中国癌症杂志 ›› 2024, Vol. 34 ›› Issue (7): 702-714.doi: 10.19401/j.cnki.1007-3639.2024.07.010

• 指南与共识 • 上一篇    

177Lu-PSMA放射性配体疗法治疗前列腺癌的临床实践专家共识(2024年版)

中国抗癌协会肿瘤核医学专业委员会, 中国医师协会核医学医师分会   

  • 收稿日期:2024-04-19 修回日期:2024-06-07 出版日期:2024-07-30 发布日期:2024-08-08
  • 通信作者: 宋少莉(ORCID: 0000-0003-2544-7522),博士,主任医师、教授,复旦大学附属肿瘤医院核医学科主任;樊卫(ORCID: 0000-0001-5418-1714),博士,主任医师、教授,中山大学肿瘤防治中心核医学科主任。

Expert consensus of 177Lu-labeled PSMA radioligand therapy for clinical practice of prostate cancer (2024 edition)

Cancer Nuclear Medicine Committee of China Anti-Cancer Association, Chinese Association of Nuclear Medicine Physicians   

  • Received:2024-04-19 Revised:2024-06-07 Published:2024-07-30 Online:2024-08-08
  • Contact: SONG Shaoli; FAN Wei

摘要:

镥-177标记前列腺特异性膜抗原放射性配体疗法(177Lu-labeled prostate-specific membrane antigen radioligand therapy,177Lu-PSMA-RLT)是一种通过精准地向前列腺癌细胞递送177Lu释放的β射线,引发肿瘤细胞DNA的辐射损伤从而杀灭肿瘤的创新治疗方法。现阶段国内外多个前列腺癌领域权威指南与共识推荐其用于治疗转移性去势抵抗性前列腺癌(metastatic castrate-resistant prostate cancer,mCRPC),国内尚未见关于177Lu-PSMA-RLT治疗前列腺癌的临床实践路径和用药规范的报道。本共识由中国抗癌协会肿瘤核医学专业委员会和中国医师协会核医学医师分会共同发起,结合现有的 177Lu-PSMA-RLT注册研究结果、真实世界数据及国内外放射性核素临床治疗经验,根据牛津循证医学中心临床证据推荐等级和证据级别来评价不同级别的证据,在适应证、患者筛选、用药不良反应、随访和辐射安全等方面给出推荐意见。本共识旨在为临床医师提供177Lu-PSMA-RLT治疗前列腺癌的临床参考,为进一步制订行业相关指南奠定基础。

关键词: 镥-177标记前列腺特异性膜抗原放射性配体疗法, 前列腺癌, 临床实践, 专家共识

Abstract:

177Lu-labeled prostate-specific membrane antigen radioligand therapy (177Lu-PSMA-RLT) is an innovative treatment approach that precisely delivers β radiation emitted by 177Lu to prostate cancer cells, causing radiation damage to the tumor cells’ DNA and thereby eliminating the tumor. At present, it has been recommended for the treatment of metastatic castrate-resistant prostate cancer (mCRPC) by many international and national authoritative guidelines and consensuses. However, there are no published clinical practice path and medication specifications for diagnosis and treatment in China. Therefore, the consensus was jointly initiated by Cancer Nuclear Medicine Committee of Chinese Anti-Cancer Association and Chinese Association of Nuclear Medicine Physicians. Physicians from these two committees combined the existing results of 177Lu-PSMA-RLT registration study, real world data domestic and international clinical experience of radionuclide treatment, and gave recommendations in terms of indications, screening adverse reactions, follow-up and radiation safety by taking different levels of evidence as reference according to clinical evidence levels and grades of recommendation from the Oxford Centre for Evidence-based Medicine. The purpose of this consensus was to provide physicians with reference for clinical application in the practice of 177Lu-PSMA-RLT for the treatment of prostate cancer based on existing evidence and lay the foundation for the development of subsequent industry-related guidelines.

Key words: 177Lu-labeled prostate-specific membrane antigen radioligand therapy, Prostate cancer, Clinical practice, Expert consensus

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