Evaluation of Safety and Dosimetry of Lu-DOTA-ZOL for Therapy of Bone Metastases

Overview

Journal J Nucl Med

Specialty Nuclear Medicine

Date 2021 Jan 9

PMID 33419945

Citations 9

Authors

Rene Fernandez

Elisabeth Eppard

Wencke Lehnert

Luis David Jimenez-Franco

Cristian Soza-Ried

Matias Ceballos

Jessica Ribbeck

Andreas Kluge

Frank Rosch

Marian Meckel

Konstantin Zhernosekov

Vasko Kramer

Horacio Amaral

Affiliations

Soon will be listed here.

Abstract

Palliative treatment of bone metastasis using radiolabeled bisphosphonates is a well-known concept proven to be safe and effective. A new therapeutic radiopharmaceutical for bone metastasis is Lu-DOTA-zoledronic acid (Lu-DOTA-ZOL). In this study, the safety and dosimetry of a single therapeutic dose of Lu-DOTA-ZOL were evaluated on the basis of a series of SPECT/CT images and blood samples. Nine patients with exclusive bone metastases from metastatic castration-resistant prostate cancer (mCRPC) (70.8 ± 8.4 y) and progression under conventional therapies participated in this prospective study. After receiving 5,780 ± 329 MBq Lu-DOTA-ZOL, patients underwent 3-dimensional whole-body SPECT/CT imaging and venous blood sampling over 7 d. Dosimetric evaluation was performed for main organs and tumor lesions. Safety was assessed by blood biomarkers. Lu-DOTA-ZOL showed fast uptake and high retention in bone lesions and fast clearance from the bloodstream in all patients. The average retention in tumor lesions was 0.02% injected activity per gram at 6 h after injection and approximately 0.01% at 170 h after injection. In this cohort, the average absorbed doses in bone tumor lesions, kidneys, red bone marrow, and bone surfaces were 4.21, 0.17, 0.36, and 1.19 Gy/GBq, respectively. The red marrow was found to be the dose-limiting organ for all patients. A median maximum tolerated injected activity of 6.0 GBq may exceed the defined threshold of 2 Gy for the red bone marrow in individual patients (4/8). Lu-DOTA-ZOL is safe and has a favorable therapeutic index compared with other radiopharmaceuticals used in the treatment of osteoblastic bone metastases. Personalized dosimetry, however, should be considered to avoid severe hematotoxicity for individual patients.

Citing Articles

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