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

doi:10.2967/jnumed.122.264456

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 journal › Article › peer-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 language	English
Pages (from-to)	574-578
Number of pages	5
Journal	Journal of Nuclear Medicine
Volume	64
Issue number	4
DOIs	https://doi.org/10.2967/jnumed.122.264456
State	Published - Apr 1 2023

Keywords

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

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10.2967/jnumed.122.264456

Cite this

Rahbar, K., Essler, M., Pabst, K. M., Eiber, M., la Fougère, C., Prasad, V., Rassek, P., Hasa, E., Dittmann, H., Bundschuh, R. A., Fendler, W. P., Kurtinecz, M., Schmall, A., Verholen, F., & Sartor, O. (2023). 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. Journal of Nuclear Medicine, 64(4), 574-578. https://doi.org/10.2967/jnumed.122.264456

@article{5e1348b8fa074dd6982d0f3533a63528,

title = "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",

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.",

keywords = "Lu-PSMA, Ra, metastatic castration-resistant prostate cancer, real-world practice, targeted a-therapy",

author = "Kambiz Rahbar and Markus Essler and Pabst, {Kim M.} and Matthias Eiber and {la Foug{\`e}re}, Christian and Vikas Prasad and Philipp Rassek and Ergela Hasa and Helmut Dittmann and Bundschuh, {Ralph A.} and Fendler, {Wolfgang P.} and Milena Kurtinecz and Anja Schmall and Frank Verholen and Oliver Sartor",

note = "Publisher Copyright: COPYRIGHT {\textcopyright} 2023 by the Society of Nuclear Medicine and Molecular Imaging.",

year = "2023",

month = apr,

day = "1",

doi = "10.2967/jnumed.122.264456",

language = "English",

volume = "64",

pages = "574--578",

journal = "Journal of Nuclear Medicine",

issn = "0161-5505",

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Rahbar, K, Essler, M, Pabst, KM, Eiber, M, la Fougère, C, Prasad, V, Rassek, P, Hasa, E, Dittmann, H, Bundschuh, RA, Fendler, WP, Kurtinecz, M, Schmall, A, Verholen, F & Sartor, O 2023, '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', Journal of Nuclear Medicine, vol. 64, no. 4, pp. 574-578. https://doi.org/10.2967/jnumed.122.264456

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. / Rahbar, Kambiz; Essler, Markus; Pabst, Kim M. et al.
In: Journal of Nuclear Medicine, Vol. 64, No. 4, 01.04.2023, p. 574-578.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Safety and Survival Outcomes of 177Lu-Prostate-Specific Membrane Antigen Therapy in Patients with Metastatic Castration-Resistant Prostate Cancer with Prior 223Ra treatment

T2 - The RALU Study

AU - Rahbar, Kambiz

AU - Essler, Markus

AU - Pabst, Kim M.

AU - Eiber, Matthias

AU - la Fougère, Christian

AU - Prasad, Vikas

AU - Rassek, Philipp

AU - Hasa, Ergela

AU - Dittmann, Helmut

AU - Bundschuh, Ralph A.

AU - Fendler, Wolfgang P.

AU - Kurtinecz, Milena

AU - Schmall, Anja

AU - Verholen, Frank

AU - Sartor, Oliver

PY - 2023/4/1

Y1 - 2023/4/1

N2 - 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.

AB - 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.

KW - Lu-PSMA

KW - Ra

KW - metastatic castration-resistant prostate cancer

KW - real-world practice

KW - targeted a-therapy

UR - http://www.scopus.com/inward/record.url?scp=85152160594&partnerID=8YFLogxK

U2 - 10.2967/jnumed.122.264456

DO - 10.2967/jnumed.122.264456

M3 - Article

C2 - 36302656

AN - SCOPUS:85152160594

SN - 0161-5505

VL - 64

SP - 574

EP - 578

JO - Journal of Nuclear Medicine

JF - Journal of Nuclear Medicine

IS - 4

ER -

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

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