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Titel: 177 Lu-PSMA-617 radioligand therapy of metastatic castration-resistant prostate cancer: Initial 254-patient results from a prospective registry (REALITY Study)
VerfasserIn: Khreish, Fadi
Ghazal, Zaidoon
Marlowe, Robert J.
Rosar, Florian
Sabet, Amir
Maus, Stephan
Linxweiler, Johannes
Bartholomä, Mark
Ezziddin, Samer
Sprache: Englisch
Titel: European Journal of Nuclear Medicine and Molecular Imaging
Bandnummer: 49
Heft: 3
Seiten: 1075–1085
Verlag/Plattform: Springer Nature
Erscheinungsjahr: 2021
Freie Schlagwörter: Metastatic castration-resistant prostate cancer (mCRPC)
Prostate-specifc membrane antigen (PSMA)
Lutetium-177-PSMA-617 radioligand therapy (177LuPSMA-617 RLT)
“Real-world” data
Everyday practice
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Purpose Preliminary data from retrospective analyses and recent data from large randomized controlled trials suggest safety and efcacy of radioligand therapy (RLT) targeting prostate-specifc membrane antigen (PSMA) in men with metastatic castration-resistant prostate cancer (mCRPC). Limited data on this modality have been published regarding large samples treated in everyday practice. Methods We analyzed prospectively collected registry data regarding lutetium-177 (177Lu)-PSMA-617 RLT of 254 consecu tive men with mCRPC seen in everyday academic practice. Since 177Lu-PSMA-617 was experimental salvage treatment following failure of individually appropriate conventional therapies, patients were generally elderly and heavily pretreated (median age 70 years; prior taxanes 74.0%, 188/254), with late–end-stage disease (visceral metastasis in 32.7%, 83/254). Primary endpoints were response to RLT, defned by changes from baseline serum prostate-specifc antigen (PSA) concen tration, PSA progression-free survival (PSA-PFS), and overall survival (OS), estimated with Kaplan–Meier statistics, and caregiver-reported and patient-reported safety. Unless noted, median (minimum–maximum) values are given. Results Patients received 3 (1–13) 177Lu-PSMA-617 activities (6.5 [2.5–11.6] GBq/cycle) every 5.7 (3.0–11.0) weeks. Best response was≥50% PSA reduction in 52.0% of patients (132/254). PSA-PFS was 5.5 (95% confdence interval [95%CI] 4.4–6.6) months and OS, 14.5 (95%CI 11.5–17.5) months. In multivariable Cox proportional-hazards modeling, response to the initial≤2 RLT administrations was the strongest signifcant prognosticator related to OS (hazard ratio 3.7 [95%CI 2.5–5.5], p<0.001). No RLT-related deaths or treatment discontinuations occurred; the most frequent RLT-related Grade 3/4 adverse events were anemia (18/254 patients, 7.1%), thrombocytopenia (11/254, 4.3%), and lymphopenia (7/254, 2.8%). RLT-related xerostomia, all grade 1/2, was noted in 53/254 (20.9%). Conclusions In a large, prospectively observed “real-world” cohort with late-stage/end-stage mCRPC and conventional treatment failure, 177Lu-PSMA-617 RLT was efective, safe, and well-tolerated. Early biochemical disease control by such therapy was associated with better OS. Prospective study earlier in the disease course may be warranted.
DOI der Erstveröffentlichung: 10.1007/s00259-021-05525-7
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-357877
hdl:20.500.11880/32632
http://dx.doi.org/10.22028/D291-35787
ISSN: 1619-7089
1619-7070
Datum des Eintrags: 18-Mär-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplementary Information
In Beziehung stehendes Objekt: https://static-content.springer.com/esm/art%3A10.1007%2Fs00259-021-05525-7/MediaObjects/259_2021_5525_MOESM1_ESM.docx
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Radiologie
M - Urologie und Kinderurologie
Professur: M - Prof. Dr. Samer Ezziddin
M - Keiner Professur zugeordnet
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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