Radiopharmaceuticals for the
Treatment of Multiple Myeloma?
Angela Dispenzieri, M.D
Alb.
1 2

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What is a Radiopharmaceutical?
A drug that delivers radiation for
therapeutic effect
Examples:
· FDA approved
· Not FDA approved
·89Strontium
·166Holmium tetra-
chloride
azcyclododecane
·153Samarium-
tetramethylenephos-
ethylenediaminetetra
phonate (166Ho-
-methylenephos-
DOTMP)
phonic acid (153Sm-
EDTMP)

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Why Radiopharmaceuticals?
· Many cancers, especially multiple
myeloma, are killed by radiation
· External beam irradiation relieves
pain in multiple myeloma and other
cancers
· Limitations: bone marrow
suppression, myelosuppression
· Only targets a single area, repeat
treatments can be difficult

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153Sm-EDTMP and Zoledronic Acid for
Elderly MM Patients
F Iuliano ASH 2003
In 5 of 8 patients, 2 courses long
term pain improvement at 14 months
(6-19)
· 1 patient received 3rd cycle
Pre
Post* P
Pain scale
7 (7-9)
2 (0-3)
0.06
Hematological response (MR) in 4 pts

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Synergistic activity of PS-341 (bortezomib) with
non-myeloablative 153Sm-EDTMP (QuadrametTM)
skeletal targeted radiotherapy in an orthotopic
model of multiple myeloma
Apollina Goel, Angela Dispenzieri, Susan M Geyer,
Suzanne Greiner, Kah-Whye Peng, and Stephen J.
Russell

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Survival Of 5TGM1 -bearing mice

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An Open-Label, Pilot Study of 153Sm Lexidronam (Quadramet) in
Patients with Recurrent or Refractory Multiple Myeloma and Bone
Pain

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A Phase I/II Study of 153Sm-EDTMP (QuadrametTM) and PS-341
(Velcade®) in Patients with Relapsed or Refractory Multiple
Myeloma

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A Phase I/II Study of 153Sm-EDTMP (QuadrametTM) and PS-341
(Velcade®) in Patients with Relapsed or Refractory Multiple
Myeloma

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