Prediction of response and survival after standardized treatment with 7400 MBq 177Lu-PSMA-617 every 4 weeks in patients with metastatic castration-resistant prostate cancer

• DOI: 10.1007/s00259-020-05082-5
• Publication Date: 2020-10-30T21:02:43Z
• Authors: Sazan Rasul; Markus Hartenbach; Tim Wollenweber; Elisabeth Kretsch...; Bernhard Grubmüller; Gero Kramer; Shahrokh Shariat; Wolfgang Wadsak; Markus Mitterhauser; Verena Pichler; Chrysoula Vraka; Marcus Hacker; Alexander R. Haug
• Keywords: Enzalutamide; Basal (medicine); Cabazitaxel

Abstract Background and aims [ 177 Lu]Lu-PSMA-617 radioligand therapy (PSMA-RLT) is a new for patients with metastatic castration-resistant prostate cancer (mCRPC). However, identification of reliable prognostic factors hampered by heterogeneous treatment regimens applied in previous studies. Hence, we sought clinical able to predict response survival PSMA-RLT homogenous group patients, all receiving 7400 MBq every 4 weeks. Patients methods Data 61 (mean age 71.6 ± 6.9 years, median basal PSA 70.7 [range 1.0–4890 μg/L]), pretreated abiraterone/enzalutamide (75.4%) docetaxel/cabazitaxel (68.9%), received three cycles 7321 592 MBq) at four weekly intervals were analyzed retrospectively. General medical conditions laboratory parameters regularly assessed. Response was based on levels 1 month after the 3rd cycle. Binary logistic regression test Kaplan-Meier estimates used evaluate predictors overall (OS). Results Forty-nine (80.3%) demonstrated terms any decline, while 21 (19.7%) showed increase or no changes their levels. Baseline hemoglobin (Hb) significantly predicted reductions ≥ 50% weeks ( P = 0.01, 95% CI: 1.09–2.09) an AUC 0.68 (95% 0.54–0.81). The Hb both < 0.05 (relative risk 1.51 0.79, 1.09–2.09 0.43–1.46), respectively. In comparison reduced Hb, normal lived longer (median not reached vs. 89 weeks, 0.016). Also, ≤ 650 μg/L had than > 97 0.031). Neither pretreatments nor distribution metastasis affected rate PSMA-RLT. Conclusion Basal level independent predictor Both baseline associated survival.