Safety and Survival Outcomes of 177 Lu-Prostate-Specific Membrane Antigen Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer with Prior 223 Ra treatment: The RALU Study

The Journal of Nuclear Medicine

article

Kambiz Rahbar¹  Markus Essler²  Kim M. Pabst³  Matthias Eiber⁴  Christian la Fougère⁵  Vikas Prasad⁶  Philipp Rassek¹  Ergela Hasa⁴  Helmut Dittmann⁵  Ralph A. Bundschuh⁷  Wolfgang P. Fendler³  Milena Kurtinecz⁸  Anja Schmall⁹  Frank Verholen⁹  Oliver Sartor^1,10 

[1] Department of Nuclear Medicine, University of Münster Medical Center;Department of Nuclear Medicine, University Hospital Bonn;Department of Nuclear Medicine, German Cancer Consortium ,(DKTK) University Hospital Essen;Department of Nuclear Medicine, Technical University of Munich;Department of Nuclear Medicine and Clinical Molecular Imaging, University Hospital Tübingen;Department of Nuclear Medicine, University of Ulm;Department of Nuclear Medicine, Medical Faculty, University of Augsburg;Bayer HealthCare Pharmaceuticals;Bayer Consumer Care;Tulane Cancer Center, Tulane Medical School

关键词: targeted α-therapy;    223Ra;    177Lu-PSMA;    metastatic castration-resistant prostate cancer;    real-world practice;   

DOI  :  10.2967/jnumed.122.264456

学科分类：医学（综合）

来源: Society of Nuclear Medicine

【 摘 要 】

The radium lutetium (RALU) study evaluated the feasibility of sequential α- and β-emitter use in patients with bone-predominant metastatic castration-resistant prostate cancer. Methods: This preplanned interim retrospective analysis investigated safety and survival outcomes with 177Lu-PSMA in patients treated with prior 223Ra. Results: Forty-nine patients were evaluated. Patients received a median of 6 223Ra injections; 59% of patients received at least 4 177Lu-PSMA cycles. Most (69%) patients received at least 4 life-prolonging therapies before 177Lu-PSMA. Common Terminology Criteria for Adverse Events grade 3–4 treatment-emergent adverse events during 177Lu-PSMA therapy and a 30-d follow-up period included anemia (18%) and thrombocytopenia (2%). Median overall survival was 12.6 mo (95% CI, 8.8–16.1 mo) and 31.4 mo (95% CI, 25.7–37.6 mo) from starting 177Lu-PSMA or 223Ra, respectively. Conclusion: 177Lu-PSMA treatment was well tolerated in patients who had received prior 223Ra. 223Ra use before 177Lu-PSMA is feasible and can be considered for future assessment of the optimal treatment sequence.

【 授权许可】

CC BY