Excellent Response to 177Lu-DOTA-IBA Therapy of Patients With Multiple Skeletal Metastases

OBJECTIVE: DOTA-ibandronic acid (DOTA-IBA) is a recently developed prodrug targeting bone metastases. Labeling with 68Ga/177Lu (68Ga/177Lu-DOTA-IBA) induces good curative effects and safety in these patients. However, there has been no evaluation of the safety and effectiveness of 177Lu-DOTA-IBA in cases of multiple bone metastases. Here, the hematological toxicity and efficacy of 177Lu-DOTA-IBA in cases of multiple bone metastases were investigated. PARTICIPANTS AND METHODS: Twenty-eight cases of multiple bone metastases were enrolled in the analysis. Following 177Lu-DOTA-IBA treatment, blood biomarkers were monitored to evaluate the safety of treatment. Karnofsky Performance Status assessments (KPS), Visual Analogue Scale (VAS) pain scores, and 68Ga-DOTA-IBA PET/CT follow-up were utilized for evaluation of the curative effect. RESULTS: The 28 enrolled patients with multiple bone metastases had a median treatment cycle of 3. The baseline hematological parameters of 25 patients (89%) were abnormal. Post-treatment follow-up showed that blood counts remained essentially unchanged from baseline, with only one patient (4%) developed new grade 3 anemia. A 79% (22/28) rate of bone pain remission was observed and follow-up 68Ga-DOTA-IBA PET/CT images showed that 15 cases (54%, 15/28) had partial remission. CONCLUSIONS: No serious adverse events were observed in patients with multiple bone metastases who received 177Lu-DOTA-IBA. The therapeutic agent demonstrated promising efficacy, particularly for pain control and improved quality of life, suggesting that 177Lu-DOTA-IBA is a safe, effective therapeutic option for this population.