Renal & Urology NewsReal-World Data Confirm Efficacy of (177)Lutetium PSMA-617 for mCRPC

The recent study by Medical University Innsbruck reports encouraging results regarding the effectiveness of ¹⁷⁷Lutetium PSMA-617 (¹⁷⁷Lu PSMA) in treating metastatic castration-resistant prostate cancer (mCRPC). The data reveals promising decreases in PSA levels and gives clinicians an actionable early marker of therapeutic response.

HCN Medical Memo
The significance of this real-world study is its validation of ¹⁷⁷Lu PSMA as a viable treatment option for mCRPC patients. The study provides actionable insights like early PSA decrease markers that can easily be incorporated into clinical practice. It serves as a useful adjunct to the more controlled environment of clinical trials, offering evidence that this treatment may also be effective in more diverse and complex cases.

Key Points:

• The retrospective study involved 233 mCRPC patients at eight high-volume European centers.
• A PSA decrease of 30% or more after the first two cycles served as an early indicator of treatment response, as noted by Isabel Heidegger, MD, and colleagues.
• In the progression of treatment cycles, 41.7%, 63.5%, and 77.8% of patients exhibited a 30% or greater decrease in PSA after the first, second, and third cycles, respectively.
• 33.7% of patients had an imaging-based response, and 13.4% had stable disease. A PSA rise after the first cycle significantly correlated with a 2.1-fold higher risk of disease progression.
• The median time to progression was 5 months, lower than the 8.7 months in the phase 3 VISION trial, partly attributed to the study’s inclusion of heavily pretreated patients and those with poor performance statuses.

Additional Points:

• More than 80% of the patients had grade group 4 or 5 cancer at the time of primary diagnosis.
• The median time until the initiation of consecutive anti-neoplastic treatment was 8.5 months.
• A gamma-glutamyl transferase level of 31 U/L or less was significantly correlated with a 1.5 times higher risk of progression in patients without visceral metastases.

By the end of the study, 48% of patients were alive, 48% had died from prostate cancer, and 4% had died from other causes.

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