Moritz B Bastian, Benedikt Wörl, Arne Blickle, Caroline Burgard, Tilman Speicher, Joel Wessendorf, Mark Bartholomä, Andrea Schaefer-Schuler, Stephan Maus, Samer Ezziddin, Florian Rosar
{"title":"高龄PSMA放射配体治疗：来自85岁以上mCRPC患者队列的见解","authors":"Moritz B Bastian, Benedikt Wörl, Arne Blickle, Caroline Burgard, Tilman Speicher, Joel Wessendorf, Mark Bartholomä, Andrea Schaefer-Schuler, Stephan Maus, Samer Ezziddin, Florian Rosar","doi":"10.1097/RLU.0000000000005968","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":10692,"journal":{"name":"Clinical Nuclear Medicine","volume":" ","pages":""},"PeriodicalIF":9.6000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"PSMA Radioligand Therapy in Advanced Age: Insights From an 85y+ mCRPC Patient Cohort.\",\"authors\":\"Moritz B Bastian, Benedikt Wörl, Arne Blickle, Caroline Burgard, Tilman Speicher, Joel Wessendorf, Mark Bartholomä, Andrea Schaefer-Schuler, Stephan Maus, Samer Ezziddin, Florian Rosar\",\"doi\":\"10.1097/RLU.0000000000005968\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>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.</p><p><strong>Materials and methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":10692,\"journal\":{\"name\":\"Clinical Nuclear Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":9.6000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/RLU.0000000000005968\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/RLU.0000000000005968","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
PSMA Radioligand Therapy in Advanced Age: Insights From an 85y+ mCRPC Patient Cohort.
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.
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.
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