Samarium for osteoblastic bone metastases and osteosarcoma

Author: Anderson, Pete

Source: Expert Opinion on Pharmacotherapy, Volume 7, Number 11, August 2006 , pp. 1475-1486(12)

Publisher: Informa Healthcare

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Abstract:

Samarium-153 lexidronam (¹⁵³Sm-EDTMP) is FDA approved for painful osteoblastic bone metastases that image on bone scan. ¹⁵³Sm-EDTMP decay has a therapeutic β-emission and a γ-photon for bone scan imaging. Monitoring of osteosarcoma radiation treatment effectiveness was performed with bone, CT, MRI and PET/CT fusion imaging. Bone scan and PET/CT improved in 5 out of 9 and 16 out of 18 osteosarcoma sites, respectively. ¹⁵³Sm-EDTMP targets multiple sites of disease, with a single administration. Side effects of ¹⁵³Sm-EDTMP (0.5 - 2.5 mCi/kg) have been minimal and include transient thrombocytopenia and neutropenia. ¹⁵³Sm-EDTMP can be combined with radiation therapy, bisphosphonates and/or chemotherapy to synergistically improve palliation. This article reviews the rationale, indications and monitoring of standard-dose samarium and investigational high-dose ¹⁵³Sm-EDTMP treatment of cancer involving bone.

Keywords: 153Sm-EDTMP; bone cancer; bone metastases; bone scan; breast cancer; MIMvista fusion imaging software; osteosarcoma; prostate cancer; skeletal neoplasia; radiation therapy; radiopharmaceutical; radiosensitisation; samarium-153 lexidronam