Abstract：
Metastatic castration-resistant prostate cancer (mCRPC) remains a challenging condition to treat despite recent advancements. This retrospective study aimed to assess the activity and tolerability of Lutetium-177 (Lu-177) PSMA-617 radioligand therapy (RLT) in mCRPC patients across multiple cancer centers in Turkey. The study included 165 patients who received at least one cycle of Lu-177 PSMA-617 RLT, with the majority having bone metastases and undergone prior treatments. Prostate-specific antigen (PSA) levels were assessed before each treatment cycle, and the biochemical response was evaluated in accordance with the Prostate Cancer Work Group 3 Criteria. The PSA decline of ≥50% was classified as a response, while an increase of ≥25% in PSA levels was indicative of progressive disease. Neither response nor progression was considered as stable disease. The Lu-177 PSMA-617 RLT led to a significant PSA response, with 50.6% of patients achieving a >50% decrease in PSA levels. Median overall survival (OS) and progression-free survival were 13.5 and 8.2 months, respectively. Patients receiving Lu-177 PSMA-617 RLT in combination with androgen receptor pathway inhibitors (ARPIs) had a higher OS compared to those receiving Lu-177 PSMA-617 RLT alone (18.2 vs 12.3 months, P = .265). The treatment was generally well-tolerated, with manageable side effects such as anemia and thrombocytopenia. This study provides real-world evidence supporting the effectiveness and safety of Lu-177 PSMA-617 RLT in mCRPC patients, particularly when used in combination with ARPIs. These findings contribute to the growing body of evidence on the potential benefits of PSMA-targeted therapies in advanced prostate cancer.
摘要：
转移性去势抵抗性前列腺癌（mCRPC）仍然是一个具有挑战性的治疗条件，尽管最近的进步。这项回顾性研究旨在评估Luttium-177（Lu-177）PSMA-617放射性配体治疗（RLT）在土耳其多个癌症中心的mCRPC患者中的活性和耐受性。该研究包括165名患者，他们接受了至少一个周期的Lu-177PSMA-617RLT，大多数患有骨转移并接受了先前的治疗。在每个治疗周期前评估前列腺特异性抗原（PSA）水平，并根据前列腺癌工作组3标准评估生化反应。PSA下降≥50%被归类为反应，而PSA水平升高≥25%则提示疾病进展.反应和进展都不被认为是稳定的疾病。Lu-177PSMA-617RLT导致明显的PSA反应，50.6%的患者PSA水平下降>50%。中位总生存期（OS）和无进展生存期分别为13.5和8.2个月，分别。与单独接受Lu-177PSMA-617RLT的患者相比，接受Lu-177PSMA-617RLT联合雄激素受体途径抑制剂（ARPIs）的患者的OS较高（18.2vs12.3个月，P=.265）。治疗一般耐受性良好，具有可控的副作用，如贫血和血小板减少症。这项研究提供了真实世界的证据支持Lu-177PSMA-617RLT在mCRPC患者中的有效性和安全性。特别是与ARPIs联合使用时。这些发现为PSMA靶向治疗晚期前列腺癌的潜在益处提供了越来越多的证据。
