MP24-05 LONG-TERM FOLLOW-UP AND PROGNOSTIC FACTOR ANALYSIS IN MEN WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (MCRPC) WHO RECEIVE PROSTATE-SPECIFIC MEMBRANE ANTIGEN (PSMA)-TARGETED LUTETIUM-177 (177LU) (2021)

You have accessJournal of UrologyProstate Cancer: Advanced (including Drug Therapy) II (MP24)1 Sep 2021MP24-05 LONG-TERM FOLLOW-UP AND PROGNOSTIC FACTOR ANALYSIS IN MEN WITH METASTATIC CASTRATION-RESISTANT PROSTATE CANCER (MCRPC) WHO RECEIVE PROSTATE-SPECIFIC MEMBRANE ANTIGEN (PSMA)-TARGETED LUTETIUM-177 (177LU) Michael Sun, Charlene Thomas, Benedict Ho, Junaid Niaz, Jones Nauseef, Joseph Osborne, Ana Molina, Cora Sternberg, David Nanus, Neil Bander, and Scott Tagawa Michael SunMichael Sun More articles by this author , Charlene ThomasCharlene Thomas More articles by this author , Benedict HoBenedict Ho More articles by this author , Junaid NiazJunaid Niaz More articles by this author , Jones NauseefJones Nauseef More articles by this author , Joseph OsborneJoseph Osborne More articles by this author , Ana MolinaAna Molina More articles by this author , Cora SternbergCora Sternberg More articles by this author , David NanusDavid Nanus More articles by this author , Neil BanderNeil Bander More articles by this author , and Scott TagawaScott Tagawa More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002015.05AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: 177Lu-PSMA is a promising investigational treatment for men with mCRPC. Optimal selection and biomarkers remain to be defined. Here, we report a combined analysis of men with mCRPC treated on sequential prospective clinical trials of PSMA-targeted 177Lu. METHODS: Patients treated on clinical trials from 2003 through 2020, with completion of treatment at least one year prior to analysis, were included. Variables included type of PSMA-targeting, dose level, co-morbidities, CALGB (Halabi) prognostic risk group, PSMA imaging, circulating tumor cell (CTC) counts, known DNA-repair (DDR) alterations (germline and/or somatic), and receipt of FDA-approved subsequent therapies. As previously published, PSMA imaging was scored based upon maximum tumor uptake relative to mean liver uptake. RESULTS: 76 men (59.9%) receiving 177Lu-J591, and 51 men (40.1%) receiving 177Lu-PSMA-617 were included in this analysis. Total median OS was 20.7 months (95% CI 17.4-24.0); 177Lu-J591 mOS 23.3 mo [95% CI 21.1-32.6], 177Lu-PSMA-617 mOS 16.7 mo [95% CI 10.9-20.7]. 26 men (20.5%) were alive 3 years after treatment. Factors associated with longer OS included CALGB prognostic score (28.1 vs. 16.9, p <0.0001), CTC decline (24.9 vs. 19.2, p=0.046), and receipt of subsequent therapy (28.1 vs. 14.8, p=0.0002). Overall, those with stronger PSMA imaging uptake lived shorter, though when analysis was restricted to PSMA PET for those receiving 177Lu-PSMA-617, higher PSMA PET SUV was associated with longer OS (18 vs. 10 mo, p=0.015). Higher administered activity (22.1 vs. 18.6, p=0.074) and DDR mutations (33.9 vs. 20.6, p=0.24) tended to have longer OS. On multivariable analysis, high Halabi risk group (HR 1.78, 95% CI 1.16-2.73, p=0.009) and total number of subsequent therapies (HR 0.79, 95% CI 0.71-0.89, p <0.001) retained their prognostic significance, with a trend for DDR mutations (HR 0.68, 95% CI 0.34-1.36, p=0.30). CONCLUSIONS: For patients receiving PSMA-targeted 177Lu, CALGB prognostic risk group, and receipt of subsequent FDA-approved therapies may influence OS. DDR mutations, higher administered activity, and CTC count decline tended to be associated with higher OS. Heterogeneity of PSMA imaging and treatment modalities in this dataset limit prognostic implications. Source of Funding: NIH, Department of Defense, Weill Cornell Medicine, Prostate Cancer Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e413-e413 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Sun More articles by this author Charlene Thomas More articles by this author Benedict Ho More articles by this author Junaid Niaz More articles by this author Jones Nauseef More articles by this author Joseph Osborne More articles by this author Ana Molina More articles by this author Cora Sternberg More articles by this author David Nanus More articles by this author Neil Bander More articles by this author Scott Tagawa More articles by this author Expand All Advertisement Loading ...