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ABSTRACT

Background: In patients with oligometastatic recurrent prostate cancer, standard treatment is androgen deprivation therapy (ADT). However, ADT has many potential side effects that may result in impaired quality of life. Early identification to select patients suitable for stereotactic ablative radiotherapy (SABR) is of utmost importance to prevent or delay start of ADT and its side effects.

Because Prostate-Specific Membrane Antigen-11- Positron Emission Tomography (PSMA-11-PET) has a higher sensitivity than choline-PET, we hypothesise that PSMA-11-PET based SABR results in longer response duration and subsequent longer delay in starting ADT than choline-PET.

METHODS

Patients with oligometastatic (≤4 metastases) recurrent prostate cancer (with no local recurrence) based on PSMA-11-PET or choline-PET treated with SABR from January 2012 until December 2017 were included. Primary endpoint was ADT-free survival. Secondary endpoints were Prostate Specific Antigen (PSA) response after SABR and time to PSA rise after SABR.
Results: Fifty patients (n = 40 PSMA-11-PET and n = 10 choline-PET) with in total 72 lesions were included. Median follow-up was 24.3 months. PSMA-11-PET enabled eligibility of patients with lower PSA levels than choline-PET (median 1.8 versus 4.2 ng/mL, p = 0.03). The PSMA-11-PET group had a significant longer PSA response duration (median 34.0 months (95% confidence interval (CI), 16.0–52.0) versus 14.7 months (95% CI 4.7–24.7), p = 0.004) with a subsequent longer ADT-free survival (median 32.7 months (95% CI, 20.8–44.5) versus 14.9 months (95% CI, 5.7–24.1), p = 0.01).

CONCLUSION

With PSMA-11-PET we are able to select patients with oligometastatic recurrent prostate cancer suitable for SABR in an earlier disease stage at lower PSA levels. PSMA-11-PET guided SABR resulted in a significant longer response duration and ADT-free survival compared with choline-PET and can therefore prevent or delay ADT related side effects.

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The Canadian Association of Nuclear Medicine (CANM) Executive Director, Hélène Samson, retired on March 1, 2021. The CANM will be under the management of NAD Marketing Inc. with Nicolas Rondeau Lapierre the General Manager. Effective immediately the CANM will have a new office location and address, however the email and website addresses remain the same.
186, Val-Chenaie
Rosemère Québec, Canada J7A 4B6
(+1) 514-963-3269
Email:  canm@canm-acmn.ca
Website:  www.canm-acmn.ca

New study to explore ways to strengthen delivery of life-saving medical isotopes

TORONTO – June 3, 2020) – The Nuclear Innovation Institute (NII) and Canadian Nuclear Isotope Council (CNIC) have partnered in an innovative study to identify challenges and evaluate potential technology, logistical, regulatory and policy solutions in Canada’s medical isotope supply chain.

Canada is a Leader in the production and Global supply of Isotopes. During the COVID-19 Pandemic, this has been never been more evident supplying critical Isotopes for medical equipment sterilization and the diagnosis and treatment of cancer.

Abstract :

Targeted radiotherapy is an evolving and promising modality of cancer treatment. The killing of cancer cells is achieved with the use of biological vectors and appropriate radionuclides. Among the many advantages of this approach are its selectiveness in delivering the radiation to the target, relatively less severe and infrequent side effects, and the possibility of assessing the uptake by the tumor prior to the therapy. Several different radiopharmaceuticals are currently being used by various administration routes and targeting mechanisms. This article aims to briefly review the current status of targeted radiotherapy as well as to outline the advantages and disadvantages of radionuclides used for this purpose.

BARCELONA, Spain, 13th October 2019 – McMaster University’s Nuclear Reactor (CAN) and NRG (NL) announced today a unique collaboration between the Netherlands and Canada in the field of nuclear medicine.

Working together, these two globally renowned research reactors will provide the world with the highest quality radioiodine (I-125), used for the treatment of prostate and other various types of cancers, at the highest level of reliability.

The importance of readily available medical isotopes

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Androgen ablating drugs increase life expectancy in men with metastatic prostate cancer, but resistance inevitably develops. In a majority of these recurrent tumors, the androgen axis is reactivated in the form of increased androgen receptor (AR) expression. Targeting proteins that are expressed as a down-stream effect of AR activity is a promising rationale for management of this disease. (more…)

5D3 is a new high-affinity murine monoclonal antibody specific for prostate-specific membrane antigen (PSMA). PSMA is a target for the imaging and therapy of prostate cancer. 111In-labeled antibodies have been used as surrogates for 177Lu/90Y-labeled therapeutics. We characterized 111In-DOTA-5D3 by SPECT/CT imaging, tissue biodistribution studies, and dosimetry.
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The role of concomitant peptide receptor radionuclide therapy (PRRT) and capecitabine therapy has shown benefit in gastroenteropancreatic neuroendocrine tumors. However, data reporting its role in paraganglioma (PGL) patients is lacking. The aim of this study was to evaluate the role of combined capecitabine and 177Lu-DOTATATE in malignant PGL patients. (more…)

Academic journals have published a large number of papers in the therapeutic nuclear medicine (NM) research field in the last 10 years. Despite this, a literature analysis has never before been made to point out the research interest in therapeutic radionuclides (RNs). For this reason, the present study aims specifically to analyze the research output on therapeutic radiometals from 2008 to 2018, with intent to quantify and identify global trends in scientific literature and emphasize the interdisciplinary nature of this research field. (more…)

Bone fracture healing is dependent upon the rapid migration and engraftment of bone marrow (BM) progenitor and stem cells to the site of injury. Stromal cell-derived factor-1 plays a crucial role in recruiting BM cells expressing its receptor CXCR4. Recently, a CXCR4 antagonist, plerixafor, has been used to mobilize BM cells into the blood in efforts to enhance cell migration to sites of injury presumably improving healing. (more…)

The worldwide supply of molybdenum-99 is expected to stabilize over the next several weeks as the High Flux Reactor in the Netherlands and the Open Pool Australian Lightwater nuclear reactor have resumed operations and are expected to reach normal Mo-99 production this week. Meanwhile, NTP Radioisotopes’ South Africa-based Pelindaba Nuclear Plant, which has finished functionality tests, is awaiting approval from the country’s National Nuclear Regulator to begin Mo-99 production runs.

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Radiolabeled somatostatin analog therapy has become an established treatment method for patients with well to moderately differentiated unresectable or metastatic neuroendocrine tumors (NETs). The most frequently used somatostatin analogs in clinical practice are octreotide and octreotate. (more…)

A generous donor has given the B.C. Cancer Foundation $18.346 million, but insists on remaining anonymous.

“Today marks an important moment in cancer research and care in Canada with one of the largest donations ever made to bring new treatment solutions to patients,” said¬†Sarah Roth, president and¬†CEO of the¬†B.C.¬†Cancer Foundation. (more…)

INTRODUCTION: Prostate-specific membrane antigen (PSMA) is an excellent prostate cancer target for theranostic applications. Many imaging agents showing high sensitivity/specificity for PSMA-expressing tissues have been developed. Some have been labeled with therapeutic radionuclides (i.e. 177Lu, 225Ac) and have had success in treating castration-resistant metastatic prostate cancer. The activity administered to patients is limited by toxicity to normal organs;

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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…)

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…)

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…)

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

Info on purchasing Y-90, please contact sales@isosolutions.com

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isoSolutions Marketing and Management will send its representative in China, Eric Huang to the 19th China Cardiovascular and Nuclear Medicine Annual meeting organized by Chinese Society of Nuclear Medicine (http://www.csnm.com.cn/) in Sichuan, China.

The 19th China Cardiovascular and Nuclear Medicine Annual Meeting will be held in Chengdu, Sichuan from July 12 to July 15, 2018. (more…)

PHILADELPHIA (Embargoed until 6:30 p.m. EDT, Tuesday, June 26, 2018) ‚Äì 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). (more…)