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First-in-human study of 177Lu-EB-PSMA-617 in patients with metastatic castration-resistant prostate cancer

Kevin Yang ⎜Sep 12, 2018 ⎜ Industry

This first-in-human study demonstrated that 177Lu-EB-PSMA-617 had higher accumulation in mCRPC and that low imaging dose appears to be effective in treating tumors with high 68Ga-PSMA-617 uptakes. Elevated uptakes of 177Lu-EBPSMA-617 in kidneys and red bone marrow were well tolerated at the administered low dose. Further investigations with increased dose and frequency of administration are warranted. (more…)

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Single Low-Dose Injection of Evans Blue Modified PSMA-617 Radioligand Therapy Eliminates Prostate-Specific Membrane Antigen Positive Tumors

Kevin Yang ⎜Sep 6, 2018 ⎜ Industry

Prostate cancer is the most frequently diagnosed malignant tumor in men worldwide. Prostate-specific membrane antigen (PSMA) is a surface molecule specifically expressed by prostate tumors and has been shown to be a valid target for internal radionuclide therapy in both preclinical and clinical settings. The most common radiotherapeutic agent is the small molecule 177Lu-PSMA-617, (more…)

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2018 Chinese Society of Nuclear Medicine Annual Meeting

Hans Peng ⎜Aug 2, 2018 ⎜ Industry

Since China was the highlighted country of 2018 SNMMI in Philadelphia, several CSNM board members presented a brief report of 2018 SNMMI to the audience. One interesting fact needs attention is that Lu-177 is the most discussed topic this year not only because Lu-177 is highly in demand during SNMMI, but also more and more professors and doctors in China have realized how important and effective Lu-177 is when it is used to diagnose and treat prostate cancer. (more…)

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Y-90 Radioembolization Long-Term Outcomes in a 185-Patient Cohort

Kevin Yang ⎜Jul 26, 2018 ⎜ Industry

Y-90 radioembolization for HCC patients with PVT appears to have an acceptable safety profile, with better survival in CP-A patients than in CP-B patients. This study confirms prior reports of survival in PVT patients treated with Y-90 radioembolization, and survival after Y-90 radioembolization appears to exceed that in
similar patients treated with systemic therapies. Despite the negative studies recently reported, Y-90 radioembolization is a reasonable treatment option in properly selected PVT patients. Further controlled studies are needed to compare it with systemic therapies or other locoregional treatments for advanced-stage HCC.

Nadine Abouchaleh1, Ahmed Gabr1, Rehan Ali1, Ali Al Asadi1, Ronald A. Mora1, Joseph Ralph Kallini1, Samdeep Mouli1, Ahsun Riaz1, Robert J Lewandowski1, and Riad Salem1–3

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SNMMI Image of the Year: PSMA PET Imaging of Theranostic for Advanced Prostate Cancer

David T. Drummond ⎜Jun 29, 2018 ⎜ Industry

PHILADELPHIA (Embargoed until 6:30 p.m. EDT, Tuesday, June 26, 2018) – In the battle against metastatic castrate-resistant prostate cancer, studies have demonstrated a high response rate to radionuclide therapy targeting prostate specific membrane antigen (PSMA) with the radionuclide lutetium-177 (177Lu). At the 2018 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), researchers reported on a phase II prospective trial. Using gallium-68 (68Ga)-PSMA11 positron emission tomography (PET) imaging, men who had exhausted conventional therapies were screened. Those with high PSMA-expression proceeded to 177Lu-PSMA617 (LuPSMA) therapy and experienced high response rates, which is clearly demonstrated in the PSMA PET imaging figure selected as the 2018 SNMMI Image of the Year.

Each year, SNMMI chooses an image that exemplifies the most promising advances in the field of nuclear medicine and molecular imaging. The state-of-the-art technologies captured in these images demonstrate the capacity to improve patient care by detecting disease, aiding diagnosis, improving clinical confidence and providing a means of selecting appropriate treatments. This year, the SNMMI Henry N. Wagner, Jr., Image of the Year was chosen from more than 2,200 abstracts submitted to the meeting and voted on by reviewers and the society leadership.
The 2018 Image of the Year goes to a team of researchers at the Peter MacCallum Cancer Centre in Melbourne, Australia. The image demonstrates exceptional responses in a series of patients who received LuPSMA therapy after other treatments stopped working. In each patient, the extent of tumor spread before and after treatment is visualized with clarity using PSMA PET. These patients experienced improved quality of life, including reduction of pain, and correlated with marked reduction of prostate specific antigen (PSA), a blood tumor marker.
“This work reflects an appreciation for all the basic science and translation work that has been performed by many groups over a long period of time to develop prostate-specific membrane antigen (PSMA) theranostics as a paradigm-changing practice for improving patient outcomes,” explained Professor Michael Hofman of the Peter MacCallum Cancer in Melbourne, Australia. “These images tell a story about exceptional responses observed in patients who had progressed after standard therapies. They match striking improvements in patient quality of life. With further research, we look forward to seeing nuclear medicine evolve as a key specialty and standard-of-care in cancer management.” He added, “I would also like to extend thanks to ANSTO, Australia’s producer of no-carrier-added Lutetium-177, and Endocyte, which produces PSMA; they helped make this study possible.”

Umar Mahmood, MD, PhD, chair of the SNMMI Scientific Program Committee, noted, “The last decade has seen a blossoming of theranostics to treat tumors with molecularly-guided radiotherapy. The expansion of patients benefiting from this approach is remarkable, and it is wonderful to know that this effort is being led by nuclear medicine physicians and scientists.”
Mahmood stated, “Prostate cancer, which affects millions of men around the world, can be painful and deadly in the metastatic setting. This phase II prospective study by Michael Hofman and colleagues clearly shows the benefit to men with castrate-resistant prostate cancer treated with a beta emitter targeting PSMA when their tumors expressed PSMA. It is gratifying to see the benefit of the approach both rigorously and objectively demonstrated in this trial, in terms of improvement in disease burden and improvement in the pain severity the men suffered.”

Abstract 531: “High activity, pain reduction and low toxicity with Lutetium-177 PSMA617 theranostics in metastatic castrate-resistant prostate cancer (mCRPC): results of a phase II prospective trial,” Michael Hofman, John Violet, Shahneen Sandhu, Justin Ferdinandus, Amir Iravani, Grace Kong, Aravind Ravi Kumar, Tim Akhurst, Sue Ping Thang, Price Jackson, Mark Scalzo, Scott Williams and Rodney Hicks, Peter MacCallum Cancer Centre, Melbourne, Australia.

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Can nuclear medicine avoid another Mo-99 shortage?

David T. Drummond ⎜Jun 11, 2018 ⎜ Industry

By Wayne Forrest, AuntMinnie.com staff writer.

Major changes are taking place in the intricate network that supplies healthcare providers around the world with molybdenum-99 (Mo-99), a key radioisotope for nuclear medicine studies. The question is, can the nuclear medicine community avoid another devastating shutdown like the one that occurred in 2009?
Back then, providers were left scrambling after a perfect storm left sites without supplies of Mo-99, which cannot be stockpiled due to its extremely short half-life. In the years since the 2009 crisis, nuclear reactor operators, nuclear medicine pharmacies and practitioners, radioisotope generator manufacturers, medical societies, and other stakeholders have banded together to ensure that adequate supplies of Mo-99 and its technetium-99m (Tc-99m) byproduct are consistently available.
“This whole occurrence of 2009 really presented a wake-up call to the industry at large, but I think we have embraced it,” said Sally Schwarz, co-director of the cyclotron facility at the Washington University School of Medicine in St. Louis. “This has been an extensive and time-consuming process to move this change forward.”

One of the more significant steps to Mo-99 stability was the creation in 2009 of a joint effort between the Organization for Economic Cooperation and Development (OECD) and the Nuclear Energy Agency (NEA). The goal is to coordinate Mo-99 production and develop ways to ensure that supply meets worldwide demand; the organizations’ members cover the gamut of nuclear medicine enthusiasts and meet every six months in Paris.
The Society of Nuclear Medicine and Molecular Imaging (SNMMI) and the European Association of Nuclear Medicine (EANM) are also on hand to advocate for physicians who use radioisotopes in the treatment of their patients.
One of the tenets of the OECD-NEA collaborative is to develop an outage reserve capacity. That means Mo-99 suppliers must have permanent arrangements in place to acquire additional capacity to cover shortfalls when reactors go offline for scheduled or unplanned maintenance.
“On the recommendations of the NEA and OECD, there is a 35% contingency supply,” said Cathy Cutler, PhD, director of the Medical Isotope Research and Production (MIRP) program at the Brookhaven National Laboratory. “If someone goes down, you can call on this 35%. They are basically asking radiators to produce this additional amount.”
The outage reserve capacity is maintained by Mo-99 suppliers paying for extra ports and time on a nuclear reactor. If a supply issue occurs, they then have a position in line to acquire additional Mo-99 to cover the shortfall.

The demand for Mo-99 is expected to grow modestly over the next four years, peaking at approximately 11,500 Ci per week. Interestingly, the anticipated upswing follows a reduced call for Mo-99 in 2017. Currently, the OECD estimates that worldwide demand for Mo-99 is at 9,000 six-day Ci per week. Mature markets account for approximately 84% of the demand, while emerging markets take the remaining 16%. The growth rate in mature markets is expected to remain stable at 0.5% through 2021.
Whatever demands are to come will be handled by fewer Mo-99 suppliers, however. On March 31, the National Research Universal (NRU) nuclear reactor in Chalk River, Ontario, Canada, went offline for the final time after serving North America for decades. Even before its permanent closure, the NRU reactor manufactured little if any Mo-99 since October 2016. In addition, the Osiris reactor in France shut down at the end of 2015. Their departure leaves four Mo-99 manufacturers who now must cover the loss.

See full article here: auntminnie.com

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Targeted a-Therapy of Metastatic Castration-Resistant Prostate Cancer Analysis Suggests Efficacy Regarding Duration of Tumor Control

Kevin Yang ⎜Jun 6, 2018 ⎜ Industry

A positive response for surrogate parameters demonstrates remarkable antitumor activity for 225Ac-PSMA-617. Swimmer-plot analysis indicates a promising duration of tumor control, especially considering the unfavorable prognostic profile of the selected advanced-stage patients. Xerostomia was the main reason patients discontinued therapy or refused additional administrations and was in the same dimension as nonresponse; this finding indicates that further modifications of the treatment regimen with regard to side effects might be necessary to further enhance the therapeutic range.

Clemens Kratochwil1, Frank Bruchertseifer2, Hendrik Rathke1, Markus Hohenfellner3, Frederik L. Giesel1, Uwe Haberkorn*1,4, and Alfred Morgenstern*2

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Prospective of 68Ga Radionuclide Contribution to the Development of Imaging Agents for Infection and Inflammation

David T. Drummond ⎜Mar 14, 2018 ⎜ Industry

During the last decade, the utilization of 68Ga for the development of imaging agents has increased considerably with the leading position in the oncology. The imaging of infection and inflammation is lagging despite strong unmet medical needs. This review presents the potential routes for the development of 68Ga-based agents for the imaging and quantification of infection and inflammation in various diseases and connection of the diagnosis to the treatment for the individualized patient management. (more…)

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isoSolutions supplier IRE is proud to announce a partnership with ASML

David T. Drummond ⎜Feb 1, 2018 ⎜ Products

IRE is proud to announce a partnership with ASML to further develop a new, non-fission production method for medical isotopes such as Mo-99/Tc-99m. This partnership has resulted in the start of the LightHouse Isotopes BV, an ambitious initiative for the development of a promising alternative production method for a sustainable long term supply of Mo-99.

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