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Trial registered on ANZCTR
Registration number
ACTRN12615000912583
Ethics application status
Approved
Date submitted
21/07/2015
Date registered
2/09/2015
Date last updated
9/02/2018
Type of registration
Retrospectively registered
Titles & IDs
Public title
Radionuclide therapy using Lutetium-177 prostate specific membrane antigen (PSMA): a pilot study in men with castrate-resistant prostate cancer (LuPSMA trial)
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Scientific title
For men with metastatic prostate cancer refractory to hormonal and chemotherapy, what is the efficacy and toxicity of radionuclide therapy with Lutetium-177 PSMA
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Secondary ID [1]
287130
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Nil
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Universal Trial Number (UTN)
U1111-1172-4095
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Trial acronym
LuPSMA Trial
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Prostate Cancer
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Condition category
Condition code
Cancer
295945
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0
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Prostate
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Targeted delivery of radiotherapy (radionuclide therapy) with intravenous administration of Lutetium-177 radiolabelled to prostate specific membrane antigen (LuPSMA).
- administered activity of 4-8 GBq, dose adjusted according to tumour burden, patient weight and renal function. LuPSMA administered on day 1 of a 6 week cycle.
- post therapy imaging following each administration of LuPSMA with quantitative SPECT/CT with each cycle to determine radiation dose delivered to tumour and normal tissues
- further cycles (up to four) will be given if post-therapy imaging demonstrates sufficient uptake to indicate further benefit. Cycles will be separated by 6 weeks
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Intervention code [1]
292381
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Treatment: Other
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Comparator / control treatment
not applicable
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Efficacy of therapy as determined by quality of life scores (determined using quality of life questionnaire (EORTC-Q30)
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Assessment method [1]
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Timepoint [1]
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3 months following completion of therapy
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Primary outcome [2]
295953
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Efficacy of therapy as determined by pain scores (determined using pain questionnaire EORT-BM22 / BPI-SF)
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Assessment method [2]
295953
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Timepoint [2]
295953
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3 months post completion of therapy
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Primary outcome [3]
295954
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Efficacy of therapy as determined as determined by imaging response (bone scan, CT, PSMA and FDG PET/CT) (using PCWG4 criteria)
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Assessment method [3]
295954
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Timepoint [3]
295954
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3 months post completion of therapy
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Secondary outcome [1]
317016
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Efficacy of therapy as determined as determined by serum PSA (primart outcome)
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Assessment method [1]
317016
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Timepoint [1]
317016
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3 months post completion of therapy
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Secondary outcome [2]
317017
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Toxicity of therapy (primary outcome)
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Assessment method [2]
317017
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Timepoint [2]
317017
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- clinical assessment prior to each administration of LuPSMA, 6 weeks and 12 weeks following completion of therapy
- vital signs following each administration of LuPSMA
- blood tests (full blood count, urea and electrolytes, liver function tests) 14 and 28 days after each administration of LuPSMA
- telephone follow-up at 14 and 28 days after each administration of LuPSMA
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Secondary outcome [3]
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Normal tissue and tumour dosimetry expressed in cGy
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Assessment method [3]
317018
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Timepoint [3]
317018
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Determined using voxel-based quantitative SPECT/CT imaging for each cycle of LuPSMA therapy
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Secondary outcome [4]
317019
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Progression free survival determined from date of commencement of PSMA therapy
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Assessment method [4]
317019
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Timepoint [4]
317019
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During follow-up period
- determined using clinical review (up to 1 year)
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Secondary outcome [5]
317020
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Overall survival
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Assessment method [5]
317020
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Timepoint [5]
317020
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During follow-up period
- determined using clinical review (up to 1 year)
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Eligibility
Key inclusion criteria
1. Pathologically confirmed prostate adenocarcinoma
2. Castration-resistant metastatic disease
3. Prior treatment with Abiraterone, Enzalutamide or both (unless contraindicated, medically unsuitable or patient refuses)
4. Prior Taxane-based chemotherapy (unless contraindicated, medically unsuitable or patient refuses)
5. Documented prostate cancer progression within last 12 months as defined by radiographic progression (soft tissue disease by RECIST v1.1 criteria OR two or more documented new metastases on a bone scan) OR new pain in an area of radiographically evident disease
6. PSMA PET/CT demonstrating uptake intensity significantly greater than liver at sites of disease
7. Eastern Cooperative Oncology Group (ECOG) Performance Status of <= 2
8. Life expectancy > 12 weeks
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Males
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Poor kidney function or kidney obstruction (estimated GFR < 40 ml/min, hydronephrosis)
2. Poor blood counts (platelet count < 75,000 x10^9 /L, neutrophil count < 1.5 x 10^9 /L, or Hb < 9.0 g/dL)
3. Poor liver function (albumin <= 25)
4. FDG PET/CT demonstrating sites of major discordant disease (i.e. FDG + PSMA-)
5. Recent radiotherapy (within 6 weeks) to sole sites of assessable disease
6. Uncontrolled intercurrent illness that would limit compliance with study protocols
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
Phase 1 / Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
17/09/2015
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Actual
28/08/2015
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Date of last participant enrolment
Anticipated
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Actual
20/06/2017
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Date of last data collection
Anticipated
13/12/2017
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Actual
8/02/2018
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Sample size
Target
30
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Accrual to date
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Final
50
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
4072
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Peter MacCallum Cancer Institute - East Melbourne
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Recruitment postcode(s) [1]
10020
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3002 - East Melbourne
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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Australian Nuclear Science and Technology Organisation (ANSTO)
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Address [1]
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New Illawarra Road, Lucas Heights, New South Wales 2234
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Country [1]
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Australia
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Primary sponsor type
Hospital
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Name
Peter MacCallum Cancer Centre
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Address
Locked Bag 1
A'Beckett Street
East Melbourne VIC 3002
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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None
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Address [1]
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None
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Country [1]
290399
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
293215
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Peter MacCallum Cancer Centre Ethics Committee
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Ethics committee address [1]
293215
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Level 4, 10 St Andrews Place East Melbourne, VIC 3002
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Ethics committee country [1]
293215
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Australia
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Date submitted for ethics approval [1]
293215
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Approval date [1]
293215
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24/07/2015
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Ethics approval number [1]
293215
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15/66
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Summary
Brief summary
The primary aim of this study is to test the safety and effectiveness of prostate specific membrane antigen (PSMA) labelled with a radioactive substance called Lutetium-177 (177Lu) in men with metastatic prostate cancer refractory to hormonal therapy and chemotherapy. Who is it for? You may be eligible to join this study if you have metastatic prostate adenocarcinoma that has progressed despite hormone treatment and chemotherapy. Study details: In this study, we will use a radioactive molecule (called Lutetium-177) that, after injection into vein, specifically attaches to cells with high PSMA Expression. This substance is taken up into prostate cancer cells, wherever they have spread (most often bones or lymph nodes) and enables targeted delivery of high doses of targeted radiation to sites of prostate cancer whilst sparing most normal tissues. This is called radionuclide therapy and uses radiation to kill prostate cancer cells. All participants who pass the screening visit selection will receive this therapy with up to 4 cycles separated by 6 weeks. You will not stay in hospital overnight but several scans will be performed requiring you to come back to the hospital for additional visits. From these scans, we will see where the radiation has gone and also quantify how much radiation was delivered to both tumours and normal tissues. Following treatment you will be mildly radioactive for a few days and there may be some restrictions on close personal contact including with pregnant women or children, but otherwise we anticipate that most patients feel will feel well and be allowed to go home the same day. Overall, participation will require you to visit the hospital approximately 14 times over around 18 months. The drug used in this study is not approved by the Therapeutic Goods Administration (TGA). This study will help inform the efficacy and side effects of LuPSMA in treating metastatic prostate cancer, and design of future larger studies assessing this therapy.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Michael Hofman
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Address
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Peter MacCallum Cancer Centre
7 St Andrews Place
East Melbourne VIC 3002
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Country
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Australia
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Phone
58938
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+61396561854
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Fax
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Email
58938
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[email protected]
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Contact person for public queries
Name
58939
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Michael Hofman
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Address
58939
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Peter MacCallum Cancer Centre
7 St Andrews Place
East Melbourne VIC 3002
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Country
58939
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Australia
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Phone
58939
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+61396561854
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Fax
58939
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Email
58939
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[email protected]
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Contact person for scientific queries
Name
58940
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Michael Hofman
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Address
58940
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Peter MacCallum Cancer Centre
7 St Andrews Place
East Melbourne VIC 3002
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Country
58940
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Australia
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Phone
58940
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+61396561854
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Fax
58940
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Email
58940
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Prostate-specific membrane antigen from diagnostic to therapeutic target: radionuclide therapy comes of age in prostate cancer.
2017
https://dx.doi.org/10.1111/bju.13871
Embase
[177Lu]-PSMA-617 radionuclide treatment in patients with metastatic castration-resistant prostate cancer (LuPSMA trial): a single-centre, single-arm, phase 2 study.
2018
https://dx.doi.org/10.1016/S1470-2045%2818%2930198-0
Embase
Deep learning renal segmentation for fully automated radiation dose estimation in unsealed source therapy.
2018
https://dx.doi.org/10.3389/fonc.2018.00215
Embase
Meeting report from the Prostate Cancer Foundation PSMA-directed radionuclide scientific working group.
2018
https://dx.doi.org/10.1002/pros.23642
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EANM procedure guidelines for radionuclide therapy with 177Lu-labelled PSMA-ligands (177Lu-PSMA-RLT).
2019
https://dx.doi.org/10.1007/s00259-019-04485-3
Embase
Poor Outcomes for Patients with Metastatic Castration-resistant Prostate Cancer with Low Prostate-specific Membrane Antigen (PSMA) Expression Deemed Ineligible for 177Lu-labelled PSMA Radioligand Therapy.
2019
https://dx.doi.org/10.1016/j.euo.2018.11.007
Embase
Radioligand therapy with 177Lu-PSMA for metastatic castration-resistant prostate cancer: A systematic review and meta-analysis.
2019
https://dx.doi.org/10.2214/AJR.18.20845
Embase
Efficacy and Safety of 177Lu-labeled Prostate-specific Membrane Antigen Radionuclide Treatment in Patients with Diffuse Bone Marrow Involvement: A Multicenter Retrospective Study.
2020
https://dx.doi.org/10.1016/j.eururo.2020.05.004
Embase
Long-term follow-up and outcomes of retreatment in an expanded 50-patient single-center Phase II prospective trial of 177Lu-PSMA-617 theranostics in metastatic castration-resistant prostate cancer.
2020
https://dx.doi.org/10.2967/jnumed.119.236414
Embase
Looking for Drugs in All the Wrong Places: Use of GCPII Inhibitors Outside the Brain.
2020
https://dx.doi.org/10.1007/s11064-019-02909-y
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Radiation dosimetry in 177lu-psma-617 therapy using a single posttreatment spect/ct scan: A novel methodology to generate time- And tissue-specific dose factors.
2020
https://dx.doi.org/10.2967/jnumed.119.233411
Embase
Application and Importance of Theranostics in the Diagnosis and Treatment of Cancer.
2021
https://dx.doi.org/10.1016/j.arcmed.2020.10.016
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Immune checkpoints, inhibitors and radionuclides in prostate cancer: Promising combinatorial therapy approach.
2021
https://dx.doi.org/10.3390/ijms22084109
Embase
PSMA: a game changer in the diagnosis and treatment of advanced prostate cancer.
2021
https://dx.doi.org/10.1007/s12032-021-01537-3
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Radionuclide Therapy in Prostate Cancer: From Standalone to Combination PSMA Theranostics.
2021
https://dx.doi.org/10.2967/jnumed.120.243295
Dimensions AI
Nomograms to predict outcomes after 177Lu-PSMA therapy in men with metastatic castration-resistant prostate cancer: an international, multicentre, retrospective study
2021
https://doi.org/10.1016/s1470-2045(21)00274-6
Embase
Lutetium Lu 177 Vipivotide Tetraxetan: First Approval.
2022
https://dx.doi.org/10.1007/s40291-022-00594-2
Embase
Prostate-specific Membrane Antigen Biology in Lethal Prostate Cancer and its Therapeutic Implications.
2022
https://dx.doi.org/10.1016/j.euf.2021.06.006
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The History of Prostate-Specific Membrane Antigen as a Theranostic Target in Prostate Cancer: The Cornerstone Role of the Prostate Cancer Foundation.
2022
https://dx.doi.org/10.2967/JNUMED.121.262997
Embase
Tumor Sink Effect in 68Ga-PSMA-11 PET: Myth or Reality?.
2022
https://dx.doi.org/10.2967/JNUMED.121.261906
Embase
Update of PSMA Theranostics in Prostate Cancer: Current Applications and Future Trends.
2022
https://dx.doi.org/10.3390/jcm11102738
Embase
Combined biology-guided radiotherapy and Lutetium PSMA theranostics treatment in metastatic castrate-resistant prostate cancer.
2023
https://dx.doi.org/10.3389/fonc.2023.1134884
Embase
PSMA PET Tumor-to-Salivary Gland Ratio to Predict Response to [177Lu]PSMA Radioligand Therapy: An International Multicenter Retrospective Study.
2023
https://dx.doi.org/10.2967/jnumed.122.265242
Dimensions AI
Innovation in Radionuclide Therapy for the Treatment of Prostate Cancers: Radiochemical Perspective and Recent Therapeutic Practices
2023
https://doi.org/10.3390/cancers15123133
N.B. These documents automatically identified may not have been verified by the study sponsor.
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