TY  - JOUR
A1  - Baumgarten, Justus
A1  - Gröner, Daniel
A1  - Nguyen Ngoc, Christina
A1  - Mader, Nicolai
A1  - Chaurasia, Maximilian
A1  - Davis, Karen
A1  - Wichert, Jennifer
A1  - Chun, Felix
A1  - Tselis, Nikolaos
A1  - Happel, Christian
A1  - Grünwald, Frank
A1  - Sabet, Amir
T1  - Safety and efficacy of 177Lutetium-PSMA-617 radioligand therapy shortly after failing 223Radium-dichloride
T2  - Cancers
N2  - Bone-seeking 223Radium-dichloride (223Ra) is an established treatment prolonging survival and reducing morbidity in selected patients with metastatic castration-resistant prostate cancer (mCRPC) with skeletal involvement. Radioligand therapy with 177Lutetium-PSMA-617 (177Lu-PSMA-617) has been increasingly implemented in patients with mCRPC failing conventional treatment options. In this study, the safety and efficacy of 177Lu-PSMA-617 in patients with progressive bone involvement under treatment with 223Ra was assessed. Twenty-eight men (median age 73 years, range 63–89 years) with progressive mCRPC, who started 177Lu-PSMA-617 within 8 weeks after the last 223Ra administration, received a median of 4 (IQR 3–6) and a total of 120 cycles of 223Ra and a median of 4 (IQR 2–7) cycles 177Lu-PSMA-617 with a mean treatment activity of 6.5 ± 1.2 GBq per cycle, reaching a mean cumulative activity of 30.7 ± 23.4 GBq. A PSA response (≥50% PSA decline 12 weeks after the first 177Lu-PSMA-617 cycle) was observed in 18/28 (64.3%) patients and imaging-based partial remission (PR) was observed in 11/28 (39.3%) patients. Median imaging-based progression-free survival (PFS) was 10 (95% CI, 6–14) months and median overall survival (OS) was 18 (95% CI, 14–22) months. Patients with low bone tumor burden (2–20 lesions) had a significantly longer OS (28 vs. 14 months, p < 0.045) compared to patients with a high tumor burden (>20 lesions). Grade ≥ 3 hematological toxicity was observed in six patients after their last treatment cycle with anemia, leukopenia and thrombocytopenia in 5/28 (17.9%), 4/28 (14.3%) and 6/28 (21.4%) patients, respectively. In progressive bone-metastatic mCRPC patients, prompt initiation of 177Lu-PSMA-617 after failing 223Ra is effective with an acceptable toxicity profile.
KW  - 177Lu-PSMA-617
KW  - 223Radium-dichloride
KW  - PSMA
KW  - mCRPC
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/81953
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-819539
SN  - 2072-6694
VL  - 14
IS  - 3, art. 557
SP  - 1
EP  - 11
PB  - MDPI
CY  - Basel
ER  -