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Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis
Introduction and aim Radioligand therapy (RLT) with 177 Lu-labelled prostate specific membrane antigen ([ 177 Lu]Lu-PSMA-X, referring with “PSMA-X” to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients hav...
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| Published in: | European journal of nuclear medicine and molecular imaging 2025-02, Vol.52 (3), p.936-954 |
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| container_title | European journal of nuclear medicine and molecular imaging |
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| creator | Almeida, Ludmila Santiago García Megías, Irene Etchebehere, Elba Cristina Sá Camargo Calapaquí Terán, Adriana K. Herrmann, Ken Giammarile, Francesco Treglia, Giorgio Delgado Bolton, Roberto C. |
| description | Introduction and aim
Radioligand therapy (RLT) with
177
Lu-labelled prostate specific membrane antigen ([
177
Lu]Lu-PSMA-X, referring with “PSMA-X” to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients having previously progressed on taxane and androgen receptor inhibitors. The aim of this study was to perform a systematic review and meta-analysis to assess the therapeutic efficacy of [
177
Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer.
Materials and methods
Searches in several bibliographic databases were made using relevant key words, and articles published up to March 2024 were included. The endpoints included prostate specific antigen (PSA) response rate (RR), progression-free survival, and overall survival. Individual patient data were pooled when feasible. PSA50 was defined as the median proportion of patients achieving at least a 50% decline in serum PSA from baseline. A meta-analysis of the PSA50 response rate (proportion meta-analysis) was performed, generating pooled estimates and 95% confidence intervals (95% CI).
Results
From the initially selected 8,414 studies published between 2019 and 2023, 24 were included in the [
177
Lu]Lu-PSMA-X treated group and 17 in the taxane treated group. Our findings show that [
177
Lu]Lu-PSMA-X RLT yielded comparable PSA50 responses in taxane-naïve patients versus those receiving taxane chemotherapy, despite considerable study heterogeneity. Notably, the taxane-naïve group had more extensive pretreatment.
Conclusions
This meta-analysis combines the largest cohorts of taxane-naïve mCRPC patients treated with [
177
Lu]Lu-PSMA-X RLT and taxane-treated mCRPC. It underscores similar PSA50 response rates in both groups, suggesting a potential role for [
177
Lu]Lu-PSMA-X RLT in taxane-naïve patients who cannot or choose not to undergo chemotherapy. |
| doi_str_mv | 10.1007/s00259-024-06932-2 |
| format | article |
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Radioligand therapy (RLT) with
177
Lu-labelled prostate specific membrane antigen ([
177
Lu]Lu-PSMA-X, referring with “PSMA-X” to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients having previously progressed on taxane and androgen receptor inhibitors. The aim of this study was to perform a systematic review and meta-analysis to assess the therapeutic efficacy of [
177
Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer.
Materials and methods
Searches in several bibliographic databases were made using relevant key words, and articles published up to March 2024 were included. The endpoints included prostate specific antigen (PSA) response rate (RR), progression-free survival, and overall survival. Individual patient data were pooled when feasible. PSA50 was defined as the median proportion of patients achieving at least a 50% decline in serum PSA from baseline. A meta-analysis of the PSA50 response rate (proportion meta-analysis) was performed, generating pooled estimates and 95% confidence intervals (95% CI).
Results
From the initially selected 8,414 studies published between 2019 and 2023, 24 were included in the [
177
Lu]Lu-PSMA-X treated group and 17 in the taxane treated group. Our findings show that [
177
Lu]Lu-PSMA-X RLT yielded comparable PSA50 responses in taxane-naïve patients versus those receiving taxane chemotherapy, despite considerable study heterogeneity. Notably, the taxane-naïve group had more extensive pretreatment.
Conclusions
This meta-analysis combines the largest cohorts of taxane-naïve mCRPC patients treated with [
177
Lu]Lu-PSMA-X RLT and taxane-treated mCRPC. It underscores similar PSA50 response rates in both groups, suggesting a potential role for [
177
Lu]Lu-PSMA-X RLT in taxane-naïve patients who cannot or choose not to undergo chemotherapy.</description><identifier>ISSN: 1619-7070</identifier><identifier>EISSN: 1619-7089</identifier><identifier>DOI: 10.1007/s00259-024-06932-2</identifier><identifier>PMID: 39453485</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Androgen receptors ; Antigens ; Bridged-Ring Compounds - therapeutic use ; Cancer therapies ; Cardiology ; Castration ; Chemical compounds ; Chemotherapy ; Effectiveness ; Heterogeneity ; Humans ; Imaging ; Inhibitors ; Lutetium - therapeutic use ; Lutetium isotopes ; Male ; Medicine ; Medicine & Public Health ; Meta-analysis ; Metastases ; Metastasis ; Neoplasm Metastasis ; Nuclear Medicine ; Oncology ; Original Article ; Orthopedics ; Pharmacology ; Prostate cancer ; Prostate-Specific Antigen - blood ; Prostatic Neoplasms, Castration-Resistant - drug therapy ; Prostatic Neoplasms, Castration-Resistant - radiotherapy ; Radioisotopes ; Radiology ; Response rates ; Survival ; Systematic review ; Taxanes ; Taxoids - therapeutic use ; Treatment Outcome</subject><ispartof>European journal of nuclear medicine and molecular imaging, 2025-02, Vol.52 (3), p.936-954</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Feb 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c223t-65557081d81ecdc098053df4af09c2772518e11b7b88ad344b708c3fd054d3233</cites><orcidid>0000-0002-9662-7259 ; 0000-0002-0550-7893 ; 0000-0002-6111-9246 ; 0000-0001-9808-780X ; 0000-0002-8632-5943 ; 0000-0001-7748-1955 ; 0000-0002-8071-6513 ; 0000-0001-9979-9227</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39453485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Almeida, Ludmila Santiago</creatorcontrib><creatorcontrib>García Megías, Irene</creatorcontrib><creatorcontrib>Etchebehere, Elba Cristina Sá Camargo</creatorcontrib><creatorcontrib>Calapaquí Terán, Adriana K.</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Giammarile, Francesco</creatorcontrib><creatorcontrib>Treglia, Giorgio</creatorcontrib><creatorcontrib>Delgado Bolton, Roberto C.</creatorcontrib><title>Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis</title><title>European journal of nuclear medicine and molecular imaging</title><addtitle>Eur J Nucl Med Mol Imaging</addtitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><description>Introduction and aim
Radioligand therapy (RLT) with
177
Lu-labelled prostate specific membrane antigen ([
177
Lu]Lu-PSMA-X, referring with “PSMA-X” to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients having previously progressed on taxane and androgen receptor inhibitors. The aim of this study was to perform a systematic review and meta-analysis to assess the therapeutic efficacy of [
177
Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer.
Materials and methods
Searches in several bibliographic databases were made using relevant key words, and articles published up to March 2024 were included. The endpoints included prostate specific antigen (PSA) response rate (RR), progression-free survival, and overall survival. Individual patient data were pooled when feasible. PSA50 was defined as the median proportion of patients achieving at least a 50% decline in serum PSA from baseline. A meta-analysis of the PSA50 response rate (proportion meta-analysis) was performed, generating pooled estimates and 95% confidence intervals (95% CI).
Results
From the initially selected 8,414 studies published between 2019 and 2023, 24 were included in the [
177
Lu]Lu-PSMA-X treated group and 17 in the taxane treated group. Our findings show that [
177
Lu]Lu-PSMA-X RLT yielded comparable PSA50 responses in taxane-naïve patients versus those receiving taxane chemotherapy, despite considerable study heterogeneity. Notably, the taxane-naïve group had more extensive pretreatment.
Conclusions
This meta-analysis combines the largest cohorts of taxane-naïve mCRPC patients treated with [
177
Lu]Lu-PSMA-X RLT and taxane-treated mCRPC. It underscores similar PSA50 response rates in both groups, suggesting a potential role for [
177
Lu]Lu-PSMA-X RLT in taxane-naïve patients who cannot or choose not to undergo chemotherapy.</description><subject>Androgen receptors</subject><subject>Antigens</subject><subject>Bridged-Ring Compounds - therapeutic use</subject><subject>Cancer therapies</subject><subject>Cardiology</subject><subject>Castration</subject><subject>Chemical compounds</subject><subject>Chemotherapy</subject><subject>Effectiveness</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>Imaging</subject><subject>Inhibitors</subject><subject>Lutetium - therapeutic use</subject><subject>Lutetium isotopes</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Neoplasm Metastasis</subject><subject>Nuclear Medicine</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Pharmacology</subject><subject>Prostate cancer</subject><subject>Prostate-Specific Antigen - blood</subject><subject>Prostatic Neoplasms, Castration-Resistant - drug therapy</subject><subject>Prostatic Neoplasms, Castration-Resistant - radiotherapy</subject><subject>Radioisotopes</subject><subject>Radiology</subject><subject>Response rates</subject><subject>Survival</subject><subject>Systematic review</subject><subject>Taxanes</subject><subject>Taxoids - therapeutic use</subject><subject>Treatment Outcome</subject><issn>1619-7070</issn><issn>1619-7089</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9Ud1qFDEUDmKxtfoCXkjA62h-JjuJd0tpq7CioIIgErLJGXdKJzMmmdZ5Kh-i7-DzmNlZ650XIYdzvp-TfAg9Y_Qlo7R-lSjlUhPKK0JXWnDCH6ATtmKa1FTph_d1TY_R45SuKGWKK_0IHQtdSVEpeYJ-r1OClDoIGfcNzjuYT7QDjLl1GJqmddZN8-wrq-vN-G0zkg8f363JF-z6brARPM49zvanDYDdDrp-EZhwGw5tsm-TYO9-3QAebG6LXcK3bd7hDrJN2c5mrhSxVH0gEVJbumWpIfbzuEjb4CC-xmucppSh21Mi3LRwi23weyFig72eCvUJOmrsdYKnh_sUfb44_3T2hmzeX749W2-I41xkspJSlr9iXjFw3lGtqBS-qWxDteN1zSVTwNi23iplvaiqbUE70XgqKy-4EKfoxaJb1vwxQsrmqh9jWSIZwaTilZa6Kii-oFx5TIrQmCG2nY2TYdTMUZolSlOiNPsoDS-k5wfpcduBv6f8za4AxAJIZRS-Q_zn_R_ZPw3krp8</recordid><startdate>20250201</startdate><enddate>20250201</enddate><creator>Almeida, Ludmila Santiago</creator><creator>García Megías, Irene</creator><creator>Etchebehere, Elba Cristina Sá Camargo</creator><creator>Calapaquí Terán, Adriana K.</creator><creator>Herrmann, Ken</creator><creator>Giammarile, Francesco</creator><creator>Treglia, Giorgio</creator><creator>Delgado Bolton, Roberto C.</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>NAPCQ</scope><orcidid>https://orcid.org/0000-0002-9662-7259</orcidid><orcidid>https://orcid.org/0000-0002-0550-7893</orcidid><orcidid>https://orcid.org/0000-0002-6111-9246</orcidid><orcidid>https://orcid.org/0000-0001-9808-780X</orcidid><orcidid>https://orcid.org/0000-0002-8632-5943</orcidid><orcidid>https://orcid.org/0000-0001-7748-1955</orcidid><orcidid>https://orcid.org/0000-0002-8071-6513</orcidid><orcidid>https://orcid.org/0000-0001-9979-9227</orcidid></search><sort><creationdate>20250201</creationdate><title>Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis</title><author>Almeida, Ludmila Santiago ; García Megías, Irene ; Etchebehere, Elba Cristina Sá Camargo ; Calapaquí Terán, Adriana K. ; Herrmann, Ken ; Giammarile, Francesco ; Treglia, Giorgio ; Delgado Bolton, Roberto C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c223t-65557081d81ecdc098053df4af09c2772518e11b7b88ad344b708c3fd054d3233</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Androgen receptors</topic><topic>Antigens</topic><topic>Bridged-Ring Compounds - therapeutic use</topic><topic>Cancer therapies</topic><topic>Cardiology</topic><topic>Castration</topic><topic>Chemical compounds</topic><topic>Chemotherapy</topic><topic>Effectiveness</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>Imaging</topic><topic>Inhibitors</topic><topic>Lutetium - therapeutic use</topic><topic>Lutetium isotopes</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Neoplasm Metastasis</topic><topic>Nuclear Medicine</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Pharmacology</topic><topic>Prostate cancer</topic><topic>Prostate-Specific Antigen - blood</topic><topic>Prostatic Neoplasms, Castration-Resistant - drug therapy</topic><topic>Prostatic Neoplasms, Castration-Resistant - radiotherapy</topic><topic>Radioisotopes</topic><topic>Radiology</topic><topic>Response rates</topic><topic>Survival</topic><topic>Systematic review</topic><topic>Taxanes</topic><topic>Taxoids - therapeutic use</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Almeida, Ludmila Santiago</creatorcontrib><creatorcontrib>García Megías, Irene</creatorcontrib><creatorcontrib>Etchebehere, Elba Cristina Sá Camargo</creatorcontrib><creatorcontrib>Calapaquí Terán, Adriana K.</creatorcontrib><creatorcontrib>Herrmann, Ken</creatorcontrib><creatorcontrib>Giammarile, Francesco</creatorcontrib><creatorcontrib>Treglia, Giorgio</creatorcontrib><creatorcontrib>Delgado Bolton, Roberto C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>European journal of nuclear medicine and molecular imaging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Almeida, Ludmila Santiago</au><au>García Megías, Irene</au><au>Etchebehere, Elba Cristina Sá Camargo</au><au>Calapaquí Terán, Adriana K.</au><au>Herrmann, Ken</au><au>Giammarile, Francesco</au><au>Treglia, Giorgio</au><au>Delgado Bolton, Roberto C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis</atitle><jtitle>European journal of nuclear medicine and molecular imaging</jtitle><stitle>Eur J Nucl Med Mol Imaging</stitle><addtitle>Eur J Nucl Med Mol Imaging</addtitle><date>2025-02-01</date><risdate>2025</risdate><volume>52</volume><issue>3</issue><spage>936</spage><epage>954</epage><pages>936-954</pages><issn>1619-7070</issn><eissn>1619-7089</eissn><abstract>Introduction and aim
Radioligand therapy (RLT) with
177
Lu-labelled prostate specific membrane antigen ([
177
Lu]Lu-PSMA-X, referring with “PSMA-X” to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients having previously progressed on taxane and androgen receptor inhibitors. The aim of this study was to perform a systematic review and meta-analysis to assess the therapeutic efficacy of [
177
Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer.
Materials and methods
Searches in several bibliographic databases were made using relevant key words, and articles published up to March 2024 were included. The endpoints included prostate specific antigen (PSA) response rate (RR), progression-free survival, and overall survival. Individual patient data were pooled when feasible. PSA50 was defined as the median proportion of patients achieving at least a 50% decline in serum PSA from baseline. A meta-analysis of the PSA50 response rate (proportion meta-analysis) was performed, generating pooled estimates and 95% confidence intervals (95% CI).
Results
From the initially selected 8,414 studies published between 2019 and 2023, 24 were included in the [
177
Lu]Lu-PSMA-X treated group and 17 in the taxane treated group. Our findings show that [
177
Lu]Lu-PSMA-X RLT yielded comparable PSA50 responses in taxane-naïve patients versus those receiving taxane chemotherapy, despite considerable study heterogeneity. Notably, the taxane-naïve group had more extensive pretreatment.
Conclusions
This meta-analysis combines the largest cohorts of taxane-naïve mCRPC patients treated with [
177
Lu]Lu-PSMA-X RLT and taxane-treated mCRPC. It underscores similar PSA50 response rates in both groups, suggesting a potential role for [
177
Lu]Lu-PSMA-X RLT in taxane-naïve patients who cannot or choose not to undergo chemotherapy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39453485</pmid><doi>10.1007/s00259-024-06932-2</doi><tpages>19</tpages><orcidid>https://orcid.org/0000-0002-9662-7259</orcidid><orcidid>https://orcid.org/0000-0002-0550-7893</orcidid><orcidid>https://orcid.org/0000-0002-6111-9246</orcidid><orcidid>https://orcid.org/0000-0001-9808-780X</orcidid><orcidid>https://orcid.org/0000-0002-8632-5943</orcidid><orcidid>https://orcid.org/0000-0001-7748-1955</orcidid><orcidid>https://orcid.org/0000-0002-8071-6513</orcidid><orcidid>https://orcid.org/0000-0001-9979-9227</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1619-7070 |
| ispartof | European journal of nuclear medicine and molecular imaging, 2025-02, Vol.52 (3), p.936-954 |
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| source | Springer Nature:Jisc Collections:Springer Nature Read and Publish 2023-2025: Springer Reading List |
| subjects | Androgen receptors Antigens Bridged-Ring Compounds - therapeutic use Cancer therapies Cardiology Castration Chemical compounds Chemotherapy Effectiveness Heterogeneity Humans Imaging Inhibitors Lutetium - therapeutic use Lutetium isotopes Male Medicine Medicine & Public Health Meta-analysis Metastases Metastasis Neoplasm Metastasis Nuclear Medicine Oncology Original Article Orthopedics Pharmacology Prostate cancer Prostate-Specific Antigen - blood Prostatic Neoplasms, Castration-Resistant - drug therapy Prostatic Neoplasms, Castration-Resistant - radiotherapy Radioisotopes Radiology Response rates Survival Systematic review Taxanes Taxoids - therapeutic use Treatment Outcome |
| title | Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis |
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