Clinical Research Papers:

Radioligand therapy of metastatic prostate cancer using 177Lu-PSMA-617 after radiation exposure to 223Ra-dichloride

Hojjat Ahmadzadehfar _, Stefanie Zimbelmann, Anna Yordanova, Rolf Fimmers, Stefan Kürpig, Elisabeth Eppard, Florian C. Gaertner, Xiao Wei, Stefan Hauser and Markus Essler

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Oncotarget. 2017; 8:55567-55574. https://doi.org/10.18632/oncotarget.15698

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Hojjat Ahmadzadehfar1,*, Stefanie Zimbelmann1,*, Anna Yordanova1, Rolf Fimmers2, Stefan Kürpig1, Elisabeth Eppard1, Florian C. Gaertner1, Xiao Wei1, Stefan Hauser3 and Markus Essler1

1 Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany

2 Institute for Medical Biometry, Informatics and Epidemiology, University of Bonn, Bonn, Germany

3 Department of Urology, University Hospital Bonn, Bonn, Germany

* These authors have contributed equally to this work

Correspondence to:

Hojjat Ahmadzadehfar, email:

Keywords: Lu-PSMA-617; hematotoxicity; radium-223; prostate cancer; radioligand therapy

Received: December 06, 2016 Accepted: February 07, 2017 Published: February 25, 2017


Radioligand therapy with 177Lu-PSMA-617 is an innovative and effective therapy for castrate-resistant metastatic prostate cancer patients. For patients with symptomatic bone metastases without visceral metastases, the guidelines recommend radionuclide therapy with 223Ra-dichloride as a single therapeutic agent or in combination with hormone therapy. The aim of this study was to evaluate the safety of repeated cycles of 177Lu-PSMA-617 after exposure to more cycles of 223Ra. Forty-nine patients were treated with three cycles of Lu-PSMA-617 divided into two groups subjected to a history of therapy with 223Ra. Group 1 included 20 patients, who had received therapy with 223Ra prior to Lu-PSMA-617 therapy. Group 2, which was the control group regarding hematotoxicity, comprised 29 patients without any history of a bone-targeted radionuclide therapy. No CTC 4° hematotoxicity was observed in the entire study population. There was no CTC 3° or CTC 4° leucopenia in either group. One and three patients from group 1 and 2, respectively, showed CTC 3° anemia. In group 1 there was significantly more CTC 2° anemia (50% vs. 6.9%) (p=0.008). One patient from group 1 (5%) showed a CTC 3° thrombocytopenia without any concurrent anemia, and two patients from group 2 (7%) showed a CTC 3° thrombocytopenia, one with CTC 3° anemia and one without any anemia. There were no significant differences between the two groups regarding leucopenia and thrombocytopenia. These results confirmed that performing repeated cycles of Lu-PSMA-617 after 223Ra seems to be safe with a very small probability of hematotoxicity.

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