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• W3025640129 abstract "1278 Background: PSMA-directed radioligand-therapy (RLT) is gaining increasing clinical importance for the treatment of metastatic, castration-resistant prostate cancer (mCRPC). However, RLT can affect remaining viable bone marrow, especially in patients with extensive osseous tumor load and prior myelotoxic treatment. We assessed the value of 99mTc-antigranulocyte scintigraphy for estimation of bone marrow reserve prior to RLT. Methods: 7 mCRPC patients with extensive osseous tumor load on 18F-PSMA-1007 PET/CT were included. 99mTc-antigranulocyte scintigraphy was performed prior to subsequent RLT to assess the bone marrow reserve in patients with impaired blood count. Both modalities were compared with regards to spatial overlap of tumor burden and viable bone marrow. In case of low spatial overlap, the patient was deemed available for PSMA-RLT. In those patients subsequently undergoing RLT, blood samples (hemoglobin, leucocytes, platelets, neutrophils) and PSA were assessed 4 and 8 weeks after RLT. Results: There was no relevant spatial correlation of bone marrow and tumor load in 6/7 patients. 4/6 patients underwent PSMA-RLT with 177Lu (2/4) or 225Ac (2/4). In 1/6 patient, bone marrow and PSMA-positive tumor load were congruent; the dosimetry simulation using population-based time activity curves revealed a 3-fold higher bone marrow dose compared to those with non-congruent findings. 2/6 patients were not treated due to acute contraindications. In those patients undergoing RLT, parameters from the blood samples did not significantly change 4 and 8 weeks after initiation of RLT (hemoglobin: 8.5±1.5 vs. 8.4±1.0 vs. 8.9±0.4 g/dl, p>0.05; leucocytes: 4.3±0.9 vs. 4.3±1.5 vs. 4.3±0.4G/I, p>0.05; platelets: 187.8±98.5 vs. 167.3±58.7 vs. 151.0±61.5 G/I, p>0.05; neutrophils: 3.0±0.8 vs. 3.3±1.5 vs. 3.4±1.0 G/I, p>0.05), whereas PSA increased (210.8±162.1 vs. 290.0±264.6 vs. 535.3±395.6 mg/ml, p<0.05). Conclusions: In case of spatial mismatch of viable bone marrow and osseous tumor load RLT seems feasible, as no high-grade bone marrow affection was observed. By contrast, congruent findings on 99mTc-antigranulocyte scintigraphy and PSMA-PET indicate higher bone marrow doses to be expectable. Therefore, additional estimation of residual viable bone marrow by means of 99mTc-antigranulocyte scintigraphy might improve patient management in borderline cases." @default.
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• W3025640129 date "2020-04-01" @default.
• W3025640129 modified "2023-09-23" @default.
• W3025640129 title "99 m Tc-antigranulocyte scintigraphy for estimation of bone marrow reserve prior to PSMA-radioligand therapy" @default.
• W3025640129 doi "https://doi.org/10.1055/s-0040-1708397" @default.
• W3025640129 hasPublicationYear "2020" @default.
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