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Ueno, N.T. et al.

Naoto T. Ueno, Jonas A. de Souza, Daniel Booser, Kazutaka Nakayama, John Madewell, Richard E. Wendt, Gabriel N. Hortobagyi, Donald Podoloff, Richard E. Champlin,

Pilot study of targeted skeletal radiation therapy for bone-only metastatic breast cancer.

PURPOSE: Bone-targeted radiation therapy is an attractive strategy for addressing bone disease with minimal systemic toxicity. This pilot study was designed to determine the safety and efficacy of (166)Holmium (Ho)-DOTMP for irradiating malignant cells and adjacent marrow in women with bone-only metastatic breast cancer. PATIENTS AND METHODS: Subjects included 6 women aged < or = 65 years with breast cancer and bone-only metastases at M. D. Anderson Cancer Center. The activity of (166)Ho-DOTMP was calculated to deliver a therapeutic absorbed dose of 22 Gy (n = 3) or 28 Gy (n = 3) to the marrow. Treatment was followed by autologous stem cell transplantation to circumvent the anticipated myelosuppresion. Median follow-up time was 40 months. RESULTS: All subjects showed prompt hematologic recovery. No patient experienced grade 3/4 acute toxicity aside from myelosuppression. Two patients developed hemorrhagic cystitis 2 years after therapy. One patient developed myelodysplastic syndrome but was found to have had pre-existing trisomy 8. Two patients remained progression free without evidence of disease for more than 6 years. Five women experienced disease relapse (4 at extraosseous sites) and died of progressive disease. Median time to progression was 10.4 months. CONCLUSION: The approach of bone-targeted radiation therapy with (166)Ho-DOTMP had an acceptable toxicity profile, and sustained complete response was obtained in 2 of 6 patients. We are conducting a phase II study to evaluate the efficacy of targeted skeletal radiation therapy for treating bone-only metastases.[1]

References

Pilot study of targeted skeletal radiation therapy for bone-only metastatic breast cancer. Ueno, N.T., de Souza, J.A., Booser, D., Nakayama, K., Madewell, J., Wendt, R.E., Hortobagyi, G.N., Podoloff, D., Champlin, R.E. Clin. Breast Cancer (2009) [Pubmed]

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