Real-World Experience with 177Lu-PSMA-617 Radioligand Therapy After Food and Drug Administration Approval

J Nucl Med. 2024 May 1;65(5):735-739. doi: 10.2967/jnumed.123.266842.

Abstract

We report our initial real-world experience with 177Lu-PSMA-617 radioligand therapy. Methods: We performed a retrospective review of patients treated with 177Lu-PSMA-617. Pretreatment PSMA PET, laboratory findings, overall survival, a fall in prostate-specific antigen by 50% (PSA50), and toxicities were evaluated. Results: Ninety-nine patients were included. Sixty patients achieved a PSA50. Seven of 18 (39%) patients who did not meet the TheraP PSMA imaging criteria achieved a PSA50. Nineteen of 31 (61%) patients who did not meet the VISION laboratory criteria achieved a PSA50. Sixty-three patients had a delay or stoppage in therapy, which was due to a good response in 19 patients and progressive disease in 14 patients. Of 10 patients with a good response who restarted treatment, 9 subsequently achieved a PSA50 on retreatment. The most common toxicities were anemia (33%) and thrombocytopenia (21%). Conclusion: At our center, patients who did not meet the TheraP PSMA imaging criteria or the VISION laboratory criteria benefited from 177Lu-PSMA-617 radioligand therapy.

Keywords: 177Lu-PSMA-617; genitourinary; oncology; radionuclide therapy; toxicities.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Dipeptides* / therapeutic use
  • Drug Approval
  • Heterocyclic Compounds, 1-Ring* / therapeutic use
  • Humans
  • Ligands
  • Lutetium* / therapeutic use
  • Male
  • Middle Aged
  • Prostate-Specific Antigen
  • Prostatic Neoplasms / diagnostic imaging
  • Prostatic Neoplasms / radiotherapy
  • Radiopharmaceuticals / adverse effects
  • Radiopharmaceuticals / therapeutic use
  • Retrospective Studies
  • Treatment Outcome
  • United States
  • United States Food and Drug Administration*

Substances

  • Lutetium
  • Pluvicto
  • Heterocyclic Compounds, 1-Ring
  • Dipeptides
  • Prostate-Specific Antigen
  • Ligands
  • Radiopharmaceuticals