161Tb-PSMA放射性配体治疗前列腺癌研究进展

Research Progress of 161Tb-PSMA Radioligand Therapy for Prostate Cancer

  • 摘要: 前列腺特异性膜抗原(PSMA)放射性配体治疗(PRLT)已成为一种重要的新型疗法,尤其适合治疗常规疗法无法有效控制的转移性去势抵抗性前列腺癌(mCRPC),以镥-177(177Lu)-PSMA-617为代表的PRLT具有良好的安全性,能有效延长mCRPC患者生存期,改善生活质量等优势。尽管177Lu-PSMA-617治疗mCRPC取得成功,但仍有部分患者不敏感,甚至对治疗无响应,出现复发情况。铽-161(161Tb)与177Lu均具有β射线,但与177Lu相比,其最大的优势在于释放针对小病灶治疗的俄歇电子和内转化电子,这种β射线与俄歇电子的协同疗法,具有满足不同大小病灶治疗的优点,使得全球范围对161Tb进行肿瘤治疗的关注度正在上升。本文将从161Tb的制备、标记、质控、辐射剂量、临床前研究、临床研究以及展望等方面对161Tb-PSMA研究进行综述,旨在为开展PRLT的医务人员及患者提供参考。

     

    Abstract: Prostate specific membrane antigen (PSMA) radioligand therapy (PRLT) has become an important new therapy, especially suitable for the treatment of metastatic castration resistant prostate cancer (mCRPC) which cannot be effectively controlled by conventional therapy. PRLT, represented by Lutetium-177 (177Lu)-PSMA-617, has good safety, can effectively prolong the survival time of mCRPC patients, and improve their quality of life. Despite the success of 177Lu-PSMA-617 in the treatment of mCRPC, some patients are still insensitive or even unresponsive to treatment, so the disease progresses and relapse is inevitable. Terbium-161 (161Tb) has the same β-rays as 177Lu, but its biggest advantage compared with 177Lu is to release Auger electrons and internal conversion electrons for the treatment of small lesions. This synergistic therapy of β-rays and Auger electron has the advantage of meeting the treatment of lesions of different sizes, which has led to a rising interest in 161Tb for tumor therapy worldwide. In this paper, the preparation, labeling, quality control, radiation dose, preclinical research, clinical research and prospects of 161Tb-PSMA will be reviewed, aiming to provide references for medical staff and patients who carry out PRLT.

     

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