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4. Analysis of DNA damage using the comet assay method in metastatic castration resistant prostate cancer patients receiving 177Lu-PSMA-617 radioligand therapy.

Author

Sahin, Ertan, Afsin, Hamdi, Cayirli, Yusuf Burak, Okuyan, Merve, Ulusal, Hasan, Tarakcioglu, Mehmet, and Elboga, Umut

Subjects
CASTRATION-resistant prostate cancer, DNA damage, PROSTATE cancer, CANCER patients, RADIOLIGAND assay, BLOOD testing
Abstract

Aim: To evaluate possible DNA damage in metastatic castration-resistant prostate cancer patients receiving 177Lu-PSMA-617 radioligand therapy using the comet assay method. Methods: Prospectively included patients were divided into four groups: a control group and three treatment groups receiving 2, 4, and 6 cycles, respectively. Agarose-coated comet assay slides were prepared using samples obtained from routine blood tests before treatment, and electrophoresis was performed to detect DNA damage. Descriptive statistics, normality tests, and multiple comparison tests were performed. Results: Forty-five patients with a mean age of 75.5, Gleason scores of 3+4, 4+3, 4+5, and 5+5, and ECOG performance scores of 0/1, 2, and 3 were included in the study. In a valid Comet assay analysis, a similar number of cells were examined in the four treatment groups without any statistical differences. Group analyses revealed statistically significant differences between DNA damage levels. Specifically, the number of stage 0 cells showed a significant difference between the 0-2 and 4-6 cycles groups, while the number of cells with moderate/high levels of damage showed similarities between the 4-6 cycles groups. Conclusions: This study demonstrates an increase in DNA damage in peripheral blood lymphocytes with cumulative doses in prostate cancer patients treated with 177Lu-PSMA. These findings contribute to the understanding of the relationship between DNA damage during the treatment process and treatment cycles. [ABSTRACT FROM AUTHOR]

Published
2023
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5. 177Lu-PSMA-617 Radioligand Treatment in Elderly Patients with Metastatic Castration-resistant Prostate Cancer: Therapeutic Efficacy and Safety Assessment

Author

Sahin, Ertan, Elboga, Umut, Cimen, Ufuk, Okuyan, Merve, and Cayirli, Yusuf Burak

Abstract

Objective: This study aimed to evaluate the therapeutic efficacy and safety of 177Lutetium-Prostate Specific Membrane Antigen (177Lu-PSMA-617) radioligand treatment (RLT) in metastatic castration-resistant prostate cancer (mCRPC) patients with aged older than 75 years.Methods: A total of 37 patients with mCRPC aged older than 75 years treated with 177Lu- PSMA-617 were included in this study.Pre-therapy and post-therapy biochemical, metabolic, and clinical response results and Hb, TLC, platelet, serum creatinine and bilirubin levels were checked to evaluate the therapeutic efficacy and toxicity profile. The Common Terminology Criteria for Adverse Events was used for grading adverse events caused by 177Lu-PSMA-617 treatment.Results: The mean age of the patients included in the study was 79.8±2.9 (76-92). The number of 177Lu-PSMA-617 treatment cycles ranged from two to four, and the mean administered radioactivity dose was 5.6±0.8 GBq per cycle. Partial biochemical response (PR) and partial metabolic response (PMR) were observed in 11 (29.7%) and 15 (40.6%) patients after treatment, respectively. Although improvement in ECOG scores was observed in 5 (13.5%) patients after treatment, it was not statistically significant. Grade 2 and 3 Hb toxicity was observed in 10 (27%) and 2 (5.4%) patients, respectively. Grade 2 leukocytopenia in six patients, Grade 1 thrombocytopenia in six patients, and Grade 2 serum creatinine toxicity in five patients were seen after the treatment. On the other hand, no patients developed liver toxicity and grade 3 or 4 leukocytopenia, thrombocytopenia or creatinine toxicity.Conclusion: 177Lu-PSMA-617 treatment was a safe and effective treatment option for properly selected elderly mCRPC patients.

Published
2024
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7. Comparison of [68Ga]-FAPI PET/CT and [18F]-FDG PET/CT in Multiple Myeloma: Clinical Experience

Author

Elboga, Umut, primary, Sahin, Ertan, additional, Cayirli, Yusuf Burak, additional, Okuyan, Merve, additional, Aktas, Gokmen, additional, Haydaroglu Sahin, Handan, additional, Dogan, Ilkay, additional, Kus, Tulay, additional, Akkurd, Dervis Murat, additional, Cimen, Ufuk, additional, Mumcu, Vuslat, additional, Kilbas, Benan, additional, and Celen, Yusuf Zeki, additional

Published
2022
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8. Comparison of 68Ga-FAPI PET/CT and 18FDG PET/CT Modalities in Gastrointestinal System Malignancies with Peritoneal Involvement.

Author

Elboga, Umut, Sahin, Ertan, Kus, Tulay, Cayirli, Yusuf Burak, Aktas, Gokmen, Okuyan, Merve, Cinkir, Havva Yesil, Teker, Fatih, Sever, Ozlem Nuray, Aytekin, Alper, Yılmaz, Latif, Aytekin, Aydın, Cimen, Ufuk, Mumcu, Vuslat, Kilbas, Benan, Eryilmaz, Kurtulus, Cakici, Davut, and Celen, Yusuf Zeki

Subjects
POSITRON emission tomography computed tomography, GASTROINTESTINAL cancer, METASTASIS, IMAGE quality analysis, IMAGE processing
Abstract

Purpose: In this study, we aimed to investigate the utilization of 68Ga-FAPI PET/CT in comparison to 18FDG PET/CT to evaluate the peritoneal involvement of the gastrointestinal malignancies alongside primary lesions and other metastatic foci. Procedures: A total of 37 patients with various gastrointestinal malignancies with accompanying peritoneal involvement who underwent 68Ga-FAPI PET/CT and 18FDG PET/CT imaging between September 2020 and June 2021 were included in this retrospective study. SUVmax values of 68Ga-FAPI and 18FDG were compared according to lesion locations. Also, the lesion localization ability of both imaging was compared in patient basis. Results: Of the 37 patients with peritoneal involvement (23 males and 14 females; median age, 62.8 ± 12.7 years), 35.1% (n = 13) had colorectal cancer, 37.8% (n = 14) gastric cancer, and 27.0% (n = 10) pancreaticobiliary cancer. While 45.9% of them were operated, the remaining did not have surgery. The mean time interval between two studies was 3.2 days (range: 2–6 days). The mean SUVmax value of peritoneal metastases (p < 0.001) was significantly higher with 68Ga-FAPI PET/CT compared to that with 18FDG PET/CT, as in primary lesions (p < 0.001), lymph node metastases (p = 0.006), liver metastases (p = 0.002), and bone metastases (p = 0.018). A total of 185 lesions was detected in the initial assessment with 18FDG PET/CT. Of the total lesions detected with 18FDG PET/CT, 5 of them were evaluated as benign lesions with 68Ga-FAPI PET/CT also in accordance with the reference standard. In addition to 180 lesions detected with 18FDG PET/CT, a total of 37 additional malignant lesions, 12 of which were peritoneal metastases, were detected with 68Ga-FAPI PET/CT. Conclusion: 68Ga-FAPI PET/CT was determined to be superior to 18FDG PET/CT in terms of detection of peritoneal involvement with high image quality as well as primary tumor and other metastatic foci. Consequently, 68Ga-FAPI PET/CT can be used as a complementary imaging modality especially for inconclusive 18FDG findings due to the lack of accuracy of 18FDG PET/CT in some of the metastatic regions, especially in the liver. [ABSTRACT FROM AUTHOR]

Published
2022
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10. Case Reports Presentations

Author

Dinçer, Mustafa, primary, Çelik, Cemil, additional, Helvalı, Elif Ecem, additional, Bodur, Şahin, additional, Akçaer, Emine Tuğçe, additional, Can, Serdar Süleyman, additional, Uğurlu, Görkem Karakaş, additional, İslamoğlu, Sümeyye, additional, Kaymak, Semra Ulusoy, additional, Taştorun, Yasemin, additional, Peker, Oğuz, additional, Çayköylü, Ali, additional, Soğucak, Zehra Ece, additional, Adanır, Aslı Sürer, additional, Özatalay, Esin, additional, Önder, Arif, additional, Başaran, Abdurrahman Erdem, additional, Bingöl, Ayşen, additional, Akdağ, Berhan, additional, Atagün, Murat İlhan, additional, Doğan, Yakup, additional, Bilaç, Öznur, additional, Kavurma, Canem, additional, Taşkıran, Gülseren, additional, Erdem, Aybike, additional, Kocagöz, Zehra Başar, additional, Özçetin, Adnan, additional, Ataoğlu, Ahmet, additional, Toraman, Merve Çavdar, additional, Özçelik, Özgen, additional, Kara, Hüseyin, additional, Tomar, Talya, additional, Cinemre, Buket, additional, Tokgöz, Yusuf, additional, Öznur, Taner, additional, Bolu, Abdullah, additional, Uzun, Özcan, additional, İnanlı, İkbal, additional, Altunova, Deniz, additional, Çalışkan, Ali Metehan, additional, Eren, İbrahim, additional, Elmas, Tüba Şerife, additional, Gökçenoğlu, Yasemin, additional, Çalışır, Saliha, additional, Tanrıkulu, Ali Baran, additional, Bozdoğan, Şenay Yıldız, additional, Şahin, Fatma, additional, Çamur, Ceren, additional, Gündoğmuş, İbrahim, additional, Karagöz, Abdulkadir, additional, Algül, Ayhan, additional, Doneray, Ebru, additional, Yazici, Ipek Percinel, additional, Yazici, Kemal Utku, additional, Adanır, Aslı, additional, Işıldar, Yetiş, additional, Sağlam, Ebru, additional, Bilgiç, Ayhan, additional, Akbaş, Betül, additional, Çelikkol, Çağla, additional, Öztürrk, Seher Serez, additional, Seven, Hilal, additional, Demiröz, Dudu, additional, Özbek, Seda, additional, Çiçek, İsmet Esra, additional, Coşkun, Fatma, additional, Akça, Ömer Faruk, additional, Sevinçok, Doğa, additional, Memiş, Çağdaş Öykü, additional, Çakaloz, Burcu, additional, İlhan, Bilge Çetin, additional, Elmas, Tuba Şerife, additional, Yaşar, Azra Sehure, additional, Yağlı, Nafiye, additional, Ak, Osman, additional, Başaran, Recep, additional, Balcı, Mehmet Murat, additional, Kuloğlu, Mehmet Murat, additional, Taş, İbrahim, additional, Yaşar, Sehure Azra, additional, Yıldız, Mustafa Çağrı, additional, Çiftçi, Ebru, additional, Guler, Hasan Ali, additional, Kandeger, Ali, additional, Guler, Dilara, additional, Turkoglu, Serhat, additional, Küçük, Önder, additional, Yaylacı, Ferhat, additional, Erkuran, Handan Özek, additional, Gürsoy, Betül Kurtses, additional, Öztürk, Seher Serez, additional, Ünal, Berrin, additional, Aral, Gizem, additional, Karagüzel, Evrim Özkorumak, additional, Aykut, Demet Sağlam, additional, Arslan, Filiz Civil, additional, Karagöz, Ezgi, additional, İnaloğlu, Neslihan Emir, additional, Uzun, Necati, additional, Özbek, Mutlu Muhammed, additional, Tunagür, Mustafa Tolga, additional, Doğan, Bilge, additional, Sevinçok, Levent, additional, Akgün, Abdullah, additional, Özmenler, Kamil Nahit, additional, Kara, Tayfun, additional, Akaltun, İsmail, additional, Kaya, Ayşe Erdoğan, additional, Yazıcı, Esra, additional, Sezer, Muhammed Nurullah, additional, Turan, Çağlar, additional, Sert, Engin, additional, Yıldırım, Yusuf Ezel, additional, Aydın, Pınar Çetinay, additional, Kunt, Sevilay, additional, Berkol, Tonguç Demir, additional, Esnafoglu, Erman, additional, Adıgüzel, Öznur, additional, Tunc, Serhat, additional, Basbug, Hamit Serdar, additional, Dalyan, Selçuk, additional, Ulgar, Şermin Bilgen, additional, Ayaydın, Hamza, additional, Bozbey, Sema, additional, Yazıcı, Merve, additional, Yektaş, Çiğdem, additional, Sarıgedik, Enes, additional, Asoğlu, Mehmet, additional, Ekmen, Betül Uyar, additional, Akçalı, Hasan, additional, Taş, Cuma, additional, Işık, Cansu Mercan, additional, Demirci, Belde, additional, Sarı, Seda Aybüke, additional, Çiçek, Ayla Uzun, additional, Eynalli, Ezgi, additional, Metin, Ozge, additional, Ray, Perihan Cam, additional, Tahiroglu, Aysegul Yolga, additional, Celik, Gonca Gul, additional, Akçaer, Tuğçe, additional, Kurt, Elif Merve, additional, Göncüoğlu, İbrahim Özkan, additional, Ak, İsmail, additional, Chasan, Merve Tsakir, additional, Tamam, Lut, additional, Çakmak, Soner, additional, Demirkol, Mehmet Emin, additional, Örnek, Erdem, additional, Kani, Ayşe Sakallı, additional, Topçuoğlu, Volkan, additional, Sivri, Rukiye Çolak, additional, Çetin, Nihal Yurteri, additional, Sertdemir, Merve, additional, Ürer, Emre, additional, Ekici, Gökçen İlçioğlu, additional, Kılıç, Birim Günay, additional, Turgut, Keziban, additional, Karci, Canan Kuygun, additional, Avci, Ayse, additional, Yaşar, Azra, additional, Kaplan, Sümeyra Elif, additional, Muhsinoglu, Hazal, additional, Zıblak, Alper, additional, Kenar, Ayşe Nur İnci, additional, Can, Cantekin, additional, Karcı, Canan Kuygun, additional, Kutlu, Gamze, additional, Soykan, Çağlar, additional, Şen, Cansu Pınar, additional, Ceylan, Mehmet Fatih, additional, Hesapçıoğlu, Selma Tural, additional, Öneri, Özden Şükran, additional, Karataş, Abdullah, additional, Altun, Hatice, additional, Karaaslan, Umut, additional, Kasar, Nurdan, additional, Şahin, Nilfer, additional, Balkan, Damla, additional, İbiloğlu, Aslıhan Okan, additional, Atli, Abdullah, additional, Erdogan, Rabia, additional, Yazici, Esra, additional, Mutu, Tugba, additional, Ciner, Ozlem Akcay, additional, Cilli, Ali Savas, additional, Erol, Atila, additional, Zayman, Esra Porgalı, additional, Darılmaz, Cengiz, additional, Reyhani, İsmail, additional, Karlıdağ, Rıfat, additional, Yıldırım, Kübra, additional, Dönmez, Yunus Emre, additional, Karatoprak, Serdar, additional, Özcan, Özlem, additional, Öztürk, Ali Hakan, additional, Üneri, Özden Şükran, additional, Gürbüz, Perihan Turhan, additional, Uğurlu, Mustafa, additional, Doğan, Özlem, additional, Yoldaş, Tahir Kurtuluş, additional, Bilgen, Nuran, additional, Altınyazar, Vesile, additional, Özbek, Muhammed Mutlu, additional, Ulu, Ebru, additional, Demirci, Esra, additional, Özmen, Sevgi, additional, Yeşilkaya, Ümit Haluk, additional, Onur, Ozge Sahmelikoglu, additional, Akay, Omer, additional, Balcioglu, Yasin Hasan, additional, Oncu, Fatih, additional, Yalvaç, Çiğdem Toklu, additional, Işık, Ümit, additional, Erkan, Erol, additional, Örüm, Mehmet Hamdi, additional, Bildik, Tezan, additional, Kara, Mahmut Zabit, additional, Yılmaz, Helin, additional, Tahıllıoğlu, Hasan Akın, additional, Kalenderoğlu, Aysun, additional, Eğilmez, Oğuzhan Bekir, additional, Özen, Murat Eren, additional, Kapıcı, Yaşar, additional, Kılıçoğlu, Ümit, additional, Atmaca, Murad, additional, Karimova, Gulgaz, additional, Arıcı, Asiye, additional, Sevgen, Feyza Hatice, additional, Alğan, Zehra, additional, Dalboy, Fadime, additional, Ak, Mehmet, additional, Uğuz, Faruk, additional, Kılınç, Kübra, additional, Çetin, Fatih Hilmi, additional, Türkoğlu, Serhat, additional, Yılmaz, Semra, additional, İbiloğlu, İbrahim, additional, Özkan, Mustafa, additional, Bertizlioğlu, Osman, additional, Yazar, Ece Merve, additional, Özercan, Ahmet, additional, Kuşçu, Mehmet Kemal, additional, Akbolat, Muhammet, additional, Ekinci, Gazanfer, additional, Midi, İpek, additional, Harmankaya, Fatih Mücahit, additional, Aydın, Adem, additional, Yazar, Neslihan, additional, Ataoğlu, Busra Bahar, additional, Küpeli, Neşe Yorguner, additional, Bulut, Necati Serkut, additional, Kora, Kaan, additional, Yükselir, Cihad, additional, Zincir, Serkan, additional, Miniksar, Dilşad Yıldız, additional, Bayhan, Pelin Çon, additional, Pirinççioğlu, Faruk, additional, Karka, İsmail, additional, Göbelek, Meltem, additional, Akıl, Öznur, additional, Güngören, Sümeyra, additional, Özturan, Deniz Deniz, additional, Yılmaz, Zeynep Bebek, additional, Kürekçi, Derya Deniz, additional, Özturan, Aykut, additional, Ünay, Mihriban, additional, Aytaç, Hasan Mervan, additional, Aydın, Nazan, additional, Tuncer, Can, additional, Seneger, Volkan, additional, Kahraman, Burcu Bakar, additional, Avcı, Selma Hilal, additional, Karatepe, Hasan Turan, additional, Arslan, Mehmet, additional, Çalışkan, Sıla, additional, Çokünlü, Yusuf, additional, Yücehan, Zeynep, additional, Öztrük, Seher Serez, additional, Özayhan, Hatice Yardım, additional, Karakaya, Özlem, additional, Turan, Gökçen, additional, Elbeyli Ahmet, Burak, additional, Ölmez, Safiye Bahar, additional, Çavdar, Merve, additional, Aktepe, Evrim, additional, Avşar, Pınar Aydoğan, additional, Erdoğan, Yakup, additional, Beğinoğlu, Özlem, additional, Elbay, Rümeysa Yeni, additional, Gülşen, Hayriye Hızarcıoğlu, additional, Yılmaz, Arzu, additional, İmrek, Yasemin, additional, Sari, Mesut, additional, Pala, Büşra, additional, Öztürk, Yusuf, additional, Göl, Güler, additional, Cansız, Mehmet Akif, additional, Savcı, Uğur, additional, Çıtır, Berna Gündüz, additional, Aksu, Hatice, additional, Salihoğlu, Sema Çam, additional, Birer, Nurhak Çağatay, additional, Özkula, Güler, additional, Altınörs, Ercan, additional, Baz, Fatih, additional, Yıldız, Mesut, additional, Bozatlı, Leyla, additional, Aykutlu, Hasan Cem, additional, Görker, Işık, additional, Sapdüzen, Oğuzhan, additional, Hocaoğlu, Çiçek, additional, Anak, Alphan, additional, Yılmaz, Mesut, additional, Doymaz, Yeliz, additional, Ayyıldız, Ece, additional, Baltacıoğlu, Mehmet, additional, Kayıpmaz, Selvi Ceran, additional, Altınöz, Ali Ercan, additional, Oğuz, Arzu, additional, Salihoglu, Sema Çam, additional, Gerçek, Hacer Gizem, additional, Cöngöloğlu, Mehmet Ayhan, additional, Subas, Emre, additional, Alkan, Selin, additional, Yalcin, Suat, additional, Donmezler, Suleyman, additional, Kilinc, Sevilay Umut, additional, Yalcin, Burcu Hamurisci, additional, Ozgen, Guliz, additional, Turkcan, Ahmet, additional, Kaypak, Ayse Ceren, additional, Kupeli, Nese Yorguner, additional, İnaltekin, Ali, additional, Yağcı, İbrahim, additional, Kıvrak, Yüksel, additional, Çim, Emine Füsun Akyüz, additional, Delikanli, Leyla, additional, Tuncturk, Mustafa, additional, Karakus, Oguz Bilal, additional, Kılıcoglu, Ali Guven, additional, Karacetin, Gul, additional, Okuyan, Merve, additional, İvelik, Halil İbrahim, additional, Okumuş, Burak, additional, Tekdemir, Rukiye, additional, Aydın, Memduha, additional, Taştekin, Nihal, additional, Kırşavoğlu, Betül, additional, Yalçın, Murat, additional, Ayvaz, Sibel, additional, Kırımlı, Ayşe Gülşah, additional, Kul, Ayşegül Taşdelen, additional, Pasli, Huda, additional, Ozkan, Mine, additional, and Volkan, Ferda, additional

Published
2018
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11. 68 Ga-FAPI PET/CT as an Alternative to 18 F-FDG PET/CT in the Imaging of Invasive Lobular Breast Carcinoma.

Author

Sahin E, Kus T, Aytekin A, Uzun E, Elboga U, Yilmaz L, Cayirli YB, Okuyan M, Cimen V, and Cimen U

Subjects
Female, Humans, Middle Aged, Positron Emission Tomography Computed Tomography, Fluorodeoxyglucose F18, Gallium Radioisotopes, Retrospective Studies, Positron-Emission Tomography, Breast Neoplasms diagnostic imaging, Quinolines
Abstract

Accurate staging of invasive lobular carcinoma (ILC), a subtype of breast cancer, is vital for effective clinical management. Although 18 F-FDG PET/CT is a commonly used tool, its efficacy varies across different histologic subtypes. To mitigate this challenge, our investigation delves into the potential utility of 68 Ga-fibroblast activation protein inhibitor (FAPI) PET/CT as an alternative for staging ILC, aiming to address a significant research gap using a more expansive patient cohort than the smaller samples commonly found in the existing literature. Methods: In this retrospective analysis, women diagnosed with primary ILC of the breast underwent both 18 F-FDG PET/CT and 68 Ga-FAPI PET/CT. Both modalities were compared across all lesion locations with the used reference standard. The interval between scans was 1 wk, without any intervening treatments. Lesions were categorized visually, and tracer activity was analyzed using SUV max , tumor-to-background uptake ratio, and uptake ratios. Both modalities were compared across various parameters, and statistical analysis was performed using SPSS 22.0. A P value of less than 0.05 was chosen to determine statistical significance. Results: The study included 23 female ILC patients (mean age, 51 y) with hormone-positive, human epidermal growth factor receptor type 2-negative tumors. Most (65%) had the luminal A subtype. 68 Ga-FAPI PET/CT outperformed 18 F-FDG PET/CT, with higher tumoral activity and tumor-to-background uptake ratios ( P < 0.001). Primary tumors showed significantly increased uptake with 68 Ga-FAPI PET/CT ( P < 0.001), detecting additional foci, including multicentric cancer. Axillary lymph node metastases were more frequent and had higher uptake values with 68 Ga-FAPI PET/CT ( P = 0.012). Moreover, 68 Ga-FAPI PET/CT identified more lesions, including bone and liver metastases. Pathologic features did not significantly correlate with imaging modalities, but a positive correlation was observed between peritumoral lymphocyte ratio and 68 Ga-FAPI PET/CT-to- 18 F-FDG PET/CT uptake ratios ( P = 0.026). Conclusion: This study underscores 68 Ga-FAPI PET/CT's superiority over 18 F-FDG PET/CT for ILC. 68 Ga-FAPI PET/CT excels in detecting primary breast masses, axillary lymph nodes, and distant metastases; can complement 18 F-FDG PET/CT in ILC; and holds potential as an alternative imaging method in future studies., (© 2024 by the Society of Nuclear Medicine and Molecular Imaging.)

Published
2024
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12. 177 Lu-PSMA-617 Radioligand Treatment in Elderly Patients with Metastatic Castration-resistant Prostate Cancer: Therapeutic Efficacy and Safety Assessment.

Author

Sahin E, Elboga U, Cimen U, Okuyan M, and Cayirli YB

Subjects
Humans, Male, Aged, Aged, 80 and over, Radioisotopes therapeutic use, Radioisotopes adverse effects, Treatment Outcome, Prostate-Specific Antigen blood, Prostatic Neoplasms, Castration-Resistant radiotherapy, Prostatic Neoplasms, Castration-Resistant pathology, Lutetium therapeutic use, Dipeptides therapeutic use, Dipeptides adverse effects, Radiopharmaceuticals therapeutic use, Radiopharmaceuticals adverse effects, Heterocyclic Compounds, 1-Ring therapeutic use, Heterocyclic Compounds, 1-Ring adverse effects
Abstract

Objective: This study aimed to evaluate the therapeutic efficacy and safety of 177 Lutetium-Prostate Specific Membrane Antigen ( 177 Lu-PSMA-617) radioligand treatment (RLT) in metastatic castration-resistant prostate cancer (mCRPC) patients with aged older than 75 years., Methods: A total of 37 patients with mCRPC aged older than 75 years treated with 177 Lu- PSMA-617 were included in this study. Pre-therapy and post-therapy biochemical, metabolic, and clinical response results and Hb, TLC, platelet, serum creatinine and bilirubin levels were checked to evaluate the therapeutic efficacy and toxicity profile. The Common Terminology Criteria for Adverse Events was used for grading adverse events caused by 177 Lu-PSMA-617 treatment., Results: The mean age of the patients included in the study was 79.8±2.9 (76-92). The number of 177 Lu-PSMA-617 treatment cycles ranged from two to four, and the mean administered radioactivity dose was 5.6±0.8 GBq per cycle. Partial biochemical response (PR) and partial metabolic response (PMR) were observed in 11 (29.7%) and 15 (40.6%) patients after treatment, respectively. Although improvement in ECOG scores was observed in 5 (13.5%) patients after treatment, it was not statistically significant. Grade 2 and 3 Hb toxicity was observed in 10 (27%) and 2 (5.4%) patients, respectively. Grade 2 leukocytopenia in six patients, Grade 1 thrombocytopenia in six patients, and Grade 2 serum creatinine toxicity in five patients were seen after the treatment. On the other hand, no patients developed liver toxicity and grade 3 or 4 leukocytopenia, thrombocytopenia or creatinine toxicity., Conclusion: 177 Lu-PSMA-617 treatment was a safe and effective treatment option for properly selected elderly mCRPC patients., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Published
2024
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13. Lutetium-177-PSMA-617 radioligand therapy in patients with high volume metastatic prostate cancer prior to chemotherapy and new generation androgen deprivation therapy: Clinical Experience.

Author

Celen YZ, Elboga U, Sahin E, Kus T, Okuyan M, Cayirli YB, Erturhan S, and Cimen U

Subjects
Male, Humans, Androgen Antagonists therapeutic use, Androgens, Positron Emission Tomography Computed Tomography, Treatment Outcome, Retrospective Studies, Gonadotropin-Releasing Hormone, Prostate-Specific Antigen, Prostatic Neoplasms, Castration-Resistant drug therapy, Prostatic Neoplasms, Castration-Resistant radiotherapy
Abstract

Objective: We aimed to evaluate the efficacy oflutetium-177-prostate-specific membrane antigen-617 ( 177 Lu-PSMA-617) with the luteinizing hormone releasing hormone (LHRH) analogues in the first or in the second-line setting formetastatic castration sensitive patients and metastatic castration resistance after progression with LHRH analogues., Subjects and Methods: Sixteen consecutive patients with high volume metastatic prostate cancer undergone 177 Lu-PSMA-617 therapy who were refused chemotherapy and were unable to use new generation anti-androgen drugs because of unavailibility of reimbursement, were included in this retrospective study. Prostate specific antigen (PSA) response (>50% decrease), disease control rate (DCR: complete or partial response), progression-free survival (PFS) and overall survival (OS) were calculated to evaluate according to the clinicopathological features of the patients. Treatment response evaluated by 68 Ga-PSMA-11 positron emission tomography/computed tomography (PET/CT)., Results: Mean age was 74,6 (SD±8,36). Among them, 7 (43,8%) patients has castration resistant disease, while the remaining has castration sensitive disease. Lutetium-177-PSMA-617 was administered to 10 (62,5%) patients as one of the first-line treatment and 6 patients received the treatment after progression on LHRH as a second-line treatment. Considering all patients, PSA response rate and DCR were 50% and 62% respectively. The median PFS and OS (with 95% CI) were 11,2 months (11-15) and 29 months (25,6-32,4), respectively in patients treated with 177 Lu-PSMA-617 and LHRH analogues. Clinicopathological features and basal PSA level did not have effect on PSA response rates, DCR, OS and PFS. On the other hand, increment in PFS and OS (with 95% CI) was observed in castration resistant disease and in the second-line therapy; for castration resistant disease 16,5 months (12.3-19.7); 30 months (25.3-32.7), for the second-line therapy 14.5 months (12-20.5); 29 months (NR), respectively but statistically not significant. Serious toxicity was observed in a limited number of patients (18,7%), treatment-related death was not observed., Conclusion: Favorable results can be achived with second-line 177 Lu-PSMA-617 treatment in terms of OS and PFS, especially in castration-resistant disease, when chemotherapy and new generation ADT's cannot be used.

Published
2023
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