Safety and Survival Outcomes of 177Lu-Prostate-Specific Membrane Antigen Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer with Prior 223Ra treatment: The RALU Study

Kambiz Rahbar, Markus Essler, Kim M. Pabst, Matthias Eiber, Christian la Fougère, Vikas Prasad, Philipp Rassek, Ergela Hasa, Helmut Dittmann, Ralph A. Bundschuh, Wolfgang P. Fendler, Milena Kurtinecz, Anja Schmall, Frank Verholen, Oliver Sartor

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

The radium lutetium (RALU) study evaluated the feasibility of sequential a- and b-emitter use in patients with bone-predominant metastatic castration-resistant prostate cancer. Methods: This preplanned interim retrospective analysis investigated safety and survival outcomes with 177Lu-PSMA in patients treated with prior 223Ra. Results: Forty-nine patients were evaluated. Patients received a median of 6 223Ra injections; 59% of patients received at least 4 177Lu-PSMA cycles. Most (69%) patients received at least 4 life-prolonging therapies before 177Lu-PSMA. Common Terminology Criteria for Adverse Events grade 3–4 treatment-emergent adverse events during 177Lu-PSMA therapy and a 30-d follow-up period included anemia (18%) and thrombocytopenia (2%). Median overall survival was 12.6 mo (95% CI, 8.8–16.1 mo) and 31.4 mo (95% CI, 25.7–37.6 mo) from starting 177Lu-PSMA or 223Ra, respectively. Conclusion: 177Lu-PSMA treatment was well tolerated in patients who had received prior 223Ra. 223Ra use before 177Lu-PSMA is feasible and can be considered for future assessment of the optimal treatment sequence.

Original languageEnglish
Pages (from-to)574-578
Number of pages5
JournalJournal of Nuclear Medicine
Volume64
Issue number4
DOIs
StatePublished - Apr 1 2023

Keywords

  • Lu-PSMA
  • Ra
  • metastatic castration-resistant prostate cancer
  • real-world practice
  • targeted a-therapy

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