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- Title:
Long-Term Nephrotoxicity of 177Lu-PSMA Radioligand Therapy.
- Document type:
- Journal Article
- Author(s):
- Steinhelfer, Lisa; Lunger, Lukas; Cala, Lisena; Pfob, Christian H; Lapa, Constantin; Hartrampf, Philipp E; Buck, Andreas K; Schäfer, Hannah; Schmaderer, Christoph; Tauber, Robert; Brosch-Lenz, Julia; Haller, Bernhard; Meissner, Valentin H; Knorr, Karina; Weber, Wolfgang A; Eiber, Matthias
- Abstract:
- 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.
- Journal title abbreviation:
- J Nucl Med
- Year:
- 2024
- Journal volume:
- 65
- Journal issue:
- 1
- Pages contribution:
- 79-84
- Fulltext / DOI:
- doi:10.2967/jnumed.123.265986
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/37857504
- Print-ISSN:
- 0161-5505
- TUM Institution:
- Institut für Diagnostische und Interventionelle Radiologie (Prof. Makowski)
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