Genitourinary Cancer

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SU_34_2343 - Pretreatment PSA as predictive factor for outcome with 177Lu-PSMA-617 radioligand therapy for men with lymph node-positive prostate cancer: a retrospective cohort study

Sunday, October 21
1:15 PM - 2:45 PM
Location: Innovation Hub, Exhibit Hall 3

Pretreatment PSA as predictive factor for outcome with 177Lu-PSMA-617 radioligand therapy for men with lymph node-positive prostate cancer: a retrospective cohort study
F. Von Eyben; Center of Tobacco Control Research, Odense, Denmark

Purpose/Objective(s): 177Lu-PSMA-617 radioligand therapy (RLT) is a treatment of patients with end-stage prostate cancer but preliminary studies found a better response for patients with lymph node-positive prostate cancer (LNM). The present study aimed to analyze pretreatment PSA as predictive factor for the outcome of 177Lu-PSMA-617 RLT for LNM patients.

Materials/Methods: A retrospective cohort study examined 32 patients with positive sites in lymph nodes with PSMA PET/CT with or without one or two bone metastases (10 and 22 patients). The two groups received cycles of 177Lu-PSMA-617 RLT with similar cumulative 177Lu activity: median 14.5 GBq (IQR 11.95-19.3) and 14.8. GBq (IQR 12.4-19.8).

Results: After 177Lu-PSMA-617 RLT, the 22 patients with LNM had a maximal PSA decline of median 95% (IQR 72-99). Maximal PSA decline of ≥50% was found for 19 patients (86%, 95% CI 70-100).). PSA nadir <0.2 µg/L was found for three patients (14% (95% CI 0-30). Patients with LNM and PSA before 177Lu-PSMA-617 RLT of <2 µg/L had a PSA nadir of <0.2 µg/L more often than patients with a higher pretreatment PSA (p = 0.001). Ten patients with LNM and one or two bone metastases had a maximal PSA decline of median 56% (IQR 21-97). Maximal PSA decline was significantly higher for the 22 patients with LNM than for the 10 patients with LNM and one to two bone metastases (p = 0.03). None of the patients had grade 3 or 4 hematologic adverse effects. 177Lu-PSMA-617 RLT for patients with LNM and pretreatment PSA <2 µg/L gave a post-therapy nadir PSA <0.2 µg/L as often as has previously been reported for salvage lymph node dissection or salvage radiotherapy of patients with recurrent LNM.

Conclusion: A pretreatment PSA <2 µg/L was associated with the lowest posttreatment PSA nadir following 177Lu-PSMA-617 RLT for patients with LNM.

Author Disclosure: F. Von Eyben: None.

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SU_34_2343 - Pretreatment PSA as predictive factor for outcome with 177Lu-PSMA-617 radioligand therapy for men with lymph node-positive prostate cancer: a retrospective cohort study



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