Factors Predicting Biochemical Response and Survival Benefits Following Radioligand Therapy with [Lu]Lu-PSMA in Metastatic Castrate-resistant Prostate Cancer: a Review

Overview

Journal Eur J Nucl Med Mol Imaging

Specialties Biophysics
Nuclear Medicine
Radiology

Date 2021 Mar 7

PMID 33677734

Citations 16

Authors

Reyhaneh Manafi-Farid

Sara Harsini

Bahare Saidi

Hojat Ahmadzadehfar

Ken Herrmann

Alberto Briganti

Jochen Walz

Mohsen Beheshti

Affiliations

Soon will be listed here.

Abstract

Background: Prostate cancer (PC) is one of the most common cancers in men. Although the overall prognosis is favorable, the management of metastatic castration-resistant prostate cancer (mCRPC) patients is challenging. Usually, mCRPC patients with progressive disease are considered for radioligand therapy (RLT) after exhaustion of other standard treatments. The prostate-specific membrane antigen (PSMA) labeled with Lutetium-177 ([Lu]Lu-PSMA) has been widely used, showing favorable and successful results in reducing prostate-specific antigen (PSA) levels, increasing quality of life, and decreasing pain, in a multitude of studies. Nevertheless, approximately thirty percent of patients do not respond to [Lu]Lu-PSMA RLT. Here, we only reviewed and reported the evaluated factors and their impact on survival or biochemical response to treatment to have an overview of the potentialprognostic parameters in [Lu]Lu-PSMA RLT.

Methods: Studies were retrieved by searching MEDLINE/PubMed and GoogleScholar. The search keywords were as follows: {("177Lu-PSMA") AND ("radioligand") AND ("prognosis") OR ("predict")}. Studies discussing one or more factors which may be prognostic or predictive of response to [Lu]Lu-PSMA RLT, that is PSA response and survival parameters, were included.

Results: Several demographic, histological, biochemical, and imaging factors have been assessed as predictive parameters for the response to thistreatment; however, the evaluated factors were diverse, and the results mostly were divergent, except for the PSA level reduction after treatment, which unanimously predicted prolonged survival.

Conclusion: Several studies have investigated a multitude of factors to detect those predicting response to [Lu]Lu-PSMA RLT. The results wereinconsistent regarding some factors, and some were evaluated in only a few studies. Future prospective randomized trials are required to detect theindependent prognostic factors, and to further determine the clinical and survival benefits of [Lu]Lu-PSMA RLT.

Citing Articles

RECIP 1.0 + PSA for response assessment in mCRPC patients treated with Ac / Lu PSMA combination therapy.

Sheikh G, Delker A, Zacherl M, Holzgreve A, Takayama Fouladgar S, Unterrainer M EJNMMI Res. 2025; 15(1):19.

PMID: 40038098 PMC: 11880445. DOI: 10.1186/s13550-025-01211-z.

Influence of dosimetry accuracy on the correlation with treatment outcome in a preliminary PSMA radiopharmaceutical therapy study.

Hu J, Seifert R, Karkampouna S, Gomes C, Xue S, Afshar-Ormieh A Eur J Nucl Med Mol Imaging. 2024; .

PMID: 39704811 DOI: 10.1007/s00259-024-07010-3.

Predicting Response to [177Lu]Lu-PSMA Therapy in mCRPC Using Machine Learning.

Gong K, Magnier B, Lhostis S, Borrely F, Le Bon S, Houede N J Pers Med. 2024; 14(11).

PMID: 39590560 PMC: 11595926. DOI: 10.3390/jpm14111068.

Multicentric Ga-PSMA PET radiomics for treatment response assessment of Lu-PSMA-617 radioligand therapy in patients with metastatic castration-resistant prostate cancer.

Gutsche R, Gulmus G, Mottaghy F, Gartner F, Essler M, von Mallek D Front Nucl Med. 2024; 3:1234853.

PMID: 39355016 PMC: 11440964. DOI: 10.3389/fnume.2023.1234853.

Pretherapeutic PSMA PET-Derived Semiquantitative Parameters as Predictors of PSA Response in Patients with mCRPC Receiving [ Lu]Lu-PSMA-617 Radioligand Therapy.

Siripongsatian D, Jantarato A, Promteangtrong C, Kunawudhi A, Kiatkittikul P, Boonkawin N Indian J Radiol Imaging. 2024; 34(4):579-587.

PMID: 39318581 PMC: 11419753. DOI: 10.1055/s-0044-1779634.

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