NEJM：177Lu-PSMA-617靶向放疗治疗PSMA阳性转移性去势抵抗性前列腺癌

2021-06-24 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靶向放射治疗可显著延长基于成像的无进展生存率和整体生存率

晚期前列腺癌患者经一段时间的去势治疗后会出现去势抵抗，转变为去势抵抗性前列腺癌（CRPC），这部分患者发生转移的风险极高，称为转移性去势抵抗性前列腺癌患者（mCRPC）。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。

在这项国际，公开，III期试验中，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)和其他试验药物。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。

831名患者参与研究，组间患者的基线特征相近。中位随访时间为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；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；死亡危险比0.62）显著延长。所有关键次要终点中，177Lu-PSMA-617组均显示优势。177Lu-PSMA-617组3级或以上不良事件率较高（52.7% vs 38.0%），但不良事件未对患者生活质量产生影响。

研究认为，对于晚期PSMA阳性转移性去势抵抗性前列腺癌患者，177Lu-PSMA-617靶向放射治疗可显著延长基于成像的无进展生存率和整体生存率。

原始出处：

Oliver Sartor et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer. N Engl J Med，June 23，2021.

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2021-07-08 yige2012

#抗性#

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2021-06-26 ms1948154235210413

#去势抵抗性前列腺癌#

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2021-06-26 1249842em09(暂无昵称)

#转移性#

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2021-06-26 仁医06

#SMA#

40 0
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2021-06-25 旺医

顶刊就是顶刊，谢谢梅斯带来这么高水平的研究报道，我们科里同事经常看梅斯，分享梅斯上的信息

41 0
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2021-06-25 misszhang

前列腺癌相关研究，学习了，谢谢梅斯

54 0
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2021-06-24 言西早

希望疗效显著

56 0

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