177Lu-PSMA-617 RLT in mCRPC: A single center experience, the earlier could be the better

Abstract

Introduction: Radioligand therapy which targets the prostate specific membrane antigen (PSMA) has recently considered as option in the treatment of metastatic castration resistant prostate cancer (mCRPC). The aim of this study was to evaluate the biochemical, clinical and radiological data of patients received treatment with ¹⁷⁷Lu-PSMA-617 RLT in our clinic following the diagnosis of mCRPC, and to investigate the relationship between treatment timing and metastasis region and survival.

Material and methods: This is a retrospective, observational, single-center study from December 2016 to December 2019. Patients underwent ¹⁷⁷Lu-PSMA-617 RLT with a diagnosis of mCRPC. We used the Kaplan-Meier test and the Cox regression proportional hazard test to assess survival data.

Results: 95 patients with an average age of 70.45 (50-85) were evaluated retrospectively. Median follow-up was 10.86 months (8.15-11.94 months) and the median lines of ¹⁷⁷Lu-PSMA-617 RLT treatment was 4 (1-5). Median overall survival was found to be 17.03 ± 5,78 months in the patients receiving the treatment at the third or lower lines while it was 10,30 ± 0,93 months in patients receiving the treatment at the fourth or higher lines (p = 0.021). When evaluating patients with only bone metastasis and patients with bone and lymph node metastasis, the median overall survival was 11.46 ± 0.87 months and 12.13 ± 3.02 months (p = 0.445), respectively.

Conclusion: ¹⁷⁷Lu-PSMA-617 RLT treatment provides better survival in the treatment of patients diagnosed with mCRPC after standard treatments and received it earlier. ¹⁷⁷Lu-PSMA-617 RLT treatment could be an effective treatment method in mCRPC patients with bone and lymph node metastasis.

Keywords: Cáncer de próstata; Overall survival; Prostate cancer; Radioligand therapy; Supervivencia global; Terapia con radioligandos.