Early PSA Change after [177Lu]PSMA-617 Radioligand Therapy as a Predicator of Biochemical Response and Overall Survival

Cancers

Thomas F. Fassbender¹  Philipp T. Meyer¹  Felix Kind¹  Juri Ruf¹  Geoffroy Andrieux²  Melanie Boerries² 

[1] Department of Nuclear Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Hugstetter Str. 55, D-79106 Freiburg, Germany;Institute of Medical Bioinformatics and Systems Medicine, Faculty of Medicine, Medical Center—University of Freiburg, University of Freiburg, Breisacher Str. 153, D-79110 Freiburg, Germany;

关键词: castration refractory metastatic prostate cancer;    PSMA;    PSA;    radioligand therapy;    [¹⁷⁷Lu]PSMA-617;   

DOI  :  10.3390/cancers14010149

来源: DOAJ

【 摘 要 】

Purpose: Radioligand therapy with [¹⁷⁷Lu]PSMA-617 (PSMA-RLT) is a promising therapeutic option for metastatic castration-resistant prostate cancer (mCPRP). This study assessed the prognostic value of early PSA measurements during PSMA-RLT. Methods: 27 patients with mCRPC scheduled for PSMA-RLT were prospectively enrolled for a serial short-interval PSA-assessment. Change in PSA (∆%PSA) during two treatment cycles was correlated with biochemical response (BR) and change in tumor volume on PET (TV) after 16 weeks (w16), as well as overall survival (OS). PCWG3 criteria and the recently recommended threshold of ∆%PSA ≤ −30% were assessed for their predictive value. Results: ∆%PSA first correlated with BR, TV and OS after 4 weeks (c1w4). At c1w4, ∆%PSA ≤ −30% was associated with the biochemical response at w16 (p = 0.003) and a longer median OS (p = 0.025), whereas the PCWG3-derived threshold of ∆%PSA ≤ −50% showed no such correlation. In contrast, ∆%PSA ≥ 25% at c1w4 was associated with biochemical progression at w16 (p = 0.003) and a shorter median OS (p < 0.001). Conclusion: PSA changes as early as four weeks after PSMA-RLT allow a significant prediction of later biochemical and PET-based imaging response, as well as OS. At this early time point, a more lenient threshold for a PSA decrease of at least 30% appears better-suited for the prediction of a positive biochemical response and longer OS. In contrast, the PCWG3-derived threshold for PSA increase (+25%) reliably anticipates biochemical progression and shorter OS.

【 授权许可】

Unknown