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Theranostics 2017; 7(6):1589-1597. doi:10.7150/thno.19050 This issue Cite

Research Paper

CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed Multiple Myeloma

Constantin Lapa1✉, Ken Herrmann1,2, Andreas Schirbel1, Heribert Hänscheid1, Katharina Lückerath1, Margret Schottelius3, Malte Kircher1, Rudolf A. Werner1, Martin Schreder4, Samuel Samnick1, Saskia Kropf5, Stefan Knop4, Andreas K. Buck1, Hermann Einsele4, Hans-Juergen Wester3*, K. Martin Kortüm4*

1. Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
2. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, USA
3. Pharmaceutical Radiochemistry, Technische Universität München, Munich, Germany
4. Department of Internal Medicine II, Division of Hematology and Medical Oncology, University Hospital Würzburg, Würzburg, Germany
5. Scintomics GmbH, Fürstenfeldbruck, Germany
* equal contribution

✉ Corresponding author: Constantin Lapa, MD, Department of Nuclear Medicine, Universitätsklinikum Würzburg, Oberdürrbacher Str. 6, 97080 Würzburg, Germany. Phone: +49 - 931-2013412; Email: lapa_c de

Citation:
Lapa C, Herrmann K, Schirbel A, Hänscheid H, Lückerath K, Schottelius M, Kircher M, Werner RA, Schreder M, Samnick S, Kropf S, Knop S, Buck AK, Einsele H, Wester HJ, Kortüm KM. CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed Multiple Myeloma. Theranostics 2017; 7(6):1589-1597. doi:10.7150/thno.19050. https://www.thno.org/v07p1589.htm
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Abstract

Graphic abstract

C-X-C-motif chemokine receptor 4 (CXCR4) is a key factor for tumor growth and metastasis in several types of human cancer. We have recently reported promising first-in-man experience with CXCR4-directed endoradiotherapy (ERT) in multiple myeloma (MM).

Eight heavily pretreated MM patients underwent a total of 10 ERT cycles (7 patients with 1 cycle and a single patient with 3 cycles). ERT was administered in combination with chemotherapy and autologous stem cell support. End points were occurrence and timing of adverse events, progression-free and overall survival.

ERT was overall well tolerated without any unexpected acute adverse events or changes in vital signs. With absorbed tumor doses >30-70 Gy in intra- or extramedullary lesions, significant anti-myeloma activity was observed with 1 patient achieving complete remission and 5/8 partial remission. Directly after ERT major infectious complications were seen in one patient who died from sepsis 22 days after ERT, another patient with high tumor burden experienced lethal tumor lysis syndrome. Median progression-free survival was 54 days (range, 13-175), median overall survival was 223 days (range, 13-313). During follow-up (6 patients available), one patient died from infectious complications, 2/8 from disease progression, the remaining 3/8 patients are still alive.

CXCR4-directed ERT was well-tolerated and exerted anti-myeloma activity even at very advanced stage MM with presence of extramedullary disease. Further assessment of this novel treatment option is highly warranted.

Keywords: Multiple myeloma, PET, CXCR4, theranostics

Citation styles

APA
Lapa, C., Herrmann, K., Schirbel, A., Hänscheid, H., Lückerath, K., Schottelius, M., Kircher, M., Werner, R.A., Schreder, M., Samnick, S., Kropf, S., Knop, S., Buck, A.K., Einsele, H., Wester, H.J., Kortüm, K.M. (2017). CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed Multiple Myeloma. Theranostics, 7(6), 1589-1597. https://doi.org/10.7150/thno.19050.

ACS
Lapa, C.; Herrmann, K.; Schirbel, A.; Hänscheid, H.; Lückerath, K.; Schottelius, M.; Kircher, M.; Werner, R.A.; Schreder, M.; Samnick, S.; Kropf, S.; Knop, S.; Buck, A.K.; Einsele, H.; Wester, H.J.; Kortüm, K.M. CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed Multiple Myeloma. Theranostics 2017, 7 (6), 1589-1597. DOI: 10.7150/thno.19050.

NLM
Lapa C, Herrmann K, Schirbel A, Hänscheid H, Lückerath K, Schottelius M, Kircher M, Werner RA, Schreder M, Samnick S, Kropf S, Knop S, Buck AK, Einsele H, Wester HJ, Kortüm KM. CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed Multiple Myeloma. Theranostics 2017; 7(6):1589-1597. doi:10.7150/thno.19050. https://www.thno.org/v07p1589.htm

CSE
Lapa C, Herrmann K, Schirbel A, Hänscheid H, Lückerath K, Schottelius M, Kircher M, Werner RA, Schreder M, Samnick S, Kropf S, Knop S, Buck AK, Einsele H, Wester HJ, Kortüm KM. 2017. CXCR4-directed endoradiotherapy induces high response rates in extramedullary relapsed Multiple Myeloma. Theranostics. 7(6):1589-1597.

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