In silico study on radiobiological efficacy of Ac-225 and Lu-177 for PSMA-guided radiotherapy.

Birindelli, Gabriele; Drobnjakovic, Milos; Morath, Volker; Steiger, Katja; D'Alessandria, Calogero; Gourni, Eleni; Afshar-Oromieh, Ali; Weber, Wolfgang; Rominger, Axel; Eiber, Matthias; Shi, Kuangyu (2021). In silico study on radiobiological efficacy of Ac-225 and Lu-177 for PSMA-guided radiotherapy. Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC), 2021, pp. 4497-4500. IEEE 10.1109/EMBC46164.2021.9630297

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The good efficacy of radioligand therapy (RLT) targeting prostate specific-membrane antigen (PSMA) for the treatment of metastatic castration-resistant prostate cancer (mCRPC) has been recently demonstrated in several clinical studies. However, the treatment effect of 177Lu-PSMA-ligands is still suboptimal for a significant fraction of patients. In contrast to external beam radiotherapy, the radiation dose distribution itself is strongly influenced by the heterogeneous tumour microenvironment. Although microdosimetry is critical for RLT treatment outcome, it is difficult to clinically or experimentally establish the quantitative relation. We propose an in silico approach to quantitatively investigate the microdosimetry and its influence on treatment outcome for PSMA-directed RLT of two different radioisotopes 177Lu and 225 Ac. The ultimate goal is optimize the combined 177 Lu and 225 Ac-PSMA therapy and maximize the anti-tumour effect, while minimizing irradiation of off-target tissues.Clinical relevance- With the proposed hybrid model we show that 177Lu-PSMA-ligands treatment assures a more homogeneously distributed dose and a lower dependency of the treatment outcome on the domain vascularisation. On the other hand, the 225Ac-PSMA-ligands treatment shows a much stronger efficacy in killing tumor cells with an equivalent mean dose distribution even in an hypoxic environment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Clinic of Nuclear Medicine

UniBE Contributor:

Birindelli, Gabriele, Gourni, Eleni, Afshar Oromieh, Ali, Rominger, Axel Oliver, Shi, Kuangyu

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2694-0604

Publisher:

IEEE

Language:

English

Submitter:

Daria Vogelsang

Date Deposited:

13 Jan 2022 14:41

Last Modified:

05 Dec 2022 15:57

Publisher DOI:

10.1109/EMBC46164.2021.9630297

PubMed ID:

34892217

BORIS DOI:

10.48350/162500

URI:

https://boris.unibe.ch/id/eprint/162500

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