Radioligand therapy with drugs based on radionuclide ²²⁵Aс: experience of A.M.Granov Russian scientific center of radiology and surgical technologies

Abstract

INTRODUCTION: Peptide receptor therapy based on the 225Ac radionuclide, due to the targeted effect on tumor cells, is the most promising method of treatment for patients with generalized forms of neuroendocrine tumors and castration-resistant prostate cancer.OBJECTIVE: The aim of the work was to evaluate the effectiveness of radioligand therapy of medicinal radiopharmaceuticals with 225Ac.MATERIALS AND METHODS: Radioligand therapy based on 225Ac radionuclide was performed in 7 patients with generalized prostate cancer and 3 patients with neuroendocrine tumors.RESULTS: Systemic radiation therapy with 225Ac-PSMA 617 and 225Ac-DOTATE showed its effectiveness in clinical practice — patients have a decrease in the level of accumulation of the radiopharmaceutical (RP) in pathological foci on PET-CT with 68Ga-PSMA and 68Ga-DOTATE; a decrease in the level of prostate-specific antigen (PSA) in the blood (for prostate cancer); reduction of manifestations of asthenic, pain and carcinoid (for neuroendocrine tumors) syndromes. Dosimetric studies make it possible to assess the biodistribution of a radiopharmaceutical drug in the body, accumulation in target organs and lesions.CONCLUSION: The appointment of this type of treatment requires an integrated approach based on a thorough study of medical records, assessment of the receptor status of the tumor tissue, timely detection and prediction of adverse reactions.