NEJM:177Lu-PSMA-617靶向放疗治疗转移性去势抵抗性前列腺癌

2021-09-20 MedSci原创 MedSci原创

对于晚期PSMA阳性转移性去势抵抗性前列腺癌患者,177Lu-PSMA-617靶向放射疗法可显著提高患者无进展生存率和整生存率

去势抵抗性前列腺癌(CRPC)患者在经过初次持续雄激素剥夺治疗后疾病仍然进展,该类患者发生病情转移后,称为转移性去势抵抗性前列腺癌患者(mCRPC),尽管mCRPC患者有多重疾病延缓治疗手段,但其仍是不可治愈和致命的。mCRPC患者前列腺特异性膜抗原(PSMA)高表达,是良好的靶向治疗靶点。Lutetium-177(177Lu)-PSMA-617是一种放射性配体疗法,可向PSMA表达丰富的细胞和周围微环境传递β辐射粒子。近日研究人员评估了177Lu-PSMA-617对mCRPC患者的治疗效果。

本次研究为国际,公开,III期试验,接受过至少1种雄激素受体通路抑制剂和1-2种紫杉烷类药物治疗后仍进展的mCRPC患者参与研究。在标准护理基础上,随机接受177Lu-PSMA-617(每6周7.4 GBq,持续4-6轮)或对照。标准治疗不包含化疗、免疫治疗、radium-223 (223Ra)或其他研究药物。研究的主要终点是基于成像的无进展生存率和总生存率,次要终点包括客观反应、疾病控制和症状性骨骼事件。

总计831名患者参与研究,患者的基线特征相近。平均随访时间为20.9个月。与标准护理相比,177Lu-PSMA-617组,基于影像学的无进展生存期(中位无进展生存期:8.7 vs 3.4个月;组间进展或死亡危险比0.40)和总生存期(中位总生存期:15.3 vs 11.3个月;组间死亡危险比0.62)显著延长。所有关键次要终点中,177Lu-PSMA-617组均表现出优势。177Lu-PSMA-617组III级或III级以上不良事件风险增加(52.7% vs 38.0%),但各种不良事件均未对患者生活质量产生影响。

组间无进展生存期及总生存期差异

对于晚期PSMA阳性转移性去势抵抗性前列腺癌患者,177Lu-PSMA-617靶向放射疗法可显著提高患者无进展生存率和整生存率

原始出处:

Oliver Sartor et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med,September 16,2021.

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    2021-10-05 yige2012
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    2021-09-22 江川靖瑶

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