TAT-11: A Nuclear Medicine Perspective on the Everyday Experience of Treating Patients

Ottawa, ON, Canada (UroToday.com) Dr. Eugene Leung's talk concentrated on the everyday experience of treating patients. He noted that at Stage 4, pain is a major consideration and its relief is a major consideration in patient care.  He contrasted the two main differences in targeting: 1. chemical targeting where isotopes such as P32, Sr90, Radium - 223 are injected into the bloodstream and seek out chemical analogs for attachment, and 2. targeted therapy where a radio-labeled ligand attaches to an antigen receptor.

Dr. Leung gave a brief historical review from older beta-emitters like Sr89 were used mostly for palliative care rather than overall survival (OS). Sm153 offered a quicker response and provided a gamma-ray for imaging. Radium - 223 was a great advance due to the alpha high LET and short range. It is well tolerated and excreted through the GI system. Radium - 223 was not just palliative but actually modified the disease.

Dr. Leung described patient care at Ottawa Hospital. Treatment consists of 6 cycles one month apart. There is no cost to the patient, and they decided to share scan results with the patient. On the day of treatment (conducted on an outpatient basis), the patient is injected by IV, and the IV runs for about 5 minutes. The entire visit lasts from 45-60 minutes. No shielding for either patient or practitioner is required. Close communication with the patient is crucial because if a treatment is canceled the hospital must deal with handling the drug, either re-scheduling it for another patient or disposing of it. Ottawa has treated 116 patients, and 41 completed all six cycles. 

Presented by: Eugene Leung, MD, Division of Nuclear Medicine, The Ottawa Hospital

Written by: William Carithers, Lawrence Berkeley National Laboratory at the 11th International Symposium on Targeted Alpha Therapy (TAT-10)  April 1 - April 4, 2019 - Ottawa, ON, Canada

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