Lutetium-177-PSMA radioligand therapy in metastatic hormone-sensitive prostate cancer: A systematic review of efficacy, safety, and combination strategies.
Joseph McGrath, Robert Willis, Sudharshanan Balaji et al.
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In 30 seconds
This systematic review evaluates the efficacy and safety of Lutetium-177-PSMA radioligand therapy (¹⁷⁷Lu-PSMA-RLT) in metastatic hormone-sensitive prostate cancer (mHSPC). Fourteen studies were included, revealing PSA50 rates between 44% and 100%, with median progression-free survival (PFS) ranging from 9.5 to 31.0 months depending on treatment context. Randomized trials showed improved responses compared to controls.
Key findings
- PSA50 response rates varied from 44% to 100%, highest in treatment-naïve populations.
- Median PFS ranged from 9.5 months in high-volume cohorts to 31.0 months in combination regimens.
- Randomized trials demonstrated improved PSA/PFS responses compared to control arms.
- Toxicity was generally low, with infrequent grade ≥III adverse events.
Why it matters
Understanding the efficacy and safety of ¹⁷⁷Lu-PSMA-RLT in mHSPC is crucial for clinicians considering novel treatment options for patients, particularly those who are treatment-naïve.
What to keep in mind
Current studies face limitations of small sample sizes, heterogeneous protocols, and short follow-up durations.