Long-term tumor control following targeted alpha therapy (TAT) of low-grade gliomas (LGGs): a new treatment paradigm?

The median survival time has been reported to vary between 5 and 8 years in low-grade (WHO grade 2) astrocytoma, and between 10 and 15 years for grade 2 oligodendroglioma. Targeted alpha therapy (TAT), using the modified peptide vector [213Bi]Bi/[225Ac]Ac-DOTA-substance P, has been developed to treat glioblastoma (GBM), a prevalent malignant brain tumor. In order to assess the risk of late neurotoxicity, assuming that reduced tumor cell proliferation and invasion should directly translate into good responses in low-grade gliomas (LGGs), a limited number of patients with diffuse invasive astrocytoma (n = 8) and oligodendroglioma (n = 3) were offered TAT. In two oligodendroglioma patients, TAT was applied as a second-line treatment for tumor progression, 10 years after targeted beta therapy using [90Y]Y-DOTA-substance P. The radiopharmaceutical was locally injected directly into the tumor via a stereotactic insertion of a capsule–catheter system. The activity used for radiolabeling was 2–2.5 GBq of Bismuth-213 and 17 to 35 MBq of Actinium-225, mostly applied in a single fraction. The recurrence-free survival times were in the range of 2 to 16 years (median 11 years) in low-grade astrocytoma (n = 8), in which TAT was administered following a biopsy or tumor debulking.

KROLICKI Leszek;  KUNIKOWSKA Jolanta;  CORDIER D.;  SLAVOVA Nedelina;  KOZIARA H;  BRUCHERTSEIFER Frank;  MÄCKE H.;  MORGENSTERN Alfred;  MERLO A.; 

2023-11-22

MDPI

JRC135183

1422-0067 (online),   

https://www.mdpi.com/1422-0067/24/21/15701,    https://publications.jrc.ec.europa.eu/repository/handle/JRC135183,   

10.3390/ijms242115701 (online),