HMN 2025: How Botox mitigates debilitating dry mouth in prostate cancer sufferers receiving radiopharmaceutical remedy

Salivary gland toxicity from radiopharmaceutical remedy—notably from alpha-emitting therapies like ²²⁵Ac-PSMA—is a crucial dose-limiting aspect impact, typically resulting in debilitating dry mouth. Prior makes an attempt to alleviate dry mouth utilizing chilly packs, single anticholinergics, or exterior cooling have proven minimal protecting profit.

A dual-protective method utilizing botulinum toxin (Botox) alongside an anti-nausea patch considerably reduces salivary gland toxicity in sufferers with metastatic prostate cancer present process PSMA-targeted radiopharmaceutical remedy.

The technique led to a 30% lower in PSMA uptake by the salivary glands with out affecting the therapy’s cancer-fighting efficacy. This discount could improve therapy adherence and enhance total affected person outcomes.

The findings have been introduced on the Society of Nuclear Medicine and Molecular Imaging 2025 Annual Meeting and seem within the Journal of Nuclear Medicine.

“In order for sufferers to take care of a very good high quality of life and proceed with their remedies, it is important to handle these critical dry mouth points,” mentioned Tianzhi Zhao, analysis assistant on the Theranostics Center of Excellence within the Yong Loo Lin School of Medicine on the National University of Singapore.

“Our study explored the usage of Botox paired with a nausea patch on lowering radiation uptake to the salivary glands.”

Fourteen sufferers have been enrolled within the study and obtained Botox injections within the parotid and submandibular glands on reverse sides of the physique three to 4 weeks previous to their mixed ²²⁵Ac- and ¹⁷⁷Lu-PSMA radiopharmaceutical remedy.

Three days earlier than therapy, nausea patches have been utilized behind the ears where they remained till two hours after the therapy. Molecular imaging was carried out pre- and post-treatment to measure salivary gland uptake.

A major discount in PSMA radioligand uptake within the salivary glands was noticed. Botox-treated parotid glands confirmed a imply 30% discount in PSMA uptake in comparison with the alternative parotid gland.

A imply 17% discount in PSMA uptake was noticed in injected submandibular glands in comparison with the alternative submandibular glands. The injections have been effectively tolerated, with sufferers reporting gentle injection ache however no critical or systemic unwanted side effects. No affected person discontinued PSMA remedy resulting from dry mouth.

“This study demonstrates that Botox, administered at really helpful doses together with a nausea patch, gives a promising therapeutic technique for lowering radiation-induced salivary gland toxicity with out compromising PSMA tumor uptake,” said Jingjing Zhang, MD, Ph.D., assistant professor on the Theranostics Center of Excellence within the Yong Loo Lin School of Medicine on the National University of Singapore.

“The significance of this work lies in its direct affected person profit and its potential to broaden the therapeutic utility of PSMA radiopharmaceutical remedy, notably with alpha-emitting radionuclides like ²²⁵Ac.”

Both Botox and nausea patches are FDA-approved drugs, already accessible in scientific practice for different indications. As this method leverages authorised drugs with established security profiles, this technique could possibly be instantly utilized in skilled facilities providing PSMA radioligand remedy.

Provided by
Society of Nuclear Medicine and Molecular Imaging