Does enzalutamide related PSMA upregulation affect outcomes of lutetium-177 PSMA radioligand therapy?

IF 0.8 Q4 UROLOGY & NEPHROLOGY
Urologia Journal Pub Date : 2024-08-01 Epub Date: 2024-05-16 DOI:10.1177/03915603241249230
Turgut Bora Cengiz, Raksha Kulkarni, Matteo Novello, Anthony Hafez, Somali Gavane, Munir Ghesani, Nasrin Ghesani
{"title":"Does enzalutamide related PSMA upregulation affect outcomes of lutetium-177 PSMA radioligand therapy?","authors":"Turgut Bora Cengiz, Raksha Kulkarni, Matteo Novello, Anthony Hafez, Somali Gavane, Munir Ghesani, Nasrin Ghesani","doi":"10.1177/03915603241249230","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Enzalutamide is an antiandrogen drug used prior to lutetium-177 prostate specific membrane antigen (Lu-PSMA) radioligand therapy and has shown promising results for upregulating the PSMA expression on prostate cancer cells. In this study, we aim to compare prostate specific antigen (PSA) level changes in prostate cancer patients who received enzalutamide to those who did not.</p><p><strong>Methods: </strong>Prostate cancer patients who underwent Lu-PSMA between 2021 and 2023 were retrospectively included. Patients were grouped based on prior enzalutamide therapy: those who received enzalutamide (EZ+) for at least 14 days and those who did not (EZ-). PSA changes and F-18 DCFPyL SUV (Standardized Uptake Values) were compared.</p><p><strong>Results: </strong>Thirty-seven patients were included, 18 EZ+ and 19 EZ-. The median age, Gleason score, and prior chemo/hormonal therapies were similar for EZ+ and EZ-, except for radium-223. Eleven patients (61%) in EZ+ and 13 patients (68%) in EZ- showed a decrease in PSA after the first cycle (<i>p</i> = 0.64). Four patients (22%) in EZ+ and seven patients (37%) in EZ- had more than 50% decrease in PSA after the first cycle (<i>p</i> = 0.33). The average percent decline at the end of the treatment was 23.3% in EZ+ and 50.4% in EZ- (<i>p</i> = 0.4). There was no difference in terms of lesion with highest SUVmax, mean SUV, total tumor volume or activity on pre-therapy PSMA imaging.</p><p><strong>Conclusion: </strong>Enzalutamide treatment prior to Lu-PSMA does not improve patient outcomes when applied remotely. Larger studies evaluating the combination therapies and the timing of enzalutamide are needed to assess its correlation with Lu-PSMA outcomes.</p>","PeriodicalId":23574,"journal":{"name":"Urologia Journal","volume":" ","pages":"525-530"},"PeriodicalIF":0.8000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologia Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/03915603241249230","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/5/16 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Enzalutamide is an antiandrogen drug used prior to lutetium-177 prostate specific membrane antigen (Lu-PSMA) radioligand therapy and has shown promising results for upregulating the PSMA expression on prostate cancer cells. In this study, we aim to compare prostate specific antigen (PSA) level changes in prostate cancer patients who received enzalutamide to those who did not.

Methods: Prostate cancer patients who underwent Lu-PSMA between 2021 and 2023 were retrospectively included. Patients were grouped based on prior enzalutamide therapy: those who received enzalutamide (EZ+) for at least 14 days and those who did not (EZ-). PSA changes and F-18 DCFPyL SUV (Standardized Uptake Values) were compared.

Results: Thirty-seven patients were included, 18 EZ+ and 19 EZ-. The median age, Gleason score, and prior chemo/hormonal therapies were similar for EZ+ and EZ-, except for radium-223. Eleven patients (61%) in EZ+ and 13 patients (68%) in EZ- showed a decrease in PSA after the first cycle (p = 0.64). Four patients (22%) in EZ+ and seven patients (37%) in EZ- had more than 50% decrease in PSA after the first cycle (p = 0.33). The average percent decline at the end of the treatment was 23.3% in EZ+ and 50.4% in EZ- (p = 0.4). There was no difference in terms of lesion with highest SUVmax, mean SUV, total tumor volume or activity on pre-therapy PSMA imaging.

Conclusion: Enzalutamide treatment prior to Lu-PSMA does not improve patient outcomes when applied remotely. Larger studies evaluating the combination therapies and the timing of enzalutamide are needed to assess its correlation with Lu-PSMA outcomes.

恩杂鲁胺相关的 PSMA 上调是否会影响鲁特鎓-177 PSMA 放射性配体疗法的疗效?
背景:恩杂鲁胺是一种抗雄激素药物,用于镥-177前列腺特异性膜抗原(Lu-PSMA)放射性配体治疗前,在上调前列腺癌细胞上的PSMA表达方面显示出良好的效果。本研究旨在比较接受恩杂鲁胺治疗与未接受恩杂鲁胺治疗的前列腺癌患者的前列腺特异性抗原(PSA)水平变化:回顾性纳入2021年至2023年期间接受Lu-PSMA检查的前列腺癌患者。根据患者之前接受恩杂鲁胺治疗的情况进行分组:接受恩杂鲁胺治疗(EZ+)至少 14 天的患者和未接受恩杂鲁胺治疗(EZ-)的患者。比较 PSA 变化和 F-18 DCFPyL SUV(标准化摄取值):结果:共纳入 37 例患者,其中 18 例为 EZ+,19 例为 EZ-。除镭-223外,EZ+和EZ-患者的中位年龄、Gleason评分和既往化疗/激素疗法相似。EZ+和EZ-患者中分别有11人(61%)和13人(68%)在第一周期后PSA下降(P = 0.64)。在第一个周期后,4 名 EZ+ 患者(22%)和 7 名 EZ- 患者(37%)的 PSA 下降了 50%以上(p = 0.33)。治疗结束时,EZ+ 和 EZ- 的平均下降率分别为 23.3% 和 50.4% (p = 0.4)。在治疗前PSMA成像的最高SUVmax病灶、平均SUV、肿瘤总体积或活性方面没有差异:结论:在远程应用Lu-PSMA之前进行恩杂鲁胺治疗并不能改善患者的预后。需要对恩杂鲁胺的联合疗法和时机进行更大规模的研究,以评估其与 Lu-PSMA 结果的相关性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Urologia Journal
Urologia Journal UROLOGY & NEPHROLOGY-
CiteScore
0.60
自引率
12.50%
发文量
66
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信