Samarium for osteoblastic bone metastases and osteosarcoma

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

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