Safety of PSMA radioligand therapy in mCRPC patients with preexisting moderate to severe thrombocytopenia
Bastian MB, Sieben M, Blickle A, Burgard C, Speicher T, Bartholomä M, Schaefer-Schuler A, Maus S, Ezziddin S, Rosar F (2025)
Publication Type: Journal article
Publication year: 2025
Journal
Book Volume: 52
Pages Range: 1271-1277
Journal Issue: 4
DOI: 10.1007/s00259-024-07006-z
Abstract
Purpose: Aim of this study was to analyze the safety of prostate-specific membrane antigen radioligand therapy (PSMA-RLT) in patients with metastatic castration-resistant prostate cancer (mCRPC) with preexisting moderate to severe thrombocytopenia (CTCAE ≥ 2). Materials and methods: Seventeen mCRPC patients with preexisting thrombocytopenia (platelet count < 75 × 109/L) were included in this study. Patients received a median of 3 cycles of [177Lu]Lu-PSMA-617 (range 1–6). The course of platelet cell count was closely monitored within and after the PSMA-RLT and analyzed statistically and according to CTCAE. Results: No significant difference in platelet counts was observed between baseline and follow-up after each PSMA-RLT cycle: first cycle (54.18 ± 16.07 at baseline vs. 59.65 ± 39.16 at follow up [in × 109/L], p= 0.834), second cycle (58.56 ± 16.43 vs. 107.1 ± 56.44, p = 0.203), and third cycle (60.38 ± 16.57 vs. 132.1 ± 80.43, p = 0.148), respectively. Similarly, baseline and end of treatment values, irrespective of the number of administered cycles, did not reveal a significant difference (54.18 ± 16.07 vs. 72.06 ± 71.9, p = 0.741). After the end of therapy, irrespective of the number of administered cycles, 29.4% of patients remained stable in terms of CTCAE scoring, 41.2% changed to a higher score and 29.4% improved to a lower score. We observed no critical bleeding events due to thrombocytopenia. Conclusion: Despite the common consideration of marked preexisting thrombocytopenia as a contraindication for RLT, this study indicates feasibility of PSMA-RLT in patients with preexisting thrombocytopenia of grade ≥ 2, as in our preliminary experience, there was no RLT-induced significant deterioration of platelet cell count. Thus, patients with thrombocytopenia should not be categorically excluded from receiving PSMA-RLT.
Involved external institutions
Germany (DE)How to cite
APA:
Bastian, M.B., Sieben, M., Blickle, A., Burgard, C., Speicher, T., Bartholomä, M.,... Rosar, F. (2025). Safety of PSMA radioligand therapy in mCRPC patients with preexisting moderate to severe thrombocytopenia. European Journal of Nuclear Medicine and Molecular Imaging, 52(4), 1271-1277. https://doi.org/10.1007/s00259-024-07006-z
MLA:
Bastian, Moritz B., et al. "Safety of PSMA radioligand therapy in mCRPC patients with preexisting moderate to severe thrombocytopenia." European Journal of Nuclear Medicine and Molecular Imaging 52.4 (2025): 1271-1277.
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