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@ARTICLE{Rathke:147386,
      author       = {H. Rathke and T. Holland-Letz$^*$ and W. Mier and P.
                      Flechsig and E. Mavriopoulou and M. Röhrich and K.
                      Kopka$^*$ and M. Hohenfellner and F. L. Giesel and U. A.
                      Haberkorn$^*$ and C. Kratochwil},
      title        = {{R}esponse prediction of 177{L}u-{PSMA}-617 {RLT} using
                      {PSA}, {C}hromogranin {A}, and {LDH}.},
      journal      = {Journal of nuclear medicine},
      volume       = {61},
      number       = {5},
      issn         = {2159-662X},
      address      = {New York, NY},
      publisher    = {Soc.},
      reportid     = {DKFZ-2019-02503},
      pages        = {689-695},
      year         = {2020},
      note         = {2020 May;61(5):689-695},
      abstract     = {Neuroendocrine-like trans-differentiation of prostate
                      cancer adenocarcinomas correlates with serum levels of
                      Chromogranin A (CgA) and drives treatment resistance. Aim of
                      this work was to evaluate whether CgA could serve as a
                      response predictor for 177Lu-PSMA617 radio-ligand therapy
                      (PSMA-RLT) in comparison to the established tumor markers.
                      Methods: 100 consecutive patients with metastasized
                      castration resistant prostate cancer (mCRPC) scheduled for
                      PSMA-RLT were evaluated for prostate specific antigen (PSA),
                      lactate dehydrogenase (LDH) and CgA at baseline and in
                      follow-up of PSMA-RLT. Tumor-uptake of PSMA-ligand, a known
                      predictive marker for response, was assessed as a
                      control-variable. Results: From the 100 evaluated patients,
                      35 had partial remission (PR), 16 stable disease (SD), 15
                      mixed response (MR) and 36 progression of disease (PD). High
                      tumor-uptake (above salivary gland uptake) translated into
                      PR with an Odds Ratio (OR) of 60.265 $(95\%-CI$
                      5.038-720.922). Elevated LDH implied a reduced chance for
                      partial remission with an OR of 0.094 $(95\%-CI$ 0.017 -
                      0.518) but increases the frequency of progressive disease
                      (OR 2.717, $95\%-CI$ 1.391-5.304); All patients who achieved
                      partial remission had a normal baseline LDH. Factor-2
                      elevation of CgA increased the risk for progression with an
                      OR of 3.089 $(95\%-CI$ 1.302 - 7.332). Baseline PSA showed
                      no significant odds. Conclusion: In our cohort baseline PSA
                      had no prognostic value for response prediction. LDH was the
                      marker with the strongest prognostic value and elevated LDH
                      increased the risk for progression of disease under
                      PSMA-RLT. Elevated CgA demonstrated moderate impact as a
                      negative prognostic marker in general but was explicitly
                      related with the presence of liver metastases. Well in line
                      with literature, sufficient tumor uptake is a prerequisite
                      to achieve tumor-response.},
      cin          = {C060 / E030 / E060},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331 / I:(DE-He78)E030-20160331 /
                      I:(DE-He78)E060-20160331},
      pnm          = {319H - Addenda (POF3-319H)},
      pid          = {G:(DE-HGF)POF3-319H},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:31653712},
      doi          = {10.2967/jnumed.119.231431},
      url          = {https://inrepo02.dkfz.de/record/147386},
}