Real-world data confirm that ¹⁷⁷Lutetium PSMA-617 (¹⁷⁷Lu PSMA) is effective for treating metastatic castration-resistant prostate cancer (mCRPC), according to a recent study.

A PSA decrease of 30% or greater after the first 2 cycles of the radioligand therapy “is an early marker of response that can be easily implemented in clinical practice,” Isabel Heidegger, MD, of Medical University Innsbruck in Austria and colleagues reported in European Urology Oncology.

The investigators retrospectively studied 233 patients with mCRPC who received ¹⁷⁷Lu PSMA at 8 high-volume European centers. They observed a 30% or greater decrease in PSA in 41.7%, 63.5%, and 77.8% of patients after the first, second, and third treatment cycle, respectively. Restaging using PSMA positron emission tomography-computed tomography demonstrated that 33.7% of patients had an imaging-based response, including 2 patients with a complete response. Another 13.4% had stable disease. Patients with any PSA rise after the first cycle of ¹⁷⁷Lu PSMA had a significant 2.1-fold higher risk for disease progression, Dr Heidegger and colleagues reported.

The median time to progression was 5 months compared with 8.7 months in the phase 3 randomized multicenter VISION trial. Dr Heidegger and colleagues wrote that “the reason for the difference might be that our cohort included heavily pretreated patients and patients with ECOG performance status of 2 or 3.” In addition, more than 80% of patients in their study had grade group 4 or 5 cancer at primary diagnosis, “reflecting the aggressive disease phenotype in our cohort.”

The median time until initiation of a consecutive anti-neoplastic treatment was 8.5 months.

Real-World Data Confirm Efficacy of ¹⁷⁷Lutetium PSMA-617 for mCRPC

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