The efficacy and safety of 225Ac-PSMA-617 in metastatic castration-resistant prostate cancer

作者：Jiao Ma, Yu Zhang, Jiangchu Yangqing, Guangfu Liu, Junzheng Wang, Chunyin Zhang · 发表于：Frontiers in Oncology · 年份：2025 · DOI：10.3389/fonc.2025.1516860 · 被引用次数：6 · 研究领域：Prostate Cancer Treatment and Research、Radiopharmaceutical Chemistry and Applications、Prostate Cancer Diagnosis and Treatment

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: 15-2...