Efficacy and safety profile of 177-Lu-EDTMP for bone pain palliation in patients with metastatic bone pain.

Background: The most common symptom of patients with bone metastasis is bone pain which leads to decrease in quality of life of patients. Many different therapies are available for relief of bone pain, amongst which bone targeted radionuclide therapy is preferred in those with relapse after an initial line of treatment or those who have received maximum limit of irradiation. Various radionuclides have been previously used for bone pain palliation. Due to its medium range energy, long half-life, good binding properties, availability of gamma emissions for imaging, ¹⁷⁷ Lutetium appears useful for pain palliation. Result: 13 patients with metastatic bone pain recieved 177- Lu EDTMP. There was significant decrease in Visual Analogue Score (VAS) (p < 0.001) and Analgesic Score (AS) (p ~ 0.001) from baseline till 3 months’ post-therapy. There was improvement in Quality of life in most of the patients responding to the therapy. Overall response rate (ORR) was 76.9%. There was transient decrease in haemoglobin, WBCs and platelets post treatment. Conclusion: This study concludes that use of 177Lu-EDTMP as a systemic radionuclide therapy for pain palliation in patients with metastatic bone pain is a safe, effective and feasible alternative to conventional therapy options and other radiopharmaceuticals for pain palliation. Clinical Trial Registration : It was registered under CTRI (Clinical Trial Registry - India), Reference number: REF/2021/04/042801, Registered on 23 April 2021. URL: https://ctri.nic.in/Clinicaltrials/regtrial.php?modid=1&compid=19&EncHid=38227.67491