Frailty and [¹⁷⁷Lu]Lu-PSMA-617 therapy: tools and strategies for older men with metastatic castration-resistant prostate cancer.

IF 14.9 1区医学 Q1 MEDICINE, RESEARCH & EXPERIMENTAL

Theranostics Pub Date : 2026-07-29 eCollection Date: 2026-01-01 DOI:10.7150/thno.131438

Matteo Bauckneht, Nicolò Borsellino, Giuseppe Ferdinando Colloca, Lucia Fratino, Daniele Santini

{"title":"Frailty and [177Lu]Lu-PSMA-617 therapy: tools and strategies for older men with metastatic castration-resistant prostate cancer.","authors":"Matteo Bauckneht, Nicolò Borsellino, Giuseppe Ferdinando Colloca, Lucia Fratino, Daniele Santini","doi":"10.7150/thno.131438","DOIUrl":null,"url":null,"abstract":"The prognosis of metastatic castration-resistant prostate cancer is dismal. [177Lu]Lutetium-prostate-specific membrane antigen (PSMA)-617 ([177Lu]Lu-PSMA-617) is the new standard of care for PSMA-positive mCRPC previously treated with ARPI and taxane-based chemotherapy. The efficacy and safety of [177Lu]Lu-PSMA-617 have been confirmed by phase 2 (TheraP [NCT03392428]) and phase 3 (VISION study [NCT02511664] and PSMAfore trial [NCT04689828]) clinical trials. A substantial proportion of patients with mCRPC are older adults; however, chronological age alone should not be considered a contraindication to [177Lu]Lu-PSMA-617 therapy. Instead, therapeutic decisions must be guided by a comprehensive evaluation of life expectancy, comorbidities, and frailty. Here we review the effectiveness and safety data for [177Lu]Lu-PSMA-617, present tools for the geriatric and frailty assessments in clinical practice and discuss its utility and therapeutic indications in patients with different types of frailty.","PeriodicalId":22932,"journal":{"name":"Theranostics","volume":"16 15","pages":"8546-8558"},"PeriodicalIF":14.9000,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13549133/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Theranostics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7150/thno.131438","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}

引用次数: 0

Abstract

The prognosis of metastatic castration-resistant prostate cancer is dismal. [¹⁷⁷Lu]Lutetium-prostate-specific membrane antigen (PSMA)-617 ([¹⁷⁷Lu]Lu-PSMA-617) is the new standard of care for PSMA-positive mCRPC previously treated with ARPI and taxane-based chemotherapy. The efficacy and safety of [¹⁷⁷Lu]Lu-PSMA-617 have been confirmed by phase 2 (TheraP [NCT03392428]) and phase 3 (VISION study [NCT02511664] and PSMAfore trial [NCT04689828]) clinical trials. A substantial proportion of patients with mCRPC are older adults; however, chronological age alone should not be considered a contraindication to [¹⁷⁷Lu]Lu-PSMA-617 therapy. Instead, therapeutic decisions must be guided by a comprehensive evaluation of life expectancy, comorbidities, and frailty. Here we review the effectiveness and safety data for [¹⁷⁷Lu]Lu-PSMA-617, present tools for the geriatric and frailty assessments in clinical practice and discuss its utility and therapeutic indications in patients with different types of frailty.

查看原文本刊更多论文

衰弱和[177Lu]Lu-PSMA-617治疗：老年男性转移性去势抵抗性前列腺癌的工具和策略。

转移性去势抵抗性前列腺癌的预后很差。[177Lu] lutetium -前列腺特异性膜抗原(PSMA)-617 （[177Lu]Lu-PSMA-617）是先前接受ARPI和紫杉烷类化疗的PSMA阳性mCRPC的新护理标准。[177Lu]Lu-PSMA-617的有效性和安全性已通过2期临床试验（TheraP [NCT03392428]）和3期临床试验（VISION研究[NCT02511664]和PSMAfore试验[NCT04689828]）得到证实。相当大比例的mCRPC患者是老年人；然而，单纯的实足年龄不应被视为Lu-PSMA-617治疗的禁忌症[177Lu]。相反，治疗决定必须以预期寿命、合并症和虚弱的综合评估为指导。在这里，我们回顾了[177Lu]Lu-PSMA-617的有效性和安全性数据，介绍了临床实践中用于老年和虚弱评估的工具，并讨论了其在不同类型虚弱患者中的应用和治疗适应症。

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

Theranostics MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

25.40

自引率

1.60%

发文量

433

审稿时长

1 months

期刊介绍： Theranostics serves as a pivotal platform for the exchange of clinical and scientific insights within the diagnostic and therapeutic molecular and nanomedicine community, along with allied professions engaged in integrating molecular imaging and therapy. As a multidisciplinary journal, Theranostics showcases innovative research articles spanning fields such as in vitro diagnostics and prognostics, in vivo molecular imaging, molecular therapeutics, image-guided therapy, biosensor technology, nanobiosensors, bioelectronics, system biology, translational medicine, point-of-care applications, and personalized medicine. Encouraging a broad spectrum of biomedical research with potential theranostic applications, the journal rigorously peer-reviews primary research, alongside publishing reviews, news, and commentary that aim to bridge the gap between the laboratory, clinic, and biotechnology industries.