Abstract
The aim of this study was to evaluate the efficacy of 177Lu-PSMA-617 (Lu-PSMA) and Selective Internal Radiation Therapy (SIRT) for the treatment of liver metastases of castration resistant prostate cancer (mCRPC). Materials and Methods: Safety and survival of patients with mCRPC and liver metastases assigned to Lu-PSMA alone (n = 31) or in combination with SIRT (n = 5) was retrospectively analyzed. Additionally, a subgroup (n = 10) was analyzed using morphological and molecular response criteria. Results: Median-estimated survival was 5.7 months for Lu-PSMA alone and 8.4 months for combined sequential Lu-PSMA+SIRT. Lu-PSMA achieved discordant therapy responses with both regressive and progressive liver metastases in the same patient (best vs. worst responding metastases per patient: -35%vs.+63% diameter change; p<0.05). SIRT was superior for the treatment of liver metastases compared to Lu-PSMA (0%vs.56%progression). Conclusion: The combination of Lu-PSMA and SIRT is efficient and feasible for the treatment of advanced prostate cancer. Lu-PSMA alone seems to have limited response rates in the treatment of liver metastases.
- Copyright © 2019 by the Society of Nuclear Medicine and Molecular Imaging, Inc.