Outcomes and prognostic predictors of Lu‐177 PSMA radioligand therapy in metastatic castration‐resistant prostate cancer (Asian Population Study)

Author:

Chua Wei Ming1ORCID,Lam Winnie Wing‐Chuen12,Tong Aaron Kian‐Ti12,Sultana Rehena3,Kua Sandra Mei Yu1,Kanesvaran Ravindran34,Wong Alvin Seng Cheong5,Tay Kae Jack36,Cheng Tai Jit Lenith7,Ng David Chee Eng12,Thang Sue Ping12

Affiliation:

1. Division of Radiological Sciences Department of Nuclear Medicine and Molecular Imaging, Singapore General Hospital Singapore Singapore

2. Radiological Sciences Academic Clinical Program SingHealth Duke‐NUS Academic Medical Centre Singapore Singapore

3. Duke‐NUS Graduate Medical School Singapore Singapore

4. Department of Medical Oncology National Cancer Centre Singapore Singapore

5. Department of Hematology‐Oncology National University Cancer Institute Singapore Singapore

6. Department of Urology Singapore General Hospital Singapore Singapore

7. Department of Diagnostic Imaging National University Hospital Singapore Singapore

Abstract

AbstractAimLutetium‐177 (Lu‐177) prostate‐specific membrane antigen radioligand therapy (PSMA‐RLT) is a promising therapy for metastatic castration‐resistant prostate cancer (mCRPC), but there is limited data of its efficacy and safety in Asian population. We aim to explore the clinical outcomes of Lu‐177 PSMA‐RLT in this population.MethodsWe evaluated 84 patients with progressive mCRPC receiving Lu‐177 PSMA‐RLT between 9 May 2018 and 21 February 2022. Lu‐177‐PSMA‐I&T was administered at 6–8‐week intervals. Primary end point was overall survival (OS), and secondary end points included prostate‐specific antigen (PSA) progression‐free survival (PFS), PSA response rate, clinical response, toxicity assessment, and prognostic indicators.ResultsThe median OS and PSA PFS were 12.2 and 5.2 months, respectively. PSA decline of ≥50% was observed in 51.8% of patients. Patients achieving PSA response had longer median OS (15.0 vs. 9.5 months, p = .03) and PSA PFS (6.5 vs. 2.9 months, p < .001). Pain score improvement was seen in 19 out of 34 patients. A hematotoxicity of ≥grade 3 was observed in 13 out of 78 patients. Multivariable analyses showed that PSA velocity, alkaline phosphatase, hemoglobin (Hb), and the number of treatment cycles were independent prognostic indicators for OS. The retrospective design was the main limitation of the study.ConclusionsOur study demonstrated a similar safety and efficacy of Lu‐177 PSMA‐RLT in Asian mCRPC patients compared to the existing literature. A PSA decline ≥50% was associated with longer OS and PSA PFS. Several prognostic indicators for patient outcomes were also identified.

Publisher

Wiley

Subject

Oncology,General Medicine

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