Download PDF
Nuklearmedizin 2020; 59(03): 281-283
DOI: 10.1055/a-1151-4592
Case Report

[177Lu]Lu-DOTA-zoledronate therapy – first application in a patient with primary osseous metastatic bronchial carcinoma

Barbara Kreppel
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Florian Christoph Gaertner
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Hojjat Ahmadzadehfar
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
2   Department of Nuclear Medicine, Westfalen Hospital, Dortmund, Germany
,
Ambreen Khawar
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Frank Roesch
3   Institute of Nuclear Chemistry, Johannes Gutenberg University Mainz, Germany
,
Stefan Kürpig
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Michael Meisenheimer
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Markus Essler
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
,
Ralph Alexander Bundschuh
1   Department of Nuclear Medicine, University Medical Center Bonn, Bonn, Germany
› Author Affiliations
› Further Information
    Permissions and Reprints

Background

Radioligand therapies are gaining increasing importance in tumor therapy. With bone-seeking radiopharmaceuticals that selectively accumulate in osteoblastic active areas, such as the beta-emiting radionuclides samarium-153 and strontium-89 or the alpha-emitting radium-223, therapy options exist to palliate cancer-induced bone pain [1] [5] or even prolong survival [6]. [153Sm]Sm-EDTMP is approved for osteoblastic bone metastases regardless of the primary tumor, whereas [89Sr]Sr-Chlorid is only approved for palliative pain therapy for bone metastases of prostate cancer [2] [8]. Zoledronic acid conjugated to the macrocyclic chelator DOTA and labeled with lutetium-177 ([177Lu]Lu-DOTA-ZOL) represent a new class of promising radiopharmaceuticals for the treatment of bone metastases. The bisphosphonate derivative DOTA-ZOL can also be labeled with gallium-68 for diagnosis using positron emission tomography (PET) [7]. Zoledronic acid, a highly potent new generation bisphosphonate, inhibits bone resorption by the osteoclasts and accumulates in osteoblastic bone. Furthermore, lutetium-177 seems to have superior properties for treatment of bone metastases compared to other radioisotopes [3] [4].

We report about a lung cancer patient with osseous metastases, refractory to guideline treatment, who received radioligand therapy with [177Lu]Lu-DOTA-ZOL.



Publication History

Article published online:
28 April 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Ahmadzadehfar H, Essler M, Rahbar K. et al. Radionuclide Therapy for Bone Metastases: Utility of Scintigraphy and PET Imaging for Treatment Planning. PET Clin 2018; 13: 491-503
    CrossrefPubMedGoogle Scholar
  • 2 Bayouth JE, Macey DJ, Kasi LP. et al. Dosimetry and toxicity of samarium-153-EDTMP administered for bone pain due to skeletal metastases. J Nucl Med 1994; 35: 63-69
    PubMedGoogle Scholar
  • 3 Guerra Liberal FDC, Tavares AAS, Tavares JMRS. Comparative analysis of 11 different radioisotopes for palliative treatment of bone metastases by computational methods. Med Phys 2014; 41: 114101
    CrossrefPubMedGoogle Scholar
  • 4 Khawar A, Eppard E, Roesch F. et al. Biodistribution and post-therapy dosimetric analysis of 177LuLu-DOTAZOL in patients with osteoblastic metastases: first results. EJNMMI Res 2019; 9: 102
    CrossrefPubMedGoogle Scholar
  • 5 Pandit-Taskar N, Batraki M, Divgi CR. Radiopharmaceutical therapy for palliation of bone pain from osseous metastases. J Nucl Med 2004; 45: 1358-1365
    PubMedGoogle Scholar
  • 6 Parker C, Nilsson S, Heinrich D. et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med 2013; 369: 213-223
    CrossrefPubMedGoogle Scholar
  • 7 Pfannkuchen N, Meckel M, Bergmann R. et al. Novel Radiolabeled Bisphosphonates for PET Diagnosis and Endoradiotherapy of Bone Metastases. Pharmaceuticals (Basel) 2017; 10 (02) 45
    CrossrefPubMedGoogle Scholar
  • 8 Serafini AN, Houston SJ, Resche I. et al. Palliation of pain associated with metastatic bone cancer using samarium-153 lexidronam: a double-blind placebo-controlled clinical trial. J Clin Oncol 1998; 16: 1574-1581
    CrossrefPubMedGoogle Scholar
  • 9 Sharabi AB, Lim M, DeWeese TL. et al. Radiation and checkpoint blockade immunotherapy: radiosensitisation and potential mechanisms of synergy. The Lancet Oncology 2015; 16: e498-e509
    CrossrefPubMedGoogle Scholar