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[177Lu]PSMA-617 radionuclide therapy shows promise

Nature Reviews Urology volume 15, page 468 (2018)Cite this article

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The single-arm phase II trial recruited men with mCRPC who had progressive disease following taxane-based chemotherapy or second-generation antiandrogen therapy. All patients (n = 43) initially underwent PSMA imaging to confirm high PSMA expression at all metastatic sites, and eligible patients (n = 30) received up to four cycles of intravenous LuPSMA, according to tumour burden, with a mean administered radioactivity of 7.5 GBq per cycle. “We elected to adjust the amount of radioactivity based on tumour volume, renal function and body weight, adapted from our protocols using 177Lu to treat neuroendocrine tumours,” explains lead investigator Michael Hofman. This innovative ‘theranostics’ approach resulted in a highly personalized treatment strategy.

At a median follow up period of 25 months, the main primary end point of PSA response (defined as ≥50% PSA decline) was achieved in 17 (57%) of 30 patients (95% CI 37–75). Of the 17 patients with measurable nodal or visceral disease on imaging at baseline, 14 (82%) had an objective response, 5 (29%) had a complete response, and 9 (53%) had a partial response. PSA progression occurred in 27 (90%) patients, and median biochemical progression-free survival (bPFS) and overall survival (OS) were 7.6 months (95% CI 6.3–9.0) and 13.5 months (95% CI 10.4–22.7), respectively. Interestingly, a post-hoc analysis revealed that a ≥50% PSA decline was associated with even greater improvements in bPFS and OS.

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  1. Nature Reviews Urology http://www.nature.com/nrurol/

    Conor A. Bradley

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  1. Conor A. Bradley
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Correspondence to Conor A. Bradley.

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Bradley, C.A. [177Lu]PSMA-617 radionuclide therapy shows promise. Nat Rev Urol 15, 468 (2018). https://doi.org/10.1038/s41585-018-0029-6

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