Predictors of Overall and Disease-Free Survival in Metastatic Castration-Resistant Prostate Cancer Patients Receiving 225Ac-PSMA-617 Radioligand Therapy

摘要: Background: Metastatic prostate carcinoma over-expresses the specific membrane antigen (PSMA) making this a suitable target for radioligand therapy of disease. Here we report on our experience in series 73 castrate resistant patients treated with 225Ac-PSMA-617, identifying variables predictive overall and progression free survival following 225Ac-PSMA-617 treatment. Methods:225Ac-PSMA-617 was administered to mCRPC who had exhausted available options their Full blood count, glomerular filtration rate liver function test were obtained at baseline follow-up evaluation toxicity. 68Ga-PSMA PET/CT baseline, prior every treatment cycle patients’ selection treatment, determine activity agent be adminsitered response assessment. Serial (prostate antigen) PSA obatianed Results: Seventy-three men (mean age=69 years, range:45-85) 210 cycles 225Ac-PSMA-617. In 70% patients, decline ≥50% while 83% any decline. 29% all lesions 68Ga-PSMA-PET resolved During follow-up, 23 experienced disease 13 died from The estimated median (PFS) (OS) 15.2 months (95% CI: 13.1 – 17.4) 18 16.2 19.9) respectively. On univariate analyses factors such as PSA, decline, ≥50%, chemotherapy, radiation therapy, hemoglobin level associated longer PFS OS (all p<0.05). multivariate analyses, only Lu-PSMA remained significant association significantly OS. Xerostomia seen 85% none severe enough warrant discontinuing Anaemia 27 no grade IV bone marrow toxicity seen. Renal failure III-IV five renal impairement. Conclusion: study, > 50% proved analysis Furthermore, previous 177Lu-PSMA negatively both uni- analysis.