Prostat kanserinde Lutetium-177-PSMA tedavisi: tek merkezli gerçek yaşam deneyimi

Objective & Hypothesis:Aim: Lutetium-177–labeled PSMA radioligand therapy has emerged as a promising option in metastatic castration-resistant prostate cancer (mCRPC), yet real-world data remain limited.

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Key Findings & Data:This study aimed to evaluate clinical features, treatment patterns, and predictors of response in patients treated with Lutetium-177-PSMA therapy at a single academic center.

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Conclusion & Impact:Prospective validation is warranted.

🔬Design:Araştırma Makalesi

📍Scope:2020 Verileri

⚙️Variables:Lutetium-177-PSMA · m-KRPK · radyoligand tedavi

Abstract

Aim: Lutetium-177–labeled PSMA radioligand therapy has emerged as a promising option in metastatic castration-resistant prostate cancer (mCRPC), yet real-world data remain limited. This study aimed to evaluate clinical features, treatment patterns, and predictors of response in patients treated with Lutetium-177-PSMA therapy at a single academic center. Material and Methods: We retrospectively analyzed 49 patients with mCRPC who received Lutetium-177-PSMA between January 2020 and January 2025. Treatment response was defined as a ≥50% decline in PSA (PSA50). Associations between baseline variables and PSA50 were examined using Mann–Whitney U tests, and predictive biomarkers were evaluated by receiver operating characteristic (ROC) analysis. Results: The PSA50 response rate was 41.7%. Lower baseline PSA (p = 0.023), ALP (p = 0.037), and LDH (p = 0.004) levels, and higher hemoglobin (p = 0.024), were significantly associated with response. Hemoglobin demonstrated the highest discriminatory performance (AUC = 0.692), while PSA, ALP, and LDH showed significant but limited predictive value. Treatment was well tolerated, with only one case of grade 3-4 hematologic toxicity. Conclusion: Lutetium-177-PSMA therapy provides clinical benefit in real-world mCRPC patients. Lower tumor burden and preserved hematologic status may predict better biochemical response, with hemoglobin serving as a moderately accurate biomarker. Prospective validation is warranted.

Özet

Amaç: Lutetium-177 ile işaretli PSMA hedefli radyoligand tedavi, metastatik kastrasyona dirençli prostat kanseri (m-KRPK) için umut verici bir seçenek olarak ortaya çıkmıştır. Ancak gerçek yaşam verileri sınırlıdır. Bu çalışmada, tek merkezde Lu-177-PSMA tedavisi alan m-KRPK hastalarının klinik özellikleri, tedavi desenleri ve yanıt öngördürücü faktörleri değerlendirildi. Gereç ve Yöntemler: Ocak 2020- Ocak 2025 arasında Lu-177-PSMA tedavisi alan 49 hastanın retrospektif analizi yapılmıştır. Tedavi yanıtı PSA’da ≥%50 düşüş (PSA50) ile değerlendirildi. Temel değişkenlerin PSA50 yanıtı ile ilişkisi Mann–Whitney U testi ile, biyobelirteçlerin prediktif gücü ROC eğrisi analizi ile incelendi. Bulgular: PSA50 yanıt oranı %41,7 idi. Daha düşük başlangıç PSA, ALP ve LDH düzeyleri ile daha yüksek hemoglobin seviyeleri yanıtla anlamlı ilişkili bulundu. Hemoglobin ROC analizinde orta düzeyde ayırt edici güce sahipti (AUC = 0,692). Tedavi genellikle iyi tolere edildi ve ciddi hematolojik toksisite yalnızca bir hastada görüldü. Sonuç: Lu-177-PSMA tedavisi, m-KRPK hastalarında gerçek yaşam pratiğinde klinik fayda sağlamaktadır. Başlangıç hemoglobin düzeyi tedavi yanıtını öngörmede pratik bir biyobelirteç olabilir. Ancak prospektif çalışmalara ihtiyaç vardır. Anahtar Kelimeler: Lutetium-177-PSMA, m-KRPK, radyoligand tedavi, PSA50, biyobelirteçler

Keywords

Lutetium-177-PSMA m-KRPK radyoligand tedavi PSA50 biyobelirteçler lutetium-177-PSMA metastatic castration-resistant prostate cancer radioligand therapy predictive biomarkers

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Cite This Article

Akdoğan, O., Sütçüoğlu, O., Ateş, S. G., Gürler, F., Aydos, U., Savaş, G., Akdemır, Ü., Üner, A., Atay, L. Ö., Coşkun, U., Yazıcı, O., Özet, A., Özdemir, N. Y. (2025). Prostat kanserinde Lutetium-177-PSMA tedavisi: tek merkezli gerçek yaşam deneyimi. Turkish Journal of Clinics and Laboratory, Cilt: 16 Sayı: 3, 459–464. https://doi.org/10.18663/tjcl.1716124

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