Real world outcomes of <sup>177</sup> Lu-PSMA-617 PSMA in a racially diverse cohort of patients with metastatic castration resistant prostate cancer (mCRPC).
Abstract
97 Background: 177 Lu-PSMA-617 is approved for treatment of mCRPC based on the VISION trial cohort with limited racial diversity. We analyzed real-world outcomes of 177 Lu-PSMA-617 in a diverse cohort. We aim to determine patient characteristics predictive of a clinical response to 177 Lu-PSMA-617. Methods: A retrospective analysis was conducted on patients with mCRPC treated with 177 Lu-PSMA-617 at Emory Winship Cancer Institute between 2022-2024. Primary endpoints were PFS, OS, and PSA reduction ≥ 50% (PSA50). Univariate association by survival analysis and logistic regression was carried out. Results: We analyzed 84 patients with PSMA PET+ mCRPC treated with 177 Lu-PSMA-617; 47.6% identified as Caucasian and 42.9% identified as Black. The median cohort age was 71.5 (IQR: 64-77.5). 35.6% had grade group 5 disease. Median number of prior lines of therapy was 5 (range: 4-7). 98.8% of patients had prior treatment with novel hormonal agents; 84.5% received prior taxane treatment. 84.5% were characterized as high-volume diseases using the CHAARTED trial criterion. Median baseline PSA was 105.5 (IQR: 20.4-454.8), and ALP was 103.5 (IQR: 72-177.5). The cohort completed a median number of 4 cycles of 177 Lu-PSMA-617; 35.7% completed six cycles. The overall cohort had a 12-month survival of 84.4%. 12-month survival rate was 88.3% in the white cohort compared to 81.4% in the non-white cohort. mPFS for the overall cohort was 6 months with a 12-month PFS rate of 41.9%. 12-month mPFS for the non-white cohort was 42.7% compared to 41.5% in the white cohort. 50.0% of the overall cohort had a PSA50 response. 56.1% of the non-white cohort had a PSA50 compared to 43.9% of the white cohort (p=0.377). Net BMI decline during treatment was associated with a 56% increased risk of mortality (OS HR 1.56, CI 1.18-2.06, p<0.002). Conclusions: With similar PFS, OS, and PSA50 in this racially diverse cohort of patients with mCRPC, our results demonstrate 177 Lu-PSMA-617 effectiveness in a real-world patient population. Prospective studies are needed for further validation.
Article Details
Journal Info
Journal of Clinical Oncology
Lippincott Williams & Wilkins
Authors (16)
Margo Gerke
Emory University School of Medicine, Atlanta, GA
Angelo Marra
Emory University, Atlanta, GA
Yuan Liu
Saima Muzahir
Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, GA
Jacqueline T Brown
Winship Cancer Institute of Emory University, Atlanta, GA
Bassel Nazha
Piedmont Cancer Institute, Atlanta
Jacob E Berchuck
Dana-Farber Cancer Institute, Boston, MA
Ravi Bharat Parikh
Winship Cancer Institute of Emory University, Atlanta, GA
Jordan Alana Ciuro
Emory University, Atlanta, GA
Caitlin Hartman
Winship Cancer Institute of Emory University, Atlanta, GA
Greta Russler McClintock
Winship Cancer Institute of Emory University, Atlanta, GA
Sarah Caulfield
Emory University School of Medicine, Department of Pharmaceutical Services, Atlanta, GA
Omer Kucuk
Winship Cancer Institute of Emory University, Atlanta, GA
Bradley Curtis Carthon
Winship Cancer Institute of Emory University, Atlanta, GA
David M. Schuster
Emory University, Atlanta, GA
Mehmet Asim Bilen
From the Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda (A.B.A., N.S., S.N., L.L., L.C.), the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore (J.H.-C.), and the Investigational Drug Branch, Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Rockville (H.S., E.S.) — all in Maryland; the Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN (K.V.B., M.O., C.M., G.P.B.); AdventHealth Cancer Institute and the University of Central Florida, Orlando (G.S.); Dana–Farber/Harvard Cancer Center, Boston (S.B., B.M.); UNC Lineberger Comprehensive Cancer Center, Chapel Hill (W.Y.K.), and Duke University Medical Center and Duke Cancer Institute, Durham (J.H., S.H.) — both in North Carolina; the University of Kansas Cancer Center, Westwood (R.P.); Memorial Sloan Kettering Cancer Center, New York (M.Y.T., M.J.M., J.E.R.), and Roswell Park Comprehensive Cancer Center, Buffalo (G.C.) — both in...