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Theranostics 2024; 14(5):1829-1840. doi:10.7150/thno.92273 This issue Cite

Research Paper

[161Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [177Lu]Lu-PSMA-617

Andrea Schaefer-Schuler, Caroline Burgard, Arne Blickle, Stephan Maus, Christine Petrescu, Sven Petto, Mark Bartholomä, Tobias Stemler, Samer Ezziddin, Florian Rosar✉

Department of Nuclear Medicine, Saarland University, Medical Center, Homburg, Germany.

✉ Corresponding author: Florian Rosar, Department of Nuclear Medicine, Saarland University - Medical Center, Kirrberger Str. 100, Geb. 50, D-66421 Homburg, Germany; Tel.: +49 6841 16 14667; Fax.: +49 6841 16 24595; E-mail: florian.rosareu; ORCID- More

Citation:
Schaefer-Schuler A, Burgard C, Blickle A, Maus S, Petrescu C, Petto S, Bartholomä M, Stemler T, Ezziddin S, Rosar F. [161Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [177Lu]Lu-PSMA-617. Theranostics 2024; 14(5):1829-1840. doi:10.7150/thno.92273. https://www.thno.org/v14p1829.htm
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Abstract

Graphic abstract

Rationale: Evaluation of alternative radionuclides for use in prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) is currently focusing on 161Tb, which may provide advantages by emitting additional Auger and conversion electrons. In this pilot study, we present preliminary dosimetry data for [161Tb]Tb-PSMA-617 RLT in a direct comparison with [177Lu]Lu-PSMA-617.

Method: Six patients with metastatic castration-resistant prostate cancer (mCRPC) underwent treatment with [177Lu]Lu-PSMA-617 and subsequently - after inadequate response - with [161Tb]Tb-PSMA-617. Whole-body planar and SPECT imaging-based dosimetry of organs at risk (kidneys and salivary glands) and tumor lesions were calculated using IDAC for 177Lu and OLINDA/EXM for 161Tb. The therapeutic index (TI) of mean tumor-absorbed doses over relevant organs at risk was calculated.

Results: Mean absorbed doses to organs at risk of PSMA-RLT were slightly higher for [161Tb]Tb-PSMA-617 compared to [177Lu]Lu-PSMA-617 (kidneys: 0.643 ± 0.247 vs. 0.545 ± 0.231 Gy/GBq, factor 1.18; parotid gland: 0.367 ± 0.198 vs. 0.329 ± 0.180 Gy/GBq, factor 1.10), but markedly higher regarding tumor lesions (6.10 ± 6.59 vs 2.59 ± 3.30 Gy/GBq, factor 2.40, p < 0.001). Consequently, the mean TI was higher for [161Tb]Tb-PSMA-617 compared to [177Lu]Lu-PSMA-617 for both, the kidneys (11.54 ± 9.74 vs. 5.28 ± 5.13, p = 0.002) and the parotid gland (16.77 ± 13.10 vs. 12.51 ± 18.09, p = 0.008).

Conclusion: In this intra-individual head-to-head pilot study, [161Tb]Tb-PSMA-617 delivered higher tumor-absorbed doses and resulted in superior TI compared to [177Lu]Lu-PSMA-617. This preliminary data support 161Tb as a promising radionuclide for PSMA-RLT in mCRPC.

Keywords: 161Tb, dosimetry, PSMA, radioligand therapy, mCRPC, prostate cancer

Citation styles

APA
Schaefer-Schuler, A., Burgard, C., Blickle, A., Maus, S., Petrescu, C., Petto, S., Bartholomä, M., Stemler, T., Ezziddin, S., Rosar, F. (2024). [161Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [177Lu]Lu-PSMA-617. Theranostics, 14(5), 1829-1840. https://doi.org/10.7150/thno.92273.

ACS
Schaefer-Schuler, A.; Burgard, C.; Blickle, A.; Maus, S.; Petrescu, C.; Petto, S.; Bartholomä, M.; Stemler, T.; Ezziddin, S.; Rosar, F. [161Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [177Lu]Lu-PSMA-617. Theranostics 2024, 14 (5), 1829-1840. DOI: 10.7150/thno.92273.

NLM
Schaefer-Schuler A, Burgard C, Blickle A, Maus S, Petrescu C, Petto S, Bartholomä M, Stemler T, Ezziddin S, Rosar F. [161Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [177Lu]Lu-PSMA-617. Theranostics 2024; 14(5):1829-1840. doi:10.7150/thno.92273. https://www.thno.org/v14p1829.htm

CSE
Schaefer-Schuler A, Burgard C, Blickle A, Maus S, Petrescu C, Petto S, Bartholomä M, Stemler T, Ezziddin S, Rosar F. 2024. [161Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [177Lu]Lu-PSMA-617. Theranostics. 14(5):1829-1840.

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