Dose escalation study of rhenium-186 hydroxyethylidene diphosphonate in patients with metastatic prostate cancer

Eur J Nucl Med. 1994 Oct;21(10):1114-20. doi: 10.1007/BF00181067.


Rhenium-186 hydroxyethylidene diphosphonate (186Re-HEDP) has been used for the palliative treatment of metastatic bone pain. A phase 1 dose escalation study was performed using 186Re-HEDP. Twenty-four patients with hormone-resistant prostate cancer entered the study. Each patient had at least four bone metastases and adequate haematological function. Groups of at least three consecutive patients were treated with doses starting at 1295 MBq and increasing to 3515 MBq (escalated in increments of 555 MBq). Thrombocytopenia proved to be the dose-limiting toxicity, while leucopenia played a minor role. Early death occurred in one patient (10 days after administration) without clear relationship to the 186Re-HEDP therapy. Transient neurological dysfunction was seen in two cases. Two patients who received 3515 MBq 186Re-HEDP showed grade 3 toxicity (thrombocytes 25-50 x 10(9)/l), defined as unacceptable toxicity. After treatment alkaline phosphatase levels showed a transient decrease in all patients (mean: 26% +/- 10% IU/l; range: 11%-44%). Prostate-specific antigen values showed a decline in eight patients, preceded by a temporary increase in three patients. From this study we conclude that the maximally tolerated dose of 186Re-HEDP is 2960 MBq. A placebo-controlled comparative study on the efficacy of 186Re-HEDP has been initiated.

Publication types

  • Clinical Trial
  • Clinical Trial, Phase I
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Bone Neoplasms / radiotherapy*
  • Bone Neoplasms / secondary*
  • Etidronic Acid / administration & dosage
  • Etidronic Acid / adverse effects
  • Etidronic Acid / therapeutic use*
  • Humans
  • Male
  • Organometallic Compounds / administration & dosage
  • Organometallic Compounds / adverse effects
  • Organometallic Compounds / therapeutic use*
  • Palliative Care*
  • Prostatic Neoplasms / pathology*
  • Radioisotopes / administration & dosage
  • Radioisotopes / adverse effects
  • Radioisotopes / therapeutic use*
  • Radiotherapy Dosage
  • Rhenium / administration & dosage
  • Rhenium / adverse effects
  • Rhenium / therapeutic use*
  • Thrombocytopenia / etiology


  • Organometallic Compounds
  • Radioisotopes
  • rhenium-186(tin)etidronate
  • Rhenium
  • Etidronic Acid