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Actinium-255-PSMA Radioligand Therapy for Patients With Metastatic Castration-Resistant Prostate Cancer

Allison Casey

According to a retrospective study, actinium-255 (255Ac)-PSMA radioligand therapy showed a substantial antitumor effect among patients with metastatic castration-resistant prostate cancer and may represent a viable therapy option for patients treated with previous lines of approved agents.

This retrospective study included 488 patients with metastatic castration-resistant prostate cancer who had been treated with ≥1 cycle of 8 MBq of 255Ac-PSMA radioligand therapy. Previous lines of treatment included taxane-based chemotherapy, androgen-receptor-axis inhibitor, lutetium-177 PSMA radioligand therapy, and radium-233 dichloride. The primary outcomes of this study were overall survival (OS) and progression-free survival (PFS).

The median follow-up duration was 9.0 months, while the median OS was 15.5 months and median PFS was 7.9 months. For 71% of patients, there was information regarding treatment-induced xerostomia available. In those patients, 68% reported xerostomia following the first cycle of 255Ac-PSMA radioligand therapy. All patients who received >7 cycles of 255Ac-PSMA radioligand therapy reported xerostomia. Grade ≥3 anemia occurred in 13% of patients, thrombocytopenia in 7%, renal toxicity in 5%, and leukopenia in 4%.

Dr Sathekge et al concluded, “255Ac-PSMA radioligand therapy shows a substantial antitumour effect in [metastatic castration-resistant prostate cancer] and represents a viable therapy option in patients treated with previous lines of approved agents.”


Source:

Sathekge MM, Lawal IO, Bal C, et al. Actinium-255-PSMA radioligand therapy of metastatic castration-resistant prostate cancer (WARMTH Act): A multicentre, retrospective study. Lancet Oncol. Published online January 10, 2024. doi: 10.1016/S1470-2045(23)00638-1

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