Enhancing outcomes in mCRPC: the impact of androgen receptor inhibitor sequencing before 177Lu-PSMA-617 therapy.
1/5 보강
PICO 자동 추출 (휴리스틱, conf 2/4)
유사 논문P · Population 대상 환자/모집단
[RESULTS] Among 103 patients receiving ARPi before 177Lu-PSMA-617, 59 (57%) had enzalutamide and 44 (43%) AA.
I · Intervention 중재 / 시술
추출되지 않음
C · Comparison 대조 / 비교
추출되지 않음
O · Outcome 결과 / 결론
[CONCLUSION] Enzalutamide prior to 177Lu-PSMA-617 significantly improves OS and enhances PSMA expression compared to AA. These findings highlight the importance of treatment sequencing in mCRPC and warrant further prospective studies.
[BACKGROUND] Prostate-specific membrane antigen (PSMA) is a key target in metastatic castration resistance prostate cancer (mCRPC).
- p-value P = .068
- p-value P = .021
- HR 2.24
APA
Yazgan SC, Kayaş K, et al. (2025). Enhancing outcomes in mCRPC: the impact of androgen receptor inhibitor sequencing before 177Lu-PSMA-617 therapy.. The oncologist, 30(9). https://doi.org/10.1093/oncolo/oyaf213
MLA
Yazgan SC, et al.. "Enhancing outcomes in mCRPC: the impact of androgen receptor inhibitor sequencing before 177Lu-PSMA-617 therapy.." The oncologist, vol. 30, no. 9, 2025.
PMID
40694485
Abstract
[BACKGROUND] Prostate-specific membrane antigen (PSMA) is a key target in metastatic castration resistance prostate cancer (mCRPC). Enzalutamide, an androgen receptor pathway inhibitor (ARPi), increases PSMA expression, potentially enhancing 177Lu-PSMA-617 radioligand therapy. This study evaluates the impact of prior ARPi (enzalutamide vs abiraterone acetate [AA]) on PSMA expression, PFS, and OS.
[MATERIALS AND METHODS] A retrospective analysis of 214 mCRPC patients treated with 177Lu-PSMA-617 across six Turkish centers (2015-2025) was conducted. Patients were grouped by prior ARPi therapy. PFS and OS were analyzed using Kaplan-Meier and Cox regression methods.
[RESULTS] Among 103 patients receiving ARPi before 177Lu-PSMA-617, 59 (57%) had enzalutamide and 44 (43%) AA. Median PFS was 7.6 months for enzalutamide versus 5.3 months for AA (P = .068). Median OS was significantly longer with enzalutamide (12.8 vs 6.9 months, P = .021). Patients with Eastern Cooperative Oncology Group Performance Scores (ECOG PS) 0-1 had significantly longer OS (27.6 vs 6.9 months for PS 2-3, P < .0001). Higher PSMA SUVmax (>20) correlated with longer OS (15.1 vs 7.8 months, P = .016). Among 86 patients with detectable PSMA SUVmax, 53 had SUVmax > 20; 66% had prior enzalutamide and 34% AA. Median OS was four months longer with enzalutamide (18.1 vs 13.9 months P = .120). Multivariate analysis identified ARPi type (HR: 2.24, P = .033) and ECOG PS (HR: 5.22, P < .0001) as independent OS predictors.
[CONCLUSION] Enzalutamide prior to 177Lu-PSMA-617 significantly improves OS and enhances PSMA expression compared to AA. These findings highlight the importance of treatment sequencing in mCRPC and warrant further prospective studies.
[MATERIALS AND METHODS] A retrospective analysis of 214 mCRPC patients treated with 177Lu-PSMA-617 across six Turkish centers (2015-2025) was conducted. Patients were grouped by prior ARPi therapy. PFS and OS were analyzed using Kaplan-Meier and Cox regression methods.
[RESULTS] Among 103 patients receiving ARPi before 177Lu-PSMA-617, 59 (57%) had enzalutamide and 44 (43%) AA. Median PFS was 7.6 months for enzalutamide versus 5.3 months for AA (P = .068). Median OS was significantly longer with enzalutamide (12.8 vs 6.9 months, P = .021). Patients with Eastern Cooperative Oncology Group Performance Scores (ECOG PS) 0-1 had significantly longer OS (27.6 vs 6.9 months for PS 2-3, P < .0001). Higher PSMA SUVmax (>20) correlated with longer OS (15.1 vs 7.8 months, P = .016). Among 86 patients with detectable PSMA SUVmax, 53 had SUVmax > 20; 66% had prior enzalutamide and 34% AA. Median OS was four months longer with enzalutamide (18.1 vs 13.9 months P = .120). Multivariate analysis identified ARPi type (HR: 2.24, P = .033) and ECOG PS (HR: 5.22, P < .0001) as independent OS predictors.
[CONCLUSION] Enzalutamide prior to 177Lu-PSMA-617 significantly improves OS and enhances PSMA expression compared to AA. These findings highlight the importance of treatment sequencing in mCRPC and warrant further prospective studies.
MeSH Terms
Humans; Male; Prostatic Neoplasms, Castration-Resistant; Aged; Dipeptides; Retrospective Studies; Middle Aged; Nitriles; Phenylthiohydantoin; Heterocyclic Compounds, 1-Ring; Lutetium; Benzamides; Androgen Receptor Antagonists; Aged, 80 and over; Receptors, Androgen; Treatment Outcome; Radioisotopes; Prostate-Specific Antigen
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