Department of Urology, Koc University-School of Medicine.
From the Department of Nuclear Medicine, Molecular Imaging, and Radionuclide Therapy, Koc University-School of Medicine.
Clin Nucl Med. 2023 Dec 1;48(12):e564-e569. doi: 10.1097/RLU.0000000000004901. Epub 2023 Oct 11.
This study aimed to investigate the oncological outcomes and toxicity profile of 177 Lu-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 177 Lu-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, 177 Lu-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.
177 Lu-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 177 Lu-PSMA-I&T RLT in the management of metastatic prostate cancer.
本研究旨在探讨 177Lu-PSMA-I&T 放射性配体治疗（RLT）在转移性去势抵抗性前列腺癌（mCRPC）患者中的肿瘤学结局和毒性特征，以及我们在转移性激素敏感性前列腺癌（mHSPC）中的初步经验。
共 38 例转移性前列腺癌患者（33 例 mCRPC 和 5 例 mHSPC）接受了 177Lu-PSMA-I&T RLT，每位患者的中位数为 2 个周期（范围为 1-7）。RLT 的反应根据前列腺特异性抗原（PSA）的变化和影像学反应进行评估。临床无进展生存期和总生存期用于报告肿瘤学结局。毒性使用常见毒性标准进行评估。
在 mCRPC 中，22 例（69%）、18 例（56%）和 11 例（34%）患者的 PSA 分别出现任何程度下降、PSA 下降≥30%和 PSA 下降≥50%。RLT 治疗后的首次周期临床无进展生存期和总生存期分别为 6.3 个月和 21.4 个月。在 mHSPC 中，所有患者的 177Lu-PSMA-I&T RLT 均导致了极好的 PSA 反应（93.0%-99.9%）。仅 1 例发生临床进展和癌症相关死亡。mHSPC 和 mCRPC 的毒性特征均良好。
177Lu-PSMA-I&T RLT 在 mCRPC 患者中显示出良好的 PSA 反应（≥30%），在所有 mHSPC 患者中均显示出极好的 PSA 反应。mHSPC 和 mCRPC 中的毒性特征均良好。需要进一步研究来评估 177Lu-PSMA-I&T RLT 在转移性前列腺癌治疗中的作用。
