In:
Journal of Clinical Oncology, American Society of Clinical Oncology (ASCO), Vol. 41, No. 6_suppl ( 2023-02-20), p. 73-73
Abstract:
73 Background: 223 Ra and 177 Lu-PSMA-617 both prolong overall survival (OS) in different mCRPC settings. The observational, retrospective study, RALU, investigated safety and clinical outcomes of sequential 223 Ra/ 177 Lu-PSMA therapy in patients (pts) with mCRPC. This analysis evaluated the association of time interval between 223 Ra and 177 Lu-PSMA treatments and safety and OS outcomes of 177 Lu-PSMA. Methods: Retrospective data were collected from 2021–22 in German nuclear medicine centers for all pts receiving 177 Lu-PSMA with prior history of 223 Ra therapy. Time intervals were 〈 6 months (mo) (Group [Grp]1) or ≥6 mo (Grp 2) from last 223 Ra dose to first 177 Lu-PSMA dose. Results: 42 pts received 177 Lu-PSMA within 6 mo after 223 Ra (Grp 1) and 90 pts received 223 Ra ≥6 mo prior to 177 Lu-PSMA (Grp 2). Baseline characteristics prior to 177 Lu-PSMA therapy were, respectively: median ages 72 and 74 years; 57% and 63% with Eastern Cooperative Oncology Group performance status (ECOG PS) 1, 43% and 37% with ECOG PS 2; median prostate-specific antigen (PSA) values were 366 and 268 ng/ml, and median alkaline phosphatase (ALP) values were 133 and 149 U/L; 40% and 64% received ≥4 life prolonging therapies before starting 177 Lu-PSMA. All pts had prior 223 Ra; 57% and 77% received 6 223 Ra injections; other prior therapies were abiraterone (60%, 77%), enzalutamide (50%, 78%), docetaxel (71%, 76%) and cabazitaxel (17%, 26%). Prior to 177 Lu-PSMA, 24% and 29% of pts had visceral metastases. 45% and 52% of pts received ≥4 177 Lu-PSMA cycles. From 177 Lu-PSMA start to ≤30 days post last dose, 71% and 82% of pts had treatment-emergent adverse events (TEAEs) of any grade; most common were fatigue (12%, 7%), nausea (12%, 8%) and dry mouth (7%, 18%); 36% and 24% of pts had grade 3–4 TEAEs; excluding laboratory abnormalities, osteonecrosis of the jaw was the most frequent grade 3–4 TEAE (5%, 2%). Grade 3–4 laboratory abnormalities ( 177 Lu-PSMA start to ≤90 days post last dose) are shown; treatment-related deaths were reported for 2% and 4% of pts. AEs led to treatment delays in 10% and 9% of pts. Median OS from start of 177 Lu-PSMA was 12.0 mo (95% CI, 8.8–19.9) in Grp 1 and 13.2 mo (95% CI, 10.0–15.9) in Grp 2. During 177 Lu-PSMA therapy, PSA response ≥50% occurred in 53% and 39% and ALP response ≥30% in 28% and 14% of pts, respectively. Conclusions: In this real-world setting, treating pts with 177 Lu-PSMA within 6 mo of completing 223 Ra was clinically feasible and well tolerated: no safety signals or concerns were seen. OS outcomes were similar in pts receiving 177 Lu-PSMA 〈 6 mo vs. pts receiving it ≥6 mo after completing 223 Ra. [Table: see text]
Type of Medium:
Online Resource
ISSN:
0732-183X
,
1527-7755
DOI:
10.1200/JCO.2023.41.6_suppl.73
Language:
English
Publisher:
American Society of Clinical Oncology (ASCO)
Publication Date:
2023
detail.hit.zdb_id:
2005181-5
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