Clinical genitourinary cancer · 2026
Treatment Patterns and Survival Outcomes in a Real-World Cohort of Lutetium 177 Vipivotide Tetraxetan (LuPSMA)-Experienced Patients With Metastatic Castration-resistant Prostate Cancer (mCRPC).
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Tran Ben, Dorff Tanya, Richey Madeline, Hankinson Eunice, Olsen Patrick, Karwa Smriti, Sharpe Jason, Braunlin Megan, Kim Christopher
Аннотация
INTRODUCTION: To evaluate treatments and survival in patients with metastatic castration-resistant prostate cancer (mCRPC) who received subsequent treatment after Lutetium 177 vipivotide tetraxetan (LuPSMA) in the real-world.
METHODS: This retrospective cohort study included patients with mCRPC who initiated subsequent treatment after LuPSMA up to 07/31/2024 in the US-based Flatiron Health Research Database (FHRD) with follow-up through 07/31/2025. Overall survival was measured from initiation of systemic treatment after LuPSMA until death using the Kaplan-Meier method. Key subgroups were prior taxane exposure in mCRPC (taxane-naïve/post-taxane).
RESULTS: Among 743 patients treated with LuPSMA in the FHRD, 339 (46%) died prior to initiating subsequent therapy and 161(22%) initiated subsequent therapy during the study period. Of the 161 patients who initiated subsequent therapy, 65% (n = 105) had prior taxane therapy. Patients received 43 distinct regimens after LuPSMA; half were chemotherapy-based. The most common regimens were cabazitaxel (19%), cabazitaxel-carboplatin (12%), and enzalutamide (9%). Median duration of post-LuPSMA therapy was 2.4 months. Median overall survival was 8.0 (95% CI: 6.8-11.5) months overall and 6.8 (95% CI: 5.5-9.3) months in post-taxane subgroup (median 4 prior lines of therapy).
CONCLUSIONS: The study population reflects real-world LuPSMA use and includes a heterogeneous group of heavily pretreated patients. Systemic therapies after LuPSMA were primarily chemotherapy-based. The short duration of treatments and limited survival highlights the need for novel treatments and sequencing strategies in the post-LuPSMA setting.
METHODS: This retrospective cohort study included patients with mCRPC who initiated subsequent treatment after LuPSMA up to 07/31/2024 in the US-based Flatiron Health Research Database (FHRD) with follow-up through 07/31/2025. Overall survival was measured from initiation of systemic treatment after LuPSMA until death using the Kaplan-Meier method. Key subgroups were prior taxane exposure in mCRPC (taxane-naïve/post-taxane).
RESULTS: Among 743 patients treated with LuPSMA in the FHRD, 339 (46%) died prior to initiating subsequent therapy and 161(22%) initiated subsequent therapy during the study period. Of the 161 patients who initiated subsequent therapy, 65% (n = 105) had prior taxane therapy. Patients received 43 distinct regimens after LuPSMA; half were chemotherapy-based. The most common regimens were cabazitaxel (19%), cabazitaxel-carboplatin (12%), and enzalutamide (9%). Median duration of post-LuPSMA therapy was 2.4 months. Median overall survival was 8.0 (95% CI: 6.8-11.5) months overall and 6.8 (95% CI: 5.5-9.3) months in post-taxane subgroup (median 4 prior lines of therapy).
CONCLUSIONS: The study population reflects real-world LuPSMA use and includes a heterogeneous group of heavily pretreated patients. Systemic therapies after LuPSMA were primarily chemotherapy-based. The short duration of treatments and limited survival highlights the need for novel treatments and sequencing strategies in the post-LuPSMA setting.