Safety and efficacy of 225Ac-PSMA-617 in the treatment of metastatic castration-resistant prostate cancer
10.3760/cma.j.cn321828-20240506-00150
- VernacularTitle:225Ac-PSMA-617治疗转移性去势抵抗性前列腺癌的安全性和有效性
- Author:
Yu ZHANG
1
;
Hongyu YANG
;
Xinyi LIN
;
Dan SU
;
Yu ZHANG
;
Wenlu ZHENG
;
Zhanwen HUANG
;
Yue CHEN
Author Information
1. 西南医科大学附属医院核医学科、核医学与分子影像四川省重点实验室，泸州 646000
- Keywords:
Prostatic neoplasms;
Neoplasm metastasis;
Prostate-specific membrane antigen;
Isotope labeling;
Actinium
- From:
Chinese Journal of Nuclear Medicine and Molecular Imaging
2024;44(9):522-527
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the safety and efficacy of 225Ac-prostate specific membrane antigen (PSMA) in the treatment of metastatic castration-resistant prostate cancer (mCRPC). Methods:Eleven patients (age (70.0±8.8) years) with mCRPC who were treated with 225Ac-PSMA-617 between July 2021 and October 2023 in the Affiliated Hospital of Southwest Medical University were retrospectively analyzed. In order to assess efficacy, the Prostate Cancer Clinical Trials Working Group 3 (PCWG3) criteria were used to evaluate the changes in prostate specific antigen (PSA) level after the treatment. 68Ga-PSMA-11 PET/CT imaging was performed at the baseline and after the treatment, and molecular imaging response was assessed using the modified PET response criteria in solid tumors (PERCIST) 1.0. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method. Toxicity was assessed by common terminology criteria for adverse events version 5.0 (CTCAE 5.0). The paired t test or Wilcoxon signed rank test was used to compare the parameters before and after treatment. Results:Post-treatment PSA levels were significantly lower than pre-treatment in 9 of 11 patients (17.83(4.74, 41.25) vs 124.33(77.85, 784.22) μg/L; z=-2.67, P=0.008), and 6 of them decreasing by more than 50% and 2 patients experienced progressive disease (PD) with PSA levels rising by more than 25%. Post-treatment 68Ga-PSMA-11 PET/CT showed that 7 patients achieved partial response (PR), 2 patients achieved stable disease (SD), and 2 patients were with PD. The OS was 12.0(10.0, 18.0) months and PFS was 8.0(6.0, 11.0) months in 11 patients. There were no statistically significant differences after therapy in WBC counts, Hb, PLT, creatinine, glomerular filtration rate, alanine aminotransferase, aspartate aminotransferase, total bilirubin ( z values: from -1.07 to 0.00, t values: from -0.77 to 1.76, all P>0.05). No grade Ⅲ/Ⅳ nephrotoxicity or salivary gland toxicity was observed. Conclusion:225Ac-PSMA-617 is a promising novel therapeutic option for mCRPC with favorable safety and tolerability.
