<sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer
177Lu-PSMA-617 is a new therapy option for PSMA-positive metastatic castrate-resistant metastatic prostate cancer (mCRPC) with proven efficacy. 225Ac-PCMA-617 is an alpha emitter, making this drug potentially more powerful. Despite the active use of 225Ac-PSMA-617 worldwide, no randomized phase III...
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Russian Academy of Sciences, Tomsk National Research Medical Center
2025-01-01
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| Series: | Сибирский онкологический журнал |
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| Online Access: | https://www.siboncoj.ru/jour/article/view/3360 |
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| author | T. Yu. Kochetova V. V. Krylov S. A. Ivanov A. D. Kaprin |
| author_facet | T. Yu. Kochetova V. V. Krylov S. A. Ivanov A. D. Kaprin |
| author_sort | T. Yu. Kochetova |
| collection | DOAJ |
| description | 177Lu-PSMA-617 is a new therapy option for PSMA-positive metastatic castrate-resistant metastatic prostate cancer (mCRPC) with proven efficacy. 225Ac-PCMA-617 is an alpha emitter, making this drug potentially more powerful. Despite the active use of 225Ac-PSMA-617 worldwide, no randomized phase III studies have yet been conducted. The present prospective cohort study presents the experience of 225Ac-PSMA-617 use in the A.F. Tsyb MRRC. Material and Methods. the study included mCRPC patients with prostate-specific membrane antigen (PSMA) overexpression confirmed by PET-CT or SPECT-CT, who received the first course of therapy in 2023. Results. Forty three patients received 1 to 6 (median 2) administrations of 225Ac-PSMA-617, 26 (60 %) of these patients had a history of 177Lu-PSMA-617 therapy, 13 (30 %) had a history of radium chloride [223Ra] therapy, and 10 (23 %) patients had no history of chemotherapy. Five (12 %) had liver metastases at the time of inclusion in the study. PSA reduction of more than 50 % was recorded in 55 % of patients, with biochemical response significantly more frequent in the PSMA-naïve group, 63 % vs 35 %; the number of adverse events was also lower in this group. But no advantage in overall survival (OS) in PSMA-naïve patients was revealed at the present time. Favorable prognosis factors included a history of radium chloride [223Ra] therapy; in contrast, liver metastasis was a negative prognostic factor. the study found no differences in OS among taxane-naïve patients and patients with a history of 1–2 lines of chemotherapy. Continued therapy with androgen receptor targeted agents after initiation of 225Ac-PSMA-617 treatment also showed no effect on OS. Conclusions. 225Ac-PCMA-617 may be effective in 177Lu-PCMa resistance, but there are no data on the increase in overall patient survival when 225Ac-PCMA-617 is administered as first-line radioligand therapy. |
| format | Article |
| id | doaj-art-e623533cbeef4c62ba0b096e887d66e0 |
| institution | Kabale University |
| issn | 1814-4861 2312-3168 |
| language | Russian |
| publishDate | 2025-01-01 |
| publisher | Russian Academy of Sciences, Tomsk National Research Medical Center |
| record_format | Article |
| series | Сибирский онкологический журнал |
| spelling | doaj-art-e623533cbeef4c62ba0b096e887d66e02025-08-20T03:56:41ZrusRussian Academy of Sciences, Tomsk National Research Medical CenterСибирский онкологический журнал1814-48612312-31682025-01-01236324010.21294/1814-4861-2024-23-6-32-401305<sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancerT. Yu. Kochetova0V. V. Krylov1S. A. Ivanov2A. D. Kaprin3A. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre of the Ministry of Health of RussiaA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre of the Ministry of Health of RussiaA. Tsyb Medical Radiological Research Centre – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russia; RUDN UniversityRUDN University; National Medical Research Radiological Centre of the Ministry of Health of Russia; P.A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre of the Ministry of Health of Russia177Lu-PSMA-617 is a new therapy option for PSMA-positive metastatic castrate-resistant metastatic prostate cancer (mCRPC) with proven efficacy. 225Ac-PCMA-617 is an alpha emitter, making this drug potentially more powerful. Despite the active use of 225Ac-PSMA-617 worldwide, no randomized phase III studies have yet been conducted. The present prospective cohort study presents the experience of 225Ac-PSMA-617 use in the A.F. Tsyb MRRC. Material and Methods. the study included mCRPC patients with prostate-specific membrane antigen (PSMA) overexpression confirmed by PET-CT or SPECT-CT, who received the first course of therapy in 2023. Results. Forty three patients received 1 to 6 (median 2) administrations of 225Ac-PSMA-617, 26 (60 %) of these patients had a history of 177Lu-PSMA-617 therapy, 13 (30 %) had a history of radium chloride [223Ra] therapy, and 10 (23 %) patients had no history of chemotherapy. Five (12 %) had liver metastases at the time of inclusion in the study. PSA reduction of more than 50 % was recorded in 55 % of patients, with biochemical response significantly more frequent in the PSMA-naïve group, 63 % vs 35 %; the number of adverse events was also lower in this group. But no advantage in overall survival (OS) in PSMA-naïve patients was revealed at the present time. Favorable prognosis factors included a history of radium chloride [223Ra] therapy; in contrast, liver metastasis was a negative prognostic factor. the study found no differences in OS among taxane-naïve patients and patients with a history of 1–2 lines of chemotherapy. Continued therapy with androgen receptor targeted agents after initiation of 225Ac-PSMA-617 treatment also showed no effect on OS. Conclusions. 225Ac-PCMA-617 may be effective in 177Lu-PCMa resistance, but there are no data on the increase in overall patient survival when 225Ac-PCMA-617 is administered as first-line radioligand therapy.https://www.siboncoj.ru/jour/article/view/3360radioligand therapy<sup>225</sup>ac-psma-617castrate-resistant prostate cancerradium chloride [<sup>223</sup>ra]overall survival |
| spellingShingle | T. Yu. Kochetova V. V. Krylov S. A. Ivanov A. D. Kaprin <sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer Сибирский онкологический журнал radioligand therapy <sup>225</sup>ac-psma-617 castrate-resistant prostate cancer radium chloride [<sup>223</sup>ra] overall survival |
| title | <sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer |
| title_full | <sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer |
| title_fullStr | <sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer |
| title_full_unstemmed | <sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer |
| title_short | <sup>225</sup>Aс-PSMA-617 therapy in metastatic castration-resistant prostate cancer |
| title_sort | sup 225 sup aс psma 617 therapy in metastatic castration resistant prostate cancer |
| topic | radioligand therapy <sup>225</sup>ac-psma-617 castrate-resistant prostate cancer radium chloride [<sup>223</sup>ra] overall survival |
| url | https://www.siboncoj.ru/jour/article/view/3360 |
| work_keys_str_mv | AT tyukochetova sup225supaspsma617therapyinmetastaticcastrationresistantprostatecancer AT vvkrylov sup225supaspsma617therapyinmetastaticcastrationresistantprostatecancer AT saivanov sup225supaspsma617therapyinmetastaticcastrationresistantprostatecancer AT adkaprin sup225supaspsma617therapyinmetastaticcastrationresistantprostatecancer |