Kalender Ebuzer, Ekinci Edanur, Elboğa Umut, Şahin Ertan
Department of Nuclear Medicine, School of Medicine, Gaziantep University, Gaziantep 27310, Turkey.
Biomedicines. 2025 Feb 24;13(3):569. doi: 10.3390/biomedicines13030569.
Metastatic castration-resistant prostate cancer (mCRPC) is associated with poor prognosis, particularly in cases of liver metastases. Lu-PSMA-617 (commercially known as Pluvicto) is an FDA-approved radioligand therapy for mCRPC patients. This study aimed to evaluate the efficacy of Lu-PSMA-617 radioligand therapy (RLT) in mCRPC patients with liver metastases, focusing on progression-free survival (PFS), overall survival (OS), and factors influencing treatment response. This retrospective study included mCRPC patients (n = 32) with liver metastases treated with Lu-PSMA-617. Patient data, including prostate-specific antigen (PSA) levels, liver SUVmax values, Lutetium-PSMA therapy cycles, and survival outcomes, were collected. Kaplan-Meier survival analysis was used to calculate PFS and OS, while regression analysis was employed to identify factors associated with treatment response. The median PFS and OS were 6 and 9 months, respectively. Partial regression was observed in patients with significantly lower PSA levels (median: 90.0 ng/mL, range: 22-699 ng/mL, = 0.001) and liver SUVmax values (median: 17.9, range: 8.3-57.0, = 0.008). A higher number of Lutetium-PSMA cycles correlated with improved treatment response ( = 0.010) and reduced liver SUVmax values ( = 0.043). Lu-PSMA-617 therapy is effective in managing mCRPC with liver metastases. Increased intensity of therapy exposure, reflected by a higher number of treatment cycles, is associated with a greater biochemical response, as indicated by reduced PSA levels, thereby supporting the rationale for personalized treatment strategies. These findings support the use of Lu-PSMA-617 in mCRPC patients with liver metastases, warranting further prospective studies.
转移性去势抵抗性前列腺癌（mCRPC）预后较差，尤其是在发生肝转移的情况下。镥[177Lu]PSMA-617（商品名Pluvicto）是一种经美国食品药品监督管理局（FDA）批准用于mCRPC患者的放射性配体疗法。本研究旨在评估镥[177Lu]PSMA-617放射性配体疗法（RLT）对伴有肝转移的mCRPC患者的疗效，重点关注无进展生存期（PFS）、总生存期（OS）以及影响治疗反应的因素。这项回顾性研究纳入了32例接受镥[177Lu]PSMA-617治疗的伴有肝转移的mCRPC患者。收集了患者数据，包括前列腺特异性抗原（PSA）水平、肝脏SUVmax值、镥[177Lu]PSMA治疗周期以及生存结果。采用Kaplan-Meier生存分析计算PFS和OS，同时采用回归分析确定与治疗反应相关的因素。PFS和OS的中位数分别为6个月和9个月。在PSA水平显著较低（中位数：90.0 ng/mL，范围：22 - 699 ng/mL，P = 0.001）和肝脏SUVmax值较低（中位数：17.9，范围：8.3 - 57.0，P = 0.008）的患者中观察到部分缓解。较多的镥[177Lu]PSMA治疗周期与更好的治疗反应相关（P = 0.010），并与较低的肝脏SUVmax值相关（P = 0.043）。镥[177Lu]PSMA-617疗法在治疗伴有肝转移的mCRPC方面有效。治疗周期数越多所反映出的治疗暴露强度增加，与更好的生化反应相关，表现为PSA水平降低，从而支持了个性化治疗策略的合理性。这些发现支持在伴有肝转移的mCRPC患者中使用镥[177Lu]PSMA-617，值得进一步开展前瞻性研究。
