177Lu-PSMA vs. cabazitaxel in patients with castration-resistant prostate cancer: Real-world efficacy and safety data from the ARON-3 study Article

Full Text via DOI: 10.1016/j.ejca.2025.115789 Web of Science: 001580903600001

Cited authors

  • Mandel P, Groener D, Follacchio G, Ürün Y, Bourlon MT, Sabet A, Grünwald F, Tural D, Büttner T, Kopp RM, Taha T, Chun FK, Facchini G, Myint ZW, Seront E, Conteduca V, Quiroga MNG, Aurilio G, Palacios GA, Bogemann M, Roviello G, Matrana MR, Sammarco E, Laguado MIZ, Galli L, Ansari J, Danielli L, Molina-Cerrillo J, Rescigno P, Yazgan SC, Bastos DA, Jazieh AR, Monteiro FSM, Soares A, Massari F, Wenzel M, Capoccetti F, Santoni M

Abstract

  • Background Radioligand therapy with [Lu-177]Lutetium-177-PSMA-617 (Lu-177-PSMA) was recently introduced in clinical practice in the US, Latin America and in most European countries for progressive, metastatic castration-resistant prostate cancer (mCRPC). However, multicenter real-world data on cancer-control outcomes are scant. Methods Real-word data from the ARON-3 collaboration in progressive mCRPC patients treated with Lu-177-PSMA vs. cabazitaxel were collected. A retrospective analysis was performed, including overall survival (OS), progression free survival (PFS), time to treatment failure (TTF) and PSA50/90 rates. Results Data from 285 (50.1 %) patients receiving Lu-177-PSMA vs. 283 (49.9 %) cabazitaxel after one or two lines of ARPI and Docetaxel were analyzed. PSA50 and PSA90 rates were higher, and TTF and OS were significantly longer in Lu-177-PSMA patients, even after multivariable adjustment (p <= 0.01). This effect held true for most subgroups such as age < 70 and >= 70 years, ECOG 0-1, distant lymph nodes and one vs. two lines of prior ARPI. Incidence of grade 3-4 adverse events were comparable between both treatments (37 % vs. 43 % for Lu-177-PSMA vs. cabazitaxel cohort p = 0.5) but differed according to the type of adverse events. Sensitivity analyses with cross-over adjustment showed similar effects. Conclusions Analyzing the currently largest real-world cohort comparing Lu-177-PSMA vs. cabazitaxel, we provided robust information of Lu-177-PSMA being at least equally effective or possibly even superior to cabazitaxel regarding cancer-control outcomes with reasonable side effects.

Authors

Publication date

  • 2025

Published in

International Standard Serial Number (ISSN)

  • 0959-8049

Number of pages

  • 8

Volume

  • 229