ArticleEuropean journal of nuclear medicine and molecular imaging2025
Cancer-control outcomes of Radium- 223-pretreated lutetium- 177-PSMA Radioligand vs. Radium- 223-naïve mCRPC patients.
Article in European journal of nuclear medicine and molecular imaging, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- Theranostics for prostate cancer: A Canadian multidisciplinary expert report.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026Article
- Emerging frontiers and challenges of artificial intelligence in PSMA-PET imaging: pioneering a new chapter in prostate cancer care.Japanese journal of radiology · 2026Review
- Clinical efficacy of radium-223 in simulating real-world clinical practice: a meta-analysis.Annals of nuclear medicine · 2026Review
- Alpha and Beta Emitters in Translational Nuclear Medicine: Clinical Advances, Challenges, and Future Direction.International journal of molecular sciences · 2026Review
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12 authors.
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Abstract
purposeRadium- 223 and Lutetium- 177 prostate-specific membrane antigen radioligand therapy (Lu- 177-PSMA) are approved for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC). Data on cancer-control outcomes of sequential therapy of Lu- 177-PSMA after radium- 223 are rare.
methodsUsing the Frankfurt Metastatic Cancer database of the Prostate (FRAMCAP) database, we analyzed progression-free (PFS) and overall (OS) survival of patients after radium- 223 pretreatment vs. radium- 223-naïve controls undergoing Lu- 177-PSMA radioligand within 1 st- 7 th line mCRPC treatment.
resultsOf 329 Lu- 177-PSMA mCRPC patients 19% were radium- 223 pretreated, while 81% radium- 223-naïve. The median number of administered mCRPC systemic treatment administrations were significantly higher for radium- 223 pretreated patients (4 vs. 3, p < 0.01). No difference in further baseline or cancer characteristics were observed, similar to PSA response under Lu- 177-PSMA treatment. In PFS analyses, no significant difference between radium- 223 pretreated vs. radium- 223-naïve Lu- 177-PSMA mCRPC patients were observed, with median PFS of 16 vs. 12 months (hazard ratio [HR]: 0.73, confidence interval [CI]: 0.52-1.02, p = 0.063). In OS analysis, also no significant differences were observed with median OS of 18 vs. 15 months for radium- 223 pretreated vs. radium- 223-naïve Lu- 177-PSMA mCRPC patients (HR: 0.99, CI: 0.71-1.37, p > 0.9). Finally, after additional multivariable adjustment, no differences in PFS and OS outcomes between both groups were observed.
conclusionSequential treatment with radium- 223 prior to Lu- 177-PSMA does not affect PFS or OS outcomes in mCRPC patients. Therefore, this real-world cohort suggests that both radiopharmaceuticals can be administered within mCRPC treatment algorithm.
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