导致一些机构采用同情或未经证实的使用这种疗法，即使没有在随机对照试验中验证。因此，存在一致的证据来支持这种治疗的有效性和安全性数据。本指南的目的是协助核医学专家根据目前可获得的最佳知识，将PSMA-RLT作为“临床实践中未经证实的干预措施”提供。
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 (Lu-177-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.