Schneider, Charlotte A., Tager, Philipp, Hammes, Jochen, Fischer, Thomas, Drzezga, Alexander, Pfister, David, Heidenreich, Axel and Schmidt, Matthias (2022). Treatment outcome and identification of factors influencing overall survival after Lu-177-PSMA-617 radioligand therapy in metastatic prostate cancer. Nuklearmedizin, 61 (1). S. 25 - 33. STUTTGART: GEORG THIEME VERLAG KG. ISSN 2567-6407

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Abstract

Objective To examine the clinical benefit of Lu-177-PSMA-617 radioligand therapy for patients with metastatic castration-resistant prostate cancer (mCRPC). Patients and Methods Between November 2014 and December 2018, a total of 56 consecutive patients (median age 69.5 years; range 55-84 years) with mCRPC were included in this retrospective analysis. Patients received between 1 and 4 therapy cycles with a mean activity of 6.8 GBq per cycle. Biochemical response was evaluated using Prostate Cancer Working Group Criteria 3 (PCWG 3). Survival was assessed using Kaplan-Meier estimates and Cox proportional hazards regression analysis. This retrospective study was approved by the local ethics committee. Results A total of 139 treatment cycles with Lu-177-PSMA-617 were performed. A decline of 50% or more of prostate-specific antigen (PSA) level occurred in 54% and a PSA decline of any amount in 65% of patients. The estimated median overall survival (OS) was 16 months, in the chemotherapy subgroup 14 months. A longer OS was associated with a PSA-decline >= 50%, more than 2 cycles of therapy, cumulative activity >15 GBq and an initial alkaline phosphatase <= 220 [U/l]. These identified predictors remained significant on uni- and multivariate Cox regression analysis. Moreover, 40% of the patients who were non-responders after the first therapy cycle turned into responders after the second one. Conclusion PSA-decline >= 50%, a cumulative activity >15 GBq and an initial alkaline phosphatase <= 220 [U/l] were identified as key predictors of prolonged OS in patients with mCRPC. In contrast rapid clinical deterioration mostly due to skeletal carcinomatosis resulted in early treatment failure.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schneider, Charlotte A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tager, PhilippUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hammes, JochenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, ThomasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Drzezga, AlexanderUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pfister, DavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Heidenreich, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmidt, MatthiasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-562730
DOI: 10.1055/a-1670-9500
Journal or Publication Title: Nuklearmedizin
Volume: 61
Number: 1
Page Range: S. 25 - 33
Date: 2022
Publisher: GEORG THIEME VERLAG KG
Place of Publication: STUTTGART
ISSN: 2567-6407
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ABIRATERONEMultiple languages
Radiology, Nuclear Medicine & Medical ImagingMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/56273

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