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Eur J Nucl Med Mol Imaging. 2018 Feb;45(2):243-246. doi: 10.1007/s00259-017-3877-z. Epub 2017 Nov 13.

Delayed response after repeated 177Lu-PSMA-617 radioligand therapy in patients with metastatic castration resistant prostate cancer.

Author information

1
Department of Nuclear Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany. rahbar@uni-muenster.de.
2
Department of Urology, University Hospital Muenster, Muenster, Germany.
3
Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
4
Institute for Biostatistics, University Hospital Muenster, Muenster, Germany.
5
Department of Nuclear Medicine, University Hospital Muenster, Albert-Schweitzer-Campus 1, 48149, Muenster, Germany.

Abstract

PURPOSE:

Radioligand therapy (RLT) using Lutetium-177 labeled PSMA-617 (Lu-PSMA) ligand is a new therapeutic option for salvage therapy in heavily pretreated patients with metastatic castration resistant prostate cancer. The aim of this retrospective study was to analyze response in patients receiving 3 cycles of Lu-PSMA.

METHODS:

Seventy-one patients (median age: 72 years; range 44-87) received 3 cycles of RLT with Lu-PSMA (mean administered activity: 6.016 ± 0.543 GBq) every 8 weeks. Response was evaluated using serum PSA levels and a PSA decline ≥50% was considered as biochemical response. Additionally, any PSA decline after the first cycle was evaluated for further therapy effects after the second and third cycle.

RESULTS:

A total of 213 cycles were performed in 71 patients. Data for response and adverse events were available for all patients. A PSA decline ≥50% and some PSA decline occurred in 56% and 66% of the patients. Of 30 patients with a PSA response after the first cycle, 28 remained responders and 12/41 of non-responders responded to further therapy cycles.

CONCLUSION:

RLT with Lu-177-PSMA-617 shows respectable response rates. In this retrospective analysis, a relevant number of patients showed a delayed response, even if they did not respond to the first cycle of the therapy.

KEYWORDS:

PSMA; Prostate cancer; Prostate-specific membrane antigen; mCRPC

PMID:
29134280
DOI:
10.1007/s00259-017-3877-z

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