Results of a Prospective Phase 2 Pilot Trial of 177Lu-PSMA-617 Therapy for Metastatic Castration-Resistant Prostate Cancer Including Imaging Predictors of Treatment Response and Patterns of Progression.

摘要: Abstract Background 177Lu–PSMA-617 (Lu-PSMA) is an emerging therapy in men with metastatic castration-resistant prostate cancer. Paired theranostic agents have the potential to visually identify phenotypes that will respond targeted therapy. This study examined value of 68Ga-HBEDD PSMA-11; prostate-specific membrane antigen (PSMA) positron emission tomography (PET) predicting treatment response and disease progression Lu-PSMA within context a phase 2 prospective pilot trial. Patients Methods Men progressive, symptomatic cancer previously treated antiandrogens (abiraterone and/or enzalutamide) taxane-based chemotherapy were prospectively enrolled. Eligibility criteria included uptake on PSMA PET above or equal liver activity, no 18F-Fluoro–deoxyglucose (FDG) PET-discordant disease. received up 4 cycles at 6 weekly intervals. Repeat FDG/PSMA imaging was performed after completion (PSA) progression. The assessed using PSA correlated molecular parameters enrollment. Results Fourteen 18 screened underwent Ten (71%) 14 had (mean reduction, 59%). A ≥ 50% reduction occurred 5 (36%), and ≥ 30% 9 (64%). standardized (SUV) screening predictive of ≥ reduction: SUV max 17 ± versus 44 15 (P  Conclusion plays important role identifying subsequent patterns failure, which may aid determining next best options.