Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?

Purpose: Lutetium labelled prostate-specific membrane antigen radioligand therapy (Lu-PSMA RLT) has shown pleasing early results in management of high-volume metastatic castration resistant prostate cancer (mCRPC), but its role in the early treatment of men with only lymph node metastasis (LNM) is u...

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Autores principales:	William John Yaxley, Rhiannon McBean, David Wong, David Grimes, Paul Vasey, Mark Frydenberg, John William Yaxley
Formato:	article
Lenguaje:	EN
Publicado:	Korean Urological Association 2021
Materias:	lutetium-177 lymphatic metastasis prostate cancer psma-617 Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/f09385922af24e11a3b719c3f5dde7df
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spelling	oai:doaj.org-article:f09385922af24e11a3b719c3f5dde7df2021-11-10T04:28:39ZShould Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?10.4111/icu.202100972466-04932466-054Xhttps://doaj.org/article/f09385922af24e11a3b719c3f5dde7df2021-11-01T00:00:00Zhttps://icurology.org/pdf/10.4111/icu.20210097https://doaj.org/toc/2466-0493https://doaj.org/toc/2466-054XPurpose: Lutetium labelled prostate-specific membrane antigen radioligand therapy (Lu-PSMA RLT) has shown pleasing early results in management of high-volume metastatic castration resistant prostate cancer (mCRPC), but its role in the early treatment of men with only lymph node metastasis (LNM) is unknown. The aim was to assess the outcome of Lu-PSMA RLT earlier in the treatment of men with only LNM. Materials and Methods: Single institution retrospective review of men with only LNM on staging Ga-PSMA PET PSMA who proceeded with Lu-PSMA RLT. Results: There were 17 men with only LNM, including 13 with mCRPC and 3 who were both hormone and chemotherapy naïve. The median PSA was 3.7 (0.46–120 ng/mL). A PSA decline of ≥50% occurred in 10/17 (58.8%), decreasing to <0.2 ng/mL in 35.3% (6/17). The PSA continues to decline or remain stable in 10/17 (58.8%) with a median follow-up of 13 months, and 8/17 (47.1%) have not reached their pre-treatment levels. There were no significant side effects. There was a better PSA response in men without prior chemotherapy (p=0.05). The prostate cancer specific and overall survival is 82.4% (14/17). Conclusions: Our results identify improved PSA response to Lu-PSMA RLT in men with only LNM, especially in the chemotherapy naïve cohort, compared to previous series with more advanced mCRPC. These findings provide important proof of principle to aid with planning of future prospective randomized trials evaluating the role of Lu-PSMA RLT earlier in the management of node metastatic prostate cancer, including men naïve of ADT and chemotherapy.William John YaxleyRhiannon McBeanDavid WongDavid GrimesPaul VaseyMark FrydenbergJohn William YaxleyKorean Urological Associationarticlelutetium-177lymphatic metastasisprostate cancerpsma-617Diseases of the genitourinary system. UrologyRC870-923ENInvestigative and Clinical Urology, Vol 62, Iss 6, Pp 650-657 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	lutetium-177 lymphatic metastasis prostate cancer psma-617 Diseases of the genitourinary system. Urology RC870-923
spellingShingle	lutetium-177 lymphatic metastasis prostate cancer psma-617 Diseases of the genitourinary system. Urology RC870-923 William John Yaxley Rhiannon McBean David Wong David Grimes Paul Vasey Mark Frydenberg John William Yaxley Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
description	Purpose: Lutetium labelled prostate-specific membrane antigen radioligand therapy (Lu-PSMA RLT) has shown pleasing early results in management of high-volume metastatic castration resistant prostate cancer (mCRPC), but its role in the early treatment of men with only lymph node metastasis (LNM) is unknown. The aim was to assess the outcome of Lu-PSMA RLT earlier in the treatment of men with only LNM. Materials and Methods: Single institution retrospective review of men with only LNM on staging Ga-PSMA PET PSMA who proceeded with Lu-PSMA RLT. Results: There were 17 men with only LNM, including 13 with mCRPC and 3 who were both hormone and chemotherapy naïve. The median PSA was 3.7 (0.46–120 ng/mL). A PSA decline of ≥50% occurred in 10/17 (58.8%), decreasing to <0.2 ng/mL in 35.3% (6/17). The PSA continues to decline or remain stable in 10/17 (58.8%) with a median follow-up of 13 months, and 8/17 (47.1%) have not reached their pre-treatment levels. There were no significant side effects. There was a better PSA response in men without prior chemotherapy (p=0.05). The prostate cancer specific and overall survival is 82.4% (14/17). Conclusions: Our results identify improved PSA response to Lu-PSMA RLT in men with only LNM, especially in the chemotherapy naïve cohort, compared to previous series with more advanced mCRPC. These findings provide important proof of principle to aid with planning of future prospective randomized trials evaluating the role of Lu-PSMA RLT earlier in the management of node metastatic prostate cancer, including men naïve of ADT and chemotherapy.
format	article
author	William John Yaxley Rhiannon McBean David Wong David Grimes Paul Vasey Mark Frydenberg John William Yaxley
author_facet	William John Yaxley Rhiannon McBean David Wong David Grimes Paul Vasey Mark Frydenberg John William Yaxley
author_sort	William John Yaxley
title	Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
title_short	Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
title_full	Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
title_fullStr	Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
title_full_unstemmed	Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
title_sort	should lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?
publisher	Korean Urological Association
publishDate	2021
url	https://doaj.org/article/f09385922af24e11a3b719c3f5dde7df
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Should Lutetium-prostate specific membrane antigen radioligand therapy for metastatic prostate cancer be used earlier in men with lymph node only metastatic prostate cancer?

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