<sup>177</sup>Lu-PSMA for Extended Treatment of Metastatic Castration-Resistant Prostate Cancer.

Derlin, Thorsten; Widjaja, Liam; Werner, Rudolf A; Bengel, Frank M · J Nucl Med · 2023

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Abstract

To evaluate feasibility, additional benefit and toxicity of treatment extension of prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) in patients with metastatic castration-resistant prostate cancer (mCRPC). <b>Methods:</b> From 208 patients treated with <sup>177</sup>Lu-PSMA every 6-8 weeks, 26 patients who had not progressed and not experienced ≥grade 3 toxicity after 6 cycles continued to receive <sup>177</sup>Lu-PSMA until disease progression or complete remission or removal from treatment for toxicity or patient preference. Response rates, the additional benefit of treatment extension, and toxicity were assessed. <b>Results:</b> During treatment extension (up to 13 cycles), 50% of patients achieved an additional PSA decline (-52%±34%, range 1% to 100%), with 8% of patients receiving congruent PSA-based and imaging-based complete response. Median PFS was 450 days. Acute toxicity, including myelosuppression, was mild (≤ grade 2). Xerostomia and chronic kidney disease became more common with repetitive dosing. <b>Conclusion:</b> Extension of <sup>177</sup>Lu-PSMA treatment is feasible and effective in mCRPC.