Therapeutic Responses and Survival Effects of 177Lu-PSMA-617 Radioligand Therapy in Metastatic Castrate-Resistant Prostate Cancer: A Meta-analysis. (October 2018)

• Record Type: Journal Article
• Authors: Kim, Yong Joong; Kim, Yong-il
• Is Part Of: Clinical nuclear medicine. Volume 43:Number 10(2018)
• Publication Date: 2018-10
• Subjects: prostate cancer -- lutetium-177 -- prostate-specific membrane antigen -- PSMA-617 -- prostate-specific antigen; Nuclear medicine -- Periodicals; Radioisotope scanning -- Periodicals; Nuclear Medicine -- Periodicals; 616.07575
• DOI: 10.1097/RLU.0000000000002210
• Languages: English
• ISSNs: 0363-9762

Abstract

Abstract : Purpose: We performed a meta-analysis on the therapeutic effects of prostate-specific membrane antigen (PSMA)–617 labeled with lutetium-177 ( 177 Lu-PSMA-617) in patients with metastatic castration-resistant prostate cancer (mCRPC). Patients and Methods: The primary outcome was the therapeutic responses after the first cycle of 177 Lu-PSMA-617 radioligand therapy. The parameters studied were the pooled proportions of any prostate-specific antigen (PSA) decline and a greater than 50% PSA decline. The secondary outcome was the survival effects after 177 Lu-PSMA-617 radioligand therapy. Studied parameters were pooled hazard ratios of the overall survival according to any PSA decline and a greater than 50% PSA decline after the first cycle of 177 Lu-PSMA-617 radioligand therapy. Results: In total, 10 eligible studies with 455 patients were finally included in this meta-analysis. The pooled proportions of any PSA decline was 68.00% (95% confidence interval [CI], 63.55%–72.22%], and those with a greater than 50% PSA decline was 34.45% (95% CI, 30.14%–38.97%). The pooled hazard ratios for the overall survival of any PSA decline was 0.29 (95% CI, 0.21–0.40) with significance ( P < 0.00001); however, a greater than 50% PSA decline was 0.82 (95% CI, 0.54–1.25) with no significance ( P = 0.39). Conclusions: We suggest that approximately two-thirds of any PSA decline and one-third of a greater than 50% PSA decline can be expected after the first cycle of 177 Lu-PSMA-617 radioligand therapy in patients with mCRPC. Moreover, any PSA decline showed survival prolongation after the first cycle of the 177 Lu-PSMA-617 radioligand therapy.