Joint EANM/SNMMI procedure guideline for the use of Lu-labeled PSMA-targeted radioligand-therapy (Lu-PSMA-RLT).

Publication

Joint EANM/SNMMI procedure guideline for the use of Lu-labeled PSMA-targeted radioligand-therapy (Lu-PSMA-RLT).

Journal Paper/Review - May 29, 2023

Kratochwil Clemens, Fendler Wolfgang Peter, Eiber Matthias, Hofman Michael S, Emmett Louise, Calais Jeremie, Osborne Joseph R, Iravani Amir, Koo Phillip, Lindenberg Liza, Baum Richard, Bozkurt Murat Fani, Delgado Bolton Roberto C, Ezziddin Samer, Forrer Flavio, Hicks Rodney J, Hope Thomas A, Kabasakal Levent, Konijnenberg Mark, Kopka Klaus, Lassmann Michael, Mottaghy Felix M, Oyen Wim J G, Rahbar Kambiz, Schöder Heiko, Virgolini Irene, Bodei Lisa, Fanti Stefano, Haberkorn Uwe, Hermann Ken

Citation

Kratochwil C, Fendler W, Eiber M, Hofman M, Emmett L, Calais J, Osborne J, Iravani A, Koo P, Lindenberg L, Baum R, Bozkurt M, Delgado Bolton R, Ezziddin S, Forrer F, Hicks R, Hope T, Kabasakal L, Konijnenberg M, Kopka K, Lassmann M, Mottaghy F, Oyen W, Rahbar K, Schöder H, Virgolini I, Bodei L, Fanti S, Haberkorn U, Hermann K. Joint EANM/SNMMI procedure guideline for the use of Lu-labeled PSMA-targeted radioligand-therapy (Lu-PSMA-RLT). Eur J Nucl Med Mol Imaging 2023; 50:2830-2845.

Type

Journal Paper/Review (English)

Journal

Eur J Nucl Med Mol Imaging 2023; 50

Publication Date

May 29, 2023

Issn Electronic

1619-7089

Pages

2830-2845

Brief description/objective

Prostate-specific membrane antigen (PSMA) is expressed by the majority of clinically significant prostate adenocarcinomas, and patients with target-positive disease can easily be identified by PSMA PET imaging. Promising results with PSMA-targeted radiopharmaceutical therapy have already been obtained in early-phase studies using various combinations of targeting molecules and radiolabels. Definitive evidence of the safety and efficacy of [Lu]Lu-PSMA-617 in combination with standard-of-care has been demonstrated in patients with metastatic castration-resistant prostate cancer, whose disease had progressed after or during at least one taxane regimen and at least one novel androgen-axis drug. Preliminary data suggest that Lu-PSMA-radioligand therapy (RLT) also has high potential in additional clinical situations. Hence, the radiopharmaceuticals [Lu]Lu-PSMA-617 and [Lu]Lu-PSMA-I&T are currently being evaluated in ongoing phase 3 trials. The purpose of this guideline is to assist nuclear medicine personnel, to select patients with highest potential to benefit from Lu-PSMA-RLT, to perform the procedure in accordance with current best practice, and to prepare for possible side effects and their clinical management. We also provide expert advice, to identify those clinical situations which may justify the off-label use of [Lu]Lu-PSMA-617 or other emerging ligands on an individual patient basis.