Initial safety and efficacy data of Lutetium-177 PSMA radioligand therapy in the philippines

Lutetium-177 prostate-specific membrane antigen radioligand therapy (PRLT) is not yet part of the standard of care for prostate cancer but is available at St. Luke's Medical Center in the Philippines since 2018. This retrospective study aims to present initial data regarding the safety and efficacy of PRLT in the local setting. A chart review of all patients who underwent PRLT from June 2018 until August 2021 was done. Forty-eight patients with metastatic prostate cancer, 46 of which were castrate resistant, were included. Baseline characteristics, PRLT regimen, laboratory values, side effects, imaging responses, and outcomes were recorded. Data were analyzed using median and range, frequencies, Wilcoxon's signed-rank test, and Kaplan–Meier curves. The median age of patients was 69 years, while the median Gleason's score was 9, PSA was 57.6 ng/mL, and doubling time was 2.1 months. Around 77% of patients were heavily pretreated and 65% were found to have multiple metastases on baseline PSMA PET-CT. After receiving one to eight cycles of PRLT with median cumulative activity of 15 GBq, the median overall survival was 24 months while the median PSA progression-free survival was 14 months. There were more responders than nonresponders based on PSMA PET-CT criteria. Xerostomia, nausea, and fatigue were experienced by around 6, 8, and 19% of patients, respectively. There was no statistically significant progression of preexisting anemia, thrombocytopenia, and renal dysfunction. This study compares favorably with the results of recent prospective trials and supports the conclusion that PRLT is safe and effective for metastatic prostate cancer. (author)