Theranostics 2019; 9(17):4841-4848. doi:10.7150/thno.35759 This issue Cite

Research Paper

Second line chemotherapy and visceral metastases are associated with poor survival in patients with mCRPC receiving 177Lu-PSMA-617

Katharina Kessel1, Robert Seifert1, Michael Schäfers1, Matthias Weckesser1, Katrin Schlack2, Martin Boegemann2, Kambiz Rahbar1✉

1. Department of Nuclear Medicine, Münster University Hospital
2. Department of Urology, Münster University Hospital

Citation:
Kessel K, Seifert R, Schäfers M, Weckesser M, Schlack K, Boegemann M, Rahbar K. Second line chemotherapy and visceral metastases are associated with poor survival in patients with mCRPC receiving 177Lu-PSMA-617. Theranostics 2019; 9(17):4841-4848. doi:10.7150/thno.35759. https://www.thno.org/v09p4841.htm
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Abstract

Graphic abstract

The purpose of this study was to identify previous treatments and biomarker profile features that prognosticate overall survival (OS) in patients with mCRPC receiving 177Lu-PSMA-617.

Methods: 109 mCRPC patients treated with a median of 3 cycles of 177Lu-PSMA-617 were included. Data were analyzed according to OS as well as PSA response patterns with regard to prior therapies, laboratory biomarkers and metastatic extent in univariate as well as multivariate Cox's proportional hazards models. PSA decline was assessed using the lowest PSA levels after the first cycle of therapy (initial PSA response) and during the entire observation period (best PSA response).

Results: In total, 54 patients (49.5%) died during the observation period. First and second line chemotherapy were performed in 85% and 26%, and Abiraterone and Enzalutamide were administered in 83% and 85%, respectively. Any initial PSA decline occurred in 55% while 25% showed a PSA decline of ≥50%. The median estimated OS was 9.9 months (95% CI: 7.2-12.5) for all patients. Any initial decline of PSA was associated with significantly prolonged OS (15.5 vs. 5.7 months, p = 0.002). Second line cabazitaxel chemotherapy (6.7 vs. 15.7 months, p = 0.002) and presence of visceral metastases (5.9 vs. 16.4 months, p<0.001) were associated with shorter OS. Only visceral metastases remained significant in a multivariate analysis.

Conclusion: 177Lu-PSMA-617 is an effective therapy for patients with mCRPC. However, the present data indicate that its beneficial effects on OS are strongly influenced by pretreatment (history of second line chemotherapy with cabazitaxel) and the presence of visceral metastases at onset of 177Lu-PSMA-617 treatment.

Keywords: prostate cancer, mCRPC, 177Lu-PSMA-617, PSMA, radioligand therapy, second line chemotherapy, cabazitaxel, metastases


Citation styles

APA
Kessel, K., Seifert, R., Schäfers, M., Weckesser, M., Schlack, K., Boegemann, M., Rahbar, K. (2019). Second line chemotherapy and visceral metastases are associated with poor survival in patients with mCRPC receiving 177Lu-PSMA-617. Theranostics, 9(17), 4841-4848. https://doi.org/10.7150/thno.35759.

ACS
Kessel, K.; Seifert, R.; Schäfers, M.; Weckesser, M.; Schlack, K.; Boegemann, M.; Rahbar, K. Second line chemotherapy and visceral metastases are associated with poor survival in patients with mCRPC receiving 177Lu-PSMA-617. Theranostics 2019, 9 (17), 4841-4848. DOI: 10.7150/thno.35759.

NLM
Kessel K, Seifert R, Schäfers M, Weckesser M, Schlack K, Boegemann M, Rahbar K. Second line chemotherapy and visceral metastases are associated with poor survival in patients with mCRPC receiving 177Lu-PSMA-617. Theranostics 2019; 9(17):4841-4848. doi:10.7150/thno.35759. https://www.thno.org/v09p4841.htm

CSE
Kessel K, Seifert R, Schäfers M, Weckesser M, Schlack K, Boegemann M, Rahbar K. 2019. Second line chemotherapy and visceral metastases are associated with poor survival in patients with mCRPC receiving 177Lu-PSMA-617. Theranostics. 9(17):4841-4848.

This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/). See http://ivyspring.com/terms for full terms and conditions.
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