Long-Term Nephrotoxicity of 177Lu-PSMA Radioligand Therapy
© 2024 by the Society of Nuclear Medicine and Molecular Imaging..
β-emitting 177Lu targeting prostate-specific membrane antigen (PSMA) is an approved treatment option for metastatic castration-resistant prostate cancer. Data on its long-term nephrotoxicity are sparse. This study aimed to retrospectively evaluate post-177Lu-PSMA estimated glomerular filtration rate (eGFR) dynamics for at least 12 mo in a cohort of metastatic castration-resistant prostate cancer patients. Methods: The institutional databases of 3 German tertiary referral centers identified 106 patients who underwent at least 4 cycles of 177Lu-PSMA and had at least 12 mo of eGFR follow-up data. eGFR (by the Chronic Kidney Disease Epidemiology Collaboration formula) at 3, 6, and 12 mo after 177Lu-PSMA radioligand therapy was estimated using monoexponentially fitted curves through available eGFR data. eGFR changes were grouped (≥15%-<30%, moderate; ≥30%-<40%, severe; and ≥40%, very severe). Associations between eGFR changes (%) and nephrotoxic risk factors, prior treatment lines, and number of 177Lu-PSMA cycles were analyzed using multivariable linear regression. Results: At least moderate eGFR decreases were present in 45% (48/106) of patients; of those, nearly half (23/48) had a severe or very severe eGFR decrease. A higher number of risk factors at baseline (-4.51, P = 0.03) was associated with a greater eGFR decrease. Limitations of the study were the retrospective design, lack of a control group, and limited number of patients with a follow-up longer than 1 y. Conclusion: A considerable proportion of patients may experience moderate or severe decreases in eGFR 1 y from initiation of 177Lu-PSMA. A higher number of risk factors at baseline seems to aggravate loss of renal function. Further prospective trials are warranted to estimate the nephrotoxic potential of 177Lu-PSMA.
| Errataetall: |
CommentIn: J Nucl Med. 2024 Jan 2;65(1):85-86. - PMID 37973187 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:65 |
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| Enthalten in: |
Journal of nuclear medicine : official publication, Society of Nuclear Medicine - 65(2024), 1 vom: 02. Jan., Seite 79-84 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Steinhelfer, Lisa [VerfasserIn] |
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| Links: |
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| Themen: |
5H0DOZ21UJ |
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| Anmerkungen: |
Date Completed 04.01.2024 Date Revised 22.04.2024 published: Electronic CommentIn: J Nucl Med. 2024 Jan 2;65(1):85-86. - PMID 37973187 Citation Status MEDLINE |
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| doi: |
10.2967/jnumed.123.265986 |
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| Förderinstitution / Projekttitel: |
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NLM363499423 |
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| 245 | 1 | 0 | |a Long-Term Nephrotoxicity of 177Lu-PSMA Radioligand Therapy |
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| 500 | |a CommentIn: J Nucl Med. 2024 Jan 2;65(1):85-86. - PMID 37973187 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 by the Society of Nuclear Medicine and Molecular Imaging. | ||
| 520 | |a β-emitting 177Lu targeting prostate-specific membrane antigen (PSMA) is an approved treatment option for metastatic castration-resistant prostate cancer. Data on its long-term nephrotoxicity are sparse. This study aimed to retrospectively evaluate post-177Lu-PSMA estimated glomerular filtration rate (eGFR) dynamics for at least 12 mo in a cohort of metastatic castration-resistant prostate cancer patients. Methods: The institutional databases of 3 German tertiary referral centers identified 106 patients who underwent at least 4 cycles of 177Lu-PSMA and had at least 12 mo of eGFR follow-up data. eGFR (by the Chronic Kidney Disease Epidemiology Collaboration formula) at 3, 6, and 12 mo after 177Lu-PSMA radioligand therapy was estimated using monoexponentially fitted curves through available eGFR data. eGFR changes were grouped (≥15%-<30%, moderate; ≥30%-<40%, severe; and ≥40%, very severe). Associations between eGFR changes (%) and nephrotoxic risk factors, prior treatment lines, and number of 177Lu-PSMA cycles were analyzed using multivariable linear regression. Results: At least moderate eGFR decreases were present in 45% (48/106) of patients; of those, nearly half (23/48) had a severe or very severe eGFR decrease. A higher number of risk factors at baseline (-4.51, P = 0.03) was associated with a greater eGFR decrease. Limitations of the study were the retrospective design, lack of a control group, and limited number of patients with a follow-up longer than 1 y. Conclusion: A considerable proportion of patients may experience moderate or severe decreases in eGFR 1 y from initiation of 177Lu-PSMA. A higher number of risk factors at baseline seems to aggravate loss of renal function. Further prospective trials are warranted to estimate the nephrotoxic potential of 177Lu-PSMA | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a PSMA | |
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| 700 | 1 | |a Cala, Lisena |e verfasserin |4 aut | |
| 700 | 1 | |a Pfob, Christian H |e verfasserin |4 aut | |
| 700 | 1 | |a Lapa, Constantin |e verfasserin |4 aut | |
| 700 | 1 | |a Hartrampf, Philipp E |e verfasserin |4 aut | |
| 700 | 1 | |a Buck, Andreas K |e verfasserin |4 aut | |
| 700 | 1 | |a Schäfer, Hannah |e verfasserin |4 aut | |
| 700 | 1 | |a Schmaderer, Christoph |e verfasserin |4 aut | |
| 700 | 1 | |a Tauber, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Brosch-Lenz, Julia |e verfasserin |4 aut | |
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| 700 | 1 | |a Weber, Wolfgang A |e verfasserin |4 aut | |
| 700 | 1 | |a Eiber, Matthias |e verfasserin |4 aut | |
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