This study aimed to investigate the oncological outcomes and toxicity profile of 177Lu-PSMA-I&T radioligand therapy (RLT) in patients with metastatic castration-resistant prostate cancer (mCRPC), as well as our initial experience in metastatic hormone-sensitive prostate cancer (mHSPC).
A total of 38 consecutive patients with metastatic prostate cancer (33 mCRPC and 5 mHSPC) received 177Lu-PSMA-I&T RLT, with a median of 2 cycles per patient (range, 1-7). Response to RLT was evaluated based on prostate-specific antigen (PSA) changes and imaging response. Clinical progression-free survival and overall survival were used to report oncological outcomes. Toxicity was assessed using the Common Toxicity Criteria for Adverse Events criteria.
In mCRPC, 22 (69%), 18 (56%), and 11 (34%) patients achieved any PSA decline, PSA response of ≥30%, and PSA response of ≥50%, respectively. The clinical progression-free survival and overall survival after the first cycle of RLT were 6.3 and 21.4 months, respectively. In mHSPC, 177Lu-PSMA-I&T RLT resulted in excellent PSA response (93.0%-99.9%) in all cases. Clinical progression and cancer-related mortality occurred in only 1 case. Toxicity profile was favorable in both mHSPC and mCRPC.
177Lu-PSMA-I&T RLT demonstrated favorable PSA response (≥30%) in over half of the patients with mCRPC and excellent PSA response in all patients with mHSPC. Toxicity profile was favorable in both mHSPC and mCRPC settings. Further studies are needed to evaluate the role of 177Lu-PSMA-I&T RLT in the management of metastatic prostate cancer.
Clinical nuclear medicine. 2023 Oct 11 [Epub ahead of print]
Mehmet Onur Demirkol, Barış Esen, Hülya Seymen, Melis Şen, Burcu Uçar, Sevgilay Kurtuldu, Nil Molinas Mandel, Sevil Bavbek, Okan Falay, Derya Tilki, Tarık Esen
Department of Urology, Koc University-School of Medicine., From the Department of Nuclear Medicine, Molecular Imaging, and Radionuclide Therapy, Koc University-School of Medicine., Institute of Experimental Medicine, Istanbul University., Department of Biomedical Engineering, Istanbul Arel University., Department of Nuclear Medicine, Molecular Imaging and Radionuclide Therapy, American Hospital., Department of Medical Oncology, Koc University-School of Medicine., Department of Medical Oncology, American Hospital, Istanbul, Turkey.