Sequencing of 177Lu-PSMA-617 and Cabazitaxel Did Not Significantly Impact Survival for Patients With Metastatic Castration-Resistant Prostate Cancer

According to results from the LuCaS trial, the sequence in which ₁₇₇Lu-PSMA-617 and cabazitaxel was administered did not significantly impact survival outcomes among patients with metastatic castration-resistant prostate cancer (mCRPC). 

Prior results have demonstrated that both agents “have been shown to improve survival in patients with [mCRPC] previously treated with docetaxel and androgen receptor pathway inhibitors,” stated Hatice Bolek, MD, Ankara University Cancer Institute, Ankara, Turkey, and coauthors. Here, researchers “aimed to evaluate the impact of sequencing cabazitaxel and ₁₇₇Lu-PSMA-617 on survival outcomes in patients with mCRPC.”

In this multicenter, retrospective study, 68 patients with mCRPC received sequential ₁₇₇Lu-PSMA-617 and cabazitaxel. The primary end point was progression-free survival (PFS). Key secondary end points included overall survival (OS) and objective response rate (ORR). 

At analysis, PFS was 10.8 months for patients treated with ₁₇₇Lu-PSMA-617 first and 11.7 months for patients treated with cabazitaxel first (P = .422). The median OS was 16.6 months for patients treated with ₁₇₇Lu-PSMA-617 first and 19.9 months for patients treated with cabazitaxel first (P = .917). The ORR was 23.1% for patients treated with ₁₇₇Lu-PSMA-617 first and 16.1% for patients treated with ₁₇₇Lu-PSMA-617 second. The ORR was 25.6% for patients treated with cabazitaxel first and 31.3% for patients treated with cabazitaxel second. 

Study authors concluded, “These findings suggest that both drugs can be effectively integrated into the mCRPC treatment paradigm without concerns about the effect of sequencing…However, prospective data are needed to optimize sequencing strategies and explore their impact on specific patient subgroups for more personalized care.” 

Source: 

Bolek H, Yazgan SC, Ceylan F, et al. Comparison of two alternative sequences with cabazitaxel and ₁₇₇Lu-PSMA-617 in metastatic castration-resistant prostate cancer: A retrospective multicenter study (LuCaS). Eur J Cancer. Published online: January 8, 2025. doi: 10.1016/j.ejca.2025.115226