Rigoligand therapy with a beta-emitting 177Lutetium-labeled prostate-specific membrane antigen-ligand (177Lu-PSMA-I&T) appeared to be safe and active in heavily treated patients with metastatic castration-resistant prostate cancer (mCRPC), according to a study published in The Journal of Urology.1
Patients with mCRPC who failed treatment with both chemotherapy and novel androgen-receptor targeted therapy were treated 8-weekly with up to 4 cycles of 177Lu-PSMA-I&T.
The first 3 patients were treated with a lower activity of 3.7 GBq in their first cycle and had a favorable safety profile. In 19 subsequent patients, the activity was raised to 7.4 GBq and a total of 40 cycles were completed.
No grade 3/4 toxicities occurred with the high activity regimen. The most common grade 1/2 toxicities were dry mouth in 7 patients (37%), anemia in 6 patients (32%), and thrombopenia in 5 patients (25%).
A maximum prostate-specific antigen decline of ≥ 30%, ≥ 50%, and ≥ 90% occurred in 56%, 33%, and 11% of patients, respectively.
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Combined assessment of bone and soft-tissue metastases showed that 5% of patients achieved complete remission, 63% of patients achieved stable disease, and 32% of patients experienced progressive disease.
Eastern Cooperative Oncology group status improved or remained stable in 74% of patients.
- Heck MM, Retz M, D’Alessandria C, et al. Systemic radioligand therapy with 177LU-PSMA-I&T in patients with metastatic castration-resistant prostate cancer [published online ahead of print March 7, 2016]. J Urol. doi: 10.1016/j.juro.2016.02.2969.