Comparison of pretherapeutic osseous tumor volume and standard hematology for prediction of hematotoxicity after PSMA-targeted radioligand therapy

Purpose Hematotoxicity is a potentially dose-limiting adverse event in patients with metastasized castration-resistant prostate cancer (mCRPC) undergoing prostate-specific membrane antigen (PSMA)-directed radioligand therapy (RLT). We aimed to identify clinical or PSMA-targeted imaging-derived param...

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Bibliographic Details
Published in:European journal of nuclear medicine and molecular imaging 2021-11, Vol.48 (12), p.4077-4088
Main Authors: Widjaja, Liam, Werner, Rudolf A., Ross, Tobias L., Bengel, Frank M., Derlin, Thorsten
Format: Article
Language:English
Subjects:
Adverse events
Antigens
Cardiology
Castration
Computed tomography
Dipeptides
Hematology
Heterocyclic Compounds, 1-Ring
Humans
Imaging
Leukocytes
Leukopenia
Lymphocytes
Lymphopenia
Male
Medicine
Medicine & Public Health
Multivariate analysis
Nuclear Medicine
Oncology
Oncology – Genitourinary
Original
Original Article
Orthopedics
Parameter identification
Patients
Performance prediction
Platelets
Positron Emission Tomography Computed Tomography
Prostate
Prostate cancer
Prostatic Neoplasms, Castration-Resistant - radiotherapy
Radiology
Retrospective Studies
Subgroups
Thrombocytopenia
Treatment Outcome
Tumor Burden
Tumors
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Summary:Purpose Hematotoxicity is a potentially dose-limiting adverse event in patients with metastasized castration-resistant prostate cancer (mCRPC) undergoing prostate-specific membrane antigen (PSMA)-directed radioligand therapy (RLT). We aimed to identify clinical or PSMA-targeted imaging-derived parameters to predict hematological adverse events at early and late stages in the treatment course. Methods In 67 patients with mCRPC scheduled for 177 Lu-PSMA-617 RLT, pretherapeutic osseous tumor volume (TV) from 68 Ga-PSMA-11 PET/CT and laboratory values were assessed. We then tested the predictive capability of these parameters for early and late hematotoxicity (according to CTCAE vers. 5.0) after one cycle of RLT and in a subgroup of 32/67 (47.8%) patients after four cycles of RLT. Results After one cycle, 10/67 (14.9%) patients developed leukocytopenia (lymphocytopenia, 39/67 [58.2%]; thrombocytopenia, 17/67 [25.4%]). A cut-off of 5.6 × 10 3 /mm 3 for baseline leukocytes was defined by receiver operating characteristics (ROC) and separated between patients with and without leukocytopenia ( P  
ISSN:1619-7070
1619-7089
DOI:10.1007/s00259-021-05412-1