Samarium-153-EDTMP: Pharmacokinetic, Toxicity and Pain Response Using an Escalating Dose Schedule in Treatment of Metastatic Bone Cancer

Samarium-153-EDTMP: Pharmacokinetic, Toxicity and Pain Response Using an Escalating Dose Schedule in Treatment of Metastatic Bone Cancer

Samarium-153 emits medium-energy beta particles and an imageable gamma photon with a physical half-life of 46.3 hr. When chelated to ethylenediaminetetramethylenephosphonic acid (EDTMP), it is remarkably stable in vitro and in vivo. In this study, we administered escalating amounts of 153Sm-EDTMP, f...

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Bibliographic Details
Published in:The Journal of nuclear medicine (1978) Vol. 33; no. 8; p. 1451
Main Authors: Farhanghi, Mehdi, Holmes, Richard A, Volkert, Wynn A, Logan, K. William, Singh, Amolak
Format: Journal Article
Language:English
Published: United States Soc Nuclear Med 01-08-1992
Subjects:
Adult
Aged
Bone Neoplasms - physiopathology
Bone Neoplasms - secondary
Female
Humans
Male
Middle Aged
Organometallic Compounds - adverse effects
Organometallic Compounds - pharmacokinetics
Organometallic Compounds - therapeutic use
Organophosphorus Compounds - adverse effects
Organophosphorus Compounds - pharmacokinetics
Organophosphorus Compounds - therapeutic use
Pain - etiology
Pain - radiotherapy
Palliative Care
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Description
Summary:Samarium-153 emits medium-energy beta particles and an imageable gamma photon with a physical half-life of 46.3 hr. When chelated to ethylenediaminetetramethylenephosphonic acid (EDTMP), it is remarkably stable in vitro and in vivo. In this study, we administered escalating amounts of 153Sm-EDTMP, from 0.1 to 1.0 mCi/kg (3.7-37 MBq/kg), to 22 patients with painful metastatic bone cancer. A complete concordance was found when the scintigrams of 153Sm-EDTMP were compared qualitatively to 99mTc-HDP bone images. Moreover, the skeletal uptake of the 153Sm-EDTMP related to the number of metastatic sites (r = 0.65; p = 0.001) showed an inverse proportion to the plasma radioactivity at 30 min following injection (r = -0.79; p = 0.0001) and was unaffected by the administered (mCi/kg), (r = 0.33; p = 0.13). Myelotoxicity was observed in 10 of the 29 treatment courses and leukopenia occurred in two. Thrombocytopenia occurred in patients who had low pretreatment platelet counts, albeit within the normal range (p = 0.001), most suffered from prostate cancer (p = 0.007) and retained a higher percentage of the 153Sm-EDTMP in their skeleton (p = 0.057). In four patients an exacerbation of the pre-existing pain ("flare reaction") was recorded. Pain palliation occurred in 65% of the treated patients (mean: 3.8 mo, range: 1-11 mo). Retreatment in first time responder patients was quite effective. Our preliminary results indicate that 153Sm-EDTMP is a promising radiotherapeutic agent for palliative treatment of metastatic bone cancer pain, and further study is necessary to ascertain its optimal dose, efficacy and toxicity.
ISSN:0161-5505
1535-5667