A SYSTEMATIC REVIEW: LUTETIUM-177 PSMA-617 (LU PSMA-617) USE IN METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (MCRPC), ARE THE FINDINGS CONSISTENT?

Document Type

Conference Proceeding

Publication Date

7-17-2025

Publication Title

J Gen Intern Med

Keywords

androgen receptor, enzalutamide, lutetium 177, prostate specific antigen, vipivotide tetraxetan, conference abstract, drug therapy, human, metastatic castration resistant prostate cancer, overall survival, Preferred Reporting Items for Systematic Reviews and Meta-Analyses, progression free survival, prostate cancer, radioligand therapy, side effect, systematic review, therapy

Abstract

BACKGROUND: This review aims to evaluate a newer modality, radioligand therapy, Lu PSMA-617 use in PSMA-positive mCRPC. This allows precise radiation delivery directly to the tumor while sparing healthy tissues. Standard treatment options for mCRPC are androgen receptor inhibitors and chemotherapy. METHODS: We performed a systematic review adhering to PRISMA guidelines. We searched PubMed, EMBASE, and Google Scholar databases for primary studies published in English in the last 10 years. Only clinical trials were included, resulting in 7 trials showing the use of Lu PSMA-617 in different settings in mCRPC. RESULTS: This systematic review includes seven key trials. The LuPSMA Trial was one of the early trials that helped establish the safety and efficacy profile. The VISION study showed improved overall survival (OS) when LU-PSMA-617 was added to standard therapy. TheraP study showed no difference in OS between the two groups. On the other hand, the PSMA Fore study showed prolonged radiographic progression-free survival (rPFS) and also a 59% reduction in radiographic progression or death. RESIST-PC study showed the safety and side effects. UpFront PSMA study revealed the greater efficacy of LU-PSMA-617 in causing undetectable PSA at 48 weeks and also treatment-related side effects. The ENZA-P study showed a prolonged PSA-based PFS when LU-PSMA-617 was added to Enzalutamide. CONCLUSIONS: Our results reveal that LU-PSMA-617 showed superior efficacy in rPFS, PSA-based PFS, OS, and PSA decline of 50% or more, in the PSMA-positive mCRPC population especially in those who exhausted standard treatment options. It has a manageable safety profile, side effects were less frequent compared to chemotherapy. It would be interesting to explore its use in early prostate cancer, clinical trials are ongoing.

Volume

40

First Page

S810

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