PSMA Radioligand Therapy in Advanced Age: Insights From an 85y+ mCRPC Patient Cohort.

IF 9.6 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Clinical Nuclear Medicine Pub Date : 2025-05-12 DOI:10.1097/RLU.0000000000005968

Moritz B Bastian, Benedikt Wörl, Arne Blickle, Caroline Burgard, Tilman Speicher, Joel Wessendorf, Mark Bartholomä, Andrea Schaefer-Schuler, Stephan Maus, Samer Ezziddin, Florian Rosar

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Abstract

Purpose: With increasing life expectancy, the number of older patients with metastatic castration-resistant prostate cancer (mCRPC) continues to rise, but this group is currently underrepresented in clinical trials. This study aims to assess the efficacy and safety of prostate-specific membrane antigen (PSMA) targeted radioligand therapy (RLT) in patients over 85 years old with mCRPC.

Materials and methods: A retrospective analysis was conducted on 21 mCRPC patients aged 85 years or older receiving PSMA-RLT (range: 85-96 y). The median number of treatment cycles was 4 (range: 1-13 cycles), with a mean cumulative administered activity of 26.9±17.3 GBq (range: 8.0-87.2 GBq) of [177Lu]Lu-PSMA-617. Adverse events, including anemia, thrombocytopenia, leukopenia, renal impairment, fatigue, and xerostomia were classified according to CTCAE version 5.0.

Results: The mean best PSA response across the cohort was -37.6±73.3%, with 62% (13 of 21 patients) showing partial remission. Median progression-free survival and overall survival were 4.6 and 14.7 months, respectively. Severe adverse events were rare, occurring in 2 patients: 1 case of grade 3 anemia and 1 of grade 3 thrombocytopenia.

Conclusions: The results demonstrate that PSMA-RLT is an effective and well-tolerated treatment for mCRPC patients over 85 years, with clinical outcomes and safety comparable to those observed in studies involving younger populations. This highlights its potential as a valuable therapeutic option for this aging patient group.

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高龄PSMA放射配体治疗：来自85岁以上mCRPC患者队列的见解

目的：随着预期寿命的增加，老年转移性去势抵抗性前列腺癌（mCRPC）患者的数量持续上升，但这一群体目前在临床试验中的代表性不足。本研究旨在评估前列腺特异性膜抗原（PSMA）靶向放射配体治疗（RLT）在85岁以上mCRPC患者中的疗效和安全性。材料与方法：回顾性分析21例85岁及以上接受PSMA-RLT治疗的mCRPC患者（范围：85-96岁）。治疗周期的中位数为4（范围：1-13个周期），[177Lu]Lu-PSMA-617的平均累积给药活性为26.9±17.3 GBq（范围：8.0-87.2 GBq）。不良事件包括贫血、血小板减少、白细胞减少、肾功能损害、疲劳和口干，根据CTCAE 5.0版进行分类。结果：整个队列的平均最佳PSA反应为-37.6±73.3%,62%（21例患者中的13例）显示部分缓解。中位无进展生存期和总生存期分别为4.6个月和14.7个月。严重不良事件罕见，2例患者发生：1例3级贫血，1例3级血小板减少。结论：结果表明，PSMA-RLT对于85岁以上的mCRPC患者是一种有效且耐受性良好的治疗方法，其临床结果和安全性与涉及年轻人群的研究相当。这突出了它作为这一老年患者群体有价值的治疗选择的潜力。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Nuclear Medicine 医学-核医学

CiteScore

2.90

自引率

31.10%

发文量

1113

审稿时长

2 months

期刊介绍： Clinical Nuclear Medicine is a comprehensive and current resource for professionals in the field of nuclear medicine. It caters to both generalists and specialists, offering valuable insights on how to effectively apply nuclear medicine techniques in various clinical scenarios. With a focus on timely dissemination of information, this journal covers the latest developments that impact all aspects of the specialty. Geared towards practitioners, Clinical Nuclear Medicine is the ultimate practice-oriented publication in the field of nuclear imaging. Its informative articles are complemented by numerous illustrations that demonstrate how physicians can seamlessly integrate the knowledge gained into their everyday practice.