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ORIGINAL RESEARCH article
Front. Oncol.
Sec. Cancer Molecular Targets and Therapeutics
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1516860
The efficacy and safety of 225 Ac-PSMA-617 in metastatic castration-resistant prostate cancer
Provisionally accepted- Department of Nuclear Medicine, Southwest Medical University, Luzhou, China
Background:We aimed to report our clinical experience with the use of 225 Ac-PSMA-617 in the treatment of mCRPC patients. Methods:A retrospective analysis was conducted on 29 metastatic castration-resistant prostate cancer (mCRPC) patients treated with 225 Ac-PSMA-617. Patients underwent treatment at 8-week intervals and discontinued treatment upon disease progression or the occurrence of intolerable adverse effects. We acquired 68 Ga-PSMA-11 PET/CT images and laboratory test outcomes of patients at baseline and 8 weeks following each treatment. Short-term efficacy was evaluated through the biochemical response of serum prostate-specific antigen (PSA) and molecular tumor response criteria. A follow-up was conducted to assess the long-term effectiveness by examining the patient's overall survival (OS) and progression-free survival (PFS). The numerical rating scale (NRS) assessed the patient's pain. The side effects after treatment were evaluated based on common terminal criteria for adverse events version 5.0 (CTCAE v5.0).Results: 29 patients with mCRPC underwent a total of 50 treatment cycles. The median age of the patients was 67 years (55-84years). Out of these patients, 11 had previously underwent 177 Lu-PSMA-617 radioligand therapy (RLT). After treatment, any PSA decline was observed in 75.9% of patients, and a PSA decline≥50% was observed in 62.1%. 61.1% of patients had disease control according to molecular response. The estimated OS and PFS were 18 months (95% CI: 15-21 months) and 8 months (95% CI: 6-10 months). Univariate analysis showed that any PSA decline was positively correlated with PFS (p<0.001). The most common side effect was xerostomia, observed in 79.3% of patients. Grade III blood toxicity was observed in 7/29 patients. After treatment, the pain disappeared in 4 patients and was relieved in 13 individuals.In mCRPC, the results indicated that 225 Ac-PSMA-617 demonstrated a favorable disease control rate and relatively minimal side effects. However, additional high-quality randomized controlled trials are required for future validation.
Keywords: prostate cancer, 225 Ac-PSMA-617, Radioligand Therapy, 68 Ga-PSMA, PET/CT
Received: 25 Oct 2024; Accepted: 11 Feb 2025.
Copyright: © 2025 Ma, Zhang, Yangqing, Liu, Wang and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Chunyin Zhang, Department of Nuclear Medicine, Southwest Medical University, Luzhou, China
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