![]() Verholen: Financial Interests, Personal, Full or part-time Employment: Bayer. Bundschuh: Financial Interests, Personal, Other, Honoraria: Eisai AG Financial Interests, Personal, Advisory Role: Bayer. Rassek: Financial Interests, Personal, Other, Employment of immediate family member: Porterhouse Group AG Paracelsus Kliniken. Fendler: Financial Interests, Personal, Advisory Role: Janssen, Calyx Financial Interests, Personal, Speaker’s Bureau: Janssen, Bayer Financial Interests, Personal, Other, Honoraria: Parexel Financial Interests, Personal, Research Grant: SOFIE. Prasad: Financial Interests, Personal, Other, Honoraria: Advanced Accelerator Applications Financial Interests, Personal, Advisory Role: Bayer Financial Interests, Personal, Research Grant: Ipsen. la Fougère: Financial Interests, Personal, Advisory Role: EUSA-Pharma, Novartis, Ipsen, Oncodesign, Sirtex Medical Financial Interests, Institutional, Research Grant: Oncovision. Eiber: Financial Interests, Personal, Other, Patent application: rhPSMA Financial Interests, Personal, Stocks/Shares: Novartis, Telix Pharmaceuticals Financial Interests, Personal, Advisory Role: ABX, Advanced biochemical compounds, Blue Earth Diagnostics, Janssen Oncology, Telix Pharmaceuticals Financial Interests, Personal, Research Grant: ABX, Advanced biochemical compounds Financial Interests, Personal, Other, Travel/accommodation: Bayer Schering Pharma Financial Interests, Institutional, Advisory Role: Novartis Financial Interests, Institutional, Research Grant: Bayer, Blue Earth Diagnostics. Essler: Financial Interests, Personal, Advisory Role: Advanced Accelerator Applications, Bayer, Ipsen Financial Interests, Personal, Other, Travel/accommodation: Ipsen. Rahbar: Financial Interests, Personal, Other, Honoraria: Advanced Accelerator Applications, Bayer Financial Interests, Personal, Advisory Role: ABX GmbH, ABX-CRO, Bayer, Advanced Accelerator Applications. Dr Lila Adnane (Bayer) provided editorial assistance. ![]() Clinical trial identification Editorial acknowledgementĭr Chris Guise of Cancer Communications and Consultancy Ltd., Cheshire, UK, provided medical writing assistance, which was funded by Bayer. 223Ra and Ct order prior to 117Lu-PSMA did not alter the safety profile nor OS from the start of 177Lu-PSMA. In this real-world setting, 177Lu-PSMA therapy in pts with prior 223Ra had an acceptable safety profile and effectiveness was similar to other findings with 177Lu-PSMA, indicating no cross-resistance. Grade 3/4 laboratory abnormalities, c,d n/N (%), (95% CI)ĪSAT, aspartate aminotransferase N, number of pts per group n, number of pts with specified event TEAE, treatment-emergent adverse events a13 pts with multiple Cts were included in both groups bFrom starting 177Lu-PSMA to the end of 30-day follow-up cUp to 90 days after last 177Lu-PSMA dose dNo grade 5 toxicities occurred Conclusions Median overall survival (OS) from the start of 177Lu-PSMA treatment was 13 (95% CI 11–16), 12 (9–15) and 14 (9–17) months in the all pts, Ra-Ct-Lu and Ct-Ra-Lu groups, respectively. ALP30 response occurred in 19% of all pts and was similar in the Ra-Ct-Lu and Ct-Ra-Lu groups (13% vs 11%, respectively). During 177Lu-PSMA treatment, PSA50 response occurred in 42% of all pts, 46% of the Ra-Ct-Lu pts and 36% of the Ct-Ra-Lu pts. 73% of pts received 1–4 177Lu-PSMA cycles and 27% received ≥5 cycles. All pts had bone metastases 27% had visceral metastases. 71% of pts had received 6 223Ra injections. 56% of pts had received ≥4 life prolonging therapies, including abiraterone (71%), enzalutamide (70%), docetaxel (74%) and cabazitaxel (23%). ![]() ![]() Median prostate-specific antigen (PSA) was 285.5 ng/ml and median alkaline phosphatase (ALP) was 146.0 U/L. Before starting 177Lu-PSMA, the proportion of pts with an Eastern Cooperative Oncology Group performance status of 0, 1 or 2 was 0%, 62% and 38%, respectively. Safety and effectiveness were evaluated in all pts and by the treatment sequence ( 223Ra then chemotherapy then 177Lu-PSMA and Ct then 223Ra then 177Lu-PSMA ). ![]() Pt data were retrospectively collected in German nuclear medicine centres from 2021 to 2022. Here, we investigate the safety and effectiveness of 177Lu-PSMA in pts with metastatic castration-resistant prostate cancer (mCRPC) and prior 223Ra in the RALU study. Previous studies suggest feasibility of using 177Lu-PSMA after 233Ra with an acceptable safety profile. ![]()
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