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177Lu-PSMA-617治疗转移性去势抵抗性前列腺癌新进展
温健男1,2,程超1,陈锐3,李葇1,姜鸿媛1,左长京1*
0
(1. 海军军医大学(第二军医大学)长海医院核医学科, 上海 200433;
2. 北部战区总医院第一派驻门诊部, 沈阳 110001;
3. 海军军医大学(第二军医大学)长海医院泌尿外科, 上海 200433
*通信作者)
摘要:
姑息性手术、试验性局部治疗、外放射治疗、内分泌治疗、化学治疗等常规治疗手段对转移性去势抵抗性前列腺癌(mCRPC)患者的预后和生活质量改善效果有限。以前列腺特异性膜抗原(PSMA)为靶点的放射性配体治疗(RLT)有望改变mCRPC患者生存期短、生活质量差的现状。177镥(177Lu)标记的PSMA-617(177Lu-PSMA-617)的理化性质和药代动力学特性优异,与其他放射性核素标记的治疗探针相比,已积累了较多临床研究数据和经验,有效性、安全性、易获得性高,显示出了较好的临床价值和应用前景,但尚存在一些局限。目前,177Lu-PSMA-617 RLT仍以小样本单中心研究为主,但随着全球研究大数据的积累,其有望成为mCRPC临床常规治疗的延伸和补充。
关键词:  前列腺肿瘤  转移性去势抵抗性前列腺癌  前列腺特异性膜抗原  放射性配体治疗  177
DOI:10.16781/j.0258-879x.2021.04.0377
投稿时间:2020-10-18修订日期:2021-01-04
基金项目:上海市卫生健康委员会先进适宜技术推广项目(2019SY029),海军军医大学(第二军医大学)长海医院"234学科攀峰计划"(2019YPT002,2020YPT002).
177Lu-PSMA-617 in treatment of metastatic castration-resistant prostate cancer: an update
WEN Jian-nan1,2,CHENG Chao1,CHEN Rui3,LI Rou1,JIANG Hong-yuan1,ZUO Chang-jing1*
(1. Department of Nuclear Medicine, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China;
2. The First Outpatient Department, General Hospital of PLA Northern Theater Command, Shenyang 110001, Liaoning, China;
3. Department of Urology, Changhai Hospital, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Conventional therapy (such as palliative surgery, experimental local therapy, external radiotherapy, endocrine therapy and chemotherapy) has limited effect on the prognosis and quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC). Radioligand therapy (RLT) with prostate-specific membrane antigen (PSMA) targeted probe is expected to change the situation (short survival and poor quality of life in mCRPC patients). 177Lutetium labelled PSMA targeted ligand PSMA-617 (177Lu-PSMA-617) has excellent physical and chemical properties and pharmacokinetic properties. Compared with other radionuclide labelled probes, we have accumulated more clinical research data and experience on 177Lu-PSMA-617. High efficacy, safety and easy availability, endowed it with high clinical value and application prospects in spite of several limitations. Although research on RLT with 177Lu-PSMA-617 is still based on small sample size and single center research at present, it is expected to become an extension and supplement to clinical conventional therapy for mCRPC patients with the accumulation of big data of global research.
Key words:  prostatic neoplasms  metastatic castration-resistant prostate cancer  prostate-specific membrane antigen  radioligand therapy  177lutelium