Abstract
Determination of individual pharmacokinetics in patients undergoing radiopharmaceutical therapy is essential to define critical normal organ dosimetry. Review of a 20 year single institution experience demonstrates practical methodology for routinely characterising pharmacokinetics in each patient and calculating safe, effective therapeutic activities predicated upon prescribed radiation absorbed doses to the critical organs. In particular the results achieved in over 100 unselected consecutive clinic patients treated with 131I-rituximab radioimmunotherapy for relapsed/refractory non- Hodgkins lymphoma have matched the ORR of 75% and CR 50% achieved in formal phase II clinical trial. The low level of myelotoxicity was attributed to prospective dosimetry in each patient and prescribed dose of 0.75 Gy to whole body. Radiopeptide therapy of progressive neuroendocrine tumours with 177Lu-octreotate, illustrates application of practical dosimetry using retrospective quantitative imaging to define individual pharmacokinetics. Further challenges of multimodality combination therapy using radionuclide cocktails, chemotherapy and antivascular therapy, which will perturb pharmacokinetics, will require creative dosimetric methodology for continued safe, effective clinical practice of therapeutic nuclear oncology.
Keywords: Radiopharmaceutical pharmacodynamics, Radionuclide dosimetry, Therapeutic Nuclear Oncology, Lutetium- 177, Rhenium-188
Current Pharmaceutical Design
Title: Defining Pharmacokinetics for Individual Patient Dosimetry in Routine Radiopeptide and Radioimmunotherapy of Cancer: Australian Experience
Volume: 15 Issue: 9
Author(s): J. Harvey Turner
Affiliation:
Keywords: Radiopharmaceutical pharmacodynamics, Radionuclide dosimetry, Therapeutic Nuclear Oncology, Lutetium- 177, Rhenium-188
Abstract: Determination of individual pharmacokinetics in patients undergoing radiopharmaceutical therapy is essential to define critical normal organ dosimetry. Review of a 20 year single institution experience demonstrates practical methodology for routinely characterising pharmacokinetics in each patient and calculating safe, effective therapeutic activities predicated upon prescribed radiation absorbed doses to the critical organs. In particular the results achieved in over 100 unselected consecutive clinic patients treated with 131I-rituximab radioimmunotherapy for relapsed/refractory non- Hodgkins lymphoma have matched the ORR of 75% and CR 50% achieved in formal phase II clinical trial. The low level of myelotoxicity was attributed to prospective dosimetry in each patient and prescribed dose of 0.75 Gy to whole body. Radiopeptide therapy of progressive neuroendocrine tumours with 177Lu-octreotate, illustrates application of practical dosimetry using retrospective quantitative imaging to define individual pharmacokinetics. Further challenges of multimodality combination therapy using radionuclide cocktails, chemotherapy and antivascular therapy, which will perturb pharmacokinetics, will require creative dosimetric methodology for continued safe, effective clinical practice of therapeutic nuclear oncology.
Export Options
About this article
Cite this article as:
Turner Harvey J., Defining Pharmacokinetics for Individual Patient Dosimetry in Routine Radiopeptide and Radioimmunotherapy of Cancer: Australian Experience, Current Pharmaceutical Design 2009; 15 (9) . https://dx.doi.org/10.2174/138161209787582020
DOI https://dx.doi.org/10.2174/138161209787582020 |
Print ISSN 1381-6128 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-4286 |
Call for Papers in Thematic Issues
"Tuberculosis Prevention, Diagnosis and Drug Discovery"
The Nobel Prize-winning discoveries of Mycobacterium tuberculosis and streptomycin have enabled an appropriate diagnosis and an effective treatment of tuberculosis (TB). Since then, many newer diagnosis methods and drugs have been saving millions of lives. Despite advances in the past, TB is still a leading cause of infectious disease mortality ...read more
Current Pharmaceutical challenges in the treatment and diagnosis of neurological dysfunctions
Neurological dysfunctions (MND, ALS, MS, PD, AD, HD, ALS, Autism, OCD etc..) present significant challenges in both diagnosis and treatment, often necessitating innovative approaches and therapeutic interventions. This thematic issue aims to explore the current pharmaceutical landscape surrounding neurological disorders, shedding light on the challenges faced by researchers, clinicians, and ...read more
Emerging and re-emerging diseases
Faced with a possible endemic situation of COVID-19, the world has experienced two important phenomena, the emergence of new infectious diseases and/or the resurgence of previously eradicated infectious diseases. Furthermore, the geographic distribution of such diseases has also undergone changes. This context, in turn, may have a strong relationship with ...read more
Melanoma and Non-Melanoma Skin Cancer Treatment: Standard of Care and Recent Advances
In this thematic issue, we aim to provide a standard of care of the diagnosis and treatment of melanoma and non-melanoma skin cancer. The editor will invite authors from different countries who will write review articles of melanoma and non-melanoma skin cancers. The Diagnosis, Staging, Surgical Treatment, Non-Surgical Treatment all ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Autophagy Regulators as Potential Cancer Therapeutic agents: A Review
Current Topics in Medicinal Chemistry P-Selectin Glycoprotein Ligand-1 as a Potential Target for Humoral Immunotherapy of Multiple Myeloma (Supplementry Material)
Current Cancer Drug Targets The Role of B Cells in Multiple Sclerosis: Implications for B-Cell-Targeted Therapy
Current Medicinal Chemistry Organophosphorus Compounds: Intervention in Mechanisms of Signal Transduction Relevant to Proliferative, Immunological and Circulatory Disorders
Current Medicinal Chemistry The Aging of the Adaptive Immune System
Current Immunology Reviews (Discontinued) Preliminary Experience with Yttrium-90-labelled Rituximab (Chimeric Anti CD-20 Antibody) in Patients with Relapsed and Refractory B Cell Non-Hodgkins Lymphoma
Current Radiopharmaceuticals Gynecomastia in Infants, Children, and Adolescents
Recent Patents on Endocrine, Metabolic & Immune Drug Discovery Leukopenia Associated with Risperidone Treatment
Current Drug Safety Natural Bioactive Compounds as Adjuvant Therapy for Hepatitis C Infection
Current Nutrition & Food Science Biosystems Engineering of Prokaryotes with Tumor-Killing Capacities
Current Pharmaceutical Design Eliminating Ovarian Cancer Stem Cells: A Potential Therapeutic Target for Ovarian Cancer Chemoresistance
Current Protein & Peptide Science Innate Immunity and Intracellular Trafficking: Insights for Novel Anti- HIV-1 Therapeutics
Current Pharmacogenomics Mechanisms of Resistance Against Cancer Therapeutic Drugs
Current Pharmaceutical Biotechnology Genomic Signatures for Individualized Treatment of Malignant Tumors
Current Drug Discovery Technologies MiRNA-29: A microRNA Family with Tumor-Suppressing and Immune-Modulating Properties
Current Molecular Medicine Human Whey Promotes Sessile Bacterial Growth, Whereas Alternative Sources of Infant Nutrition Promote Planktonic Growth
Current Nutrition & Food Science Human Cognitive and Neuro-Psychiatric Bio-Markers in the Cardiac Peri-Operative Patient
Current Molecular Medicine Mesenchymal Stromal Cells Uptake and Release Paclitaxel without Reducing its Anticancer Activity
Anti-Cancer Agents in Medicinal Chemistry NF-κB Blockers Gifted by Mother Nature: Prospectives in Cancer Cell Chemosensitization
Current Pharmaceutical Design A Perspective on Clinical Islet Transplantation: Past, Present and Developments for Future
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued)