The oncologist · 2026
An assessment of time toxicity in patients receiving [177Lu]Lu-PSMA-617 for metastatic castration-resistant prostate cancer.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Scharf Zachary, Muniz Miguel, Tchitchkan Elizabeth, Rami Avina, Ravi Praful, Orme Jacob J, Tarhini Ali, Jacene Heather A, Sentana-Lledo Daniel, Childs Daniel S
Аннотация
BACKGROUND: [177Lu]Lu-PSMA-617 (LuPSMA) improves survival and quality of life in men with metastatic castration-resistant prostate cancer but requires substantial healthcare involvement. Our analysis evaluated the time toxicity associated with LuPSMA, representing the first dedicated radioligand time toxicity assessment.
MATERIALS AND METHODS: We conducted a multi-institutional retrospective study of patients initiating LuPSMA between April 2022 and March 2023. Patients were followed from first LuPSMA administration until 3 months after the final cycle, initiation of new systemic therapy, or death. Time toxicity was quantified as healthcare contact days during the at-risk interval. Associations with baseline characteristics were evaluated using negative binomial regression models. Univariate and multivariable models were performed.
RESULTS: The median age of 135 patients included in the study was 69 years, and the median prior systemic therapies was 4. Patients completed a median of 5 LuPSMA cycles over 7.6 months. Median healthcare contact days were 20 (IQR, 15-28), representing 9.5% (IQR, 6.4-13.9) of at-risk days. Fifteen patients (11%) experienced high time toxicity (>1 contact day per 5 days), while 42 (31%) had low time toxicity (≤1 contact day per 14 days). Among the 57 patients who received both cycle 1 and cycle 6, the mean per cycle healthcare contact days were 4 and 3.6, respectively (paired Wilcoxon signed-rank test, P = .04). Routine oncology visits comprised 32.7% of contact days, compared with 8.8% from hospitalizations. Lower baseline hemoglobin was independently associated with greater time toxicity (RR = 0.87; 95% CI, 0.79-0.96; P = .004).
CONCLUSION: In heavily pretreated patients, LuPSMA demonstrated relatively low time toxicity, supporting it as a time-efficient therapy.
MATERIALS AND METHODS: We conducted a multi-institutional retrospective study of patients initiating LuPSMA between April 2022 and March 2023. Patients were followed from first LuPSMA administration until 3 months after the final cycle, initiation of new systemic therapy, or death. Time toxicity was quantified as healthcare contact days during the at-risk interval. Associations with baseline characteristics were evaluated using negative binomial regression models. Univariate and multivariable models were performed.
RESULTS: The median age of 135 patients included in the study was 69 years, and the median prior systemic therapies was 4. Patients completed a median of 5 LuPSMA cycles over 7.6 months. Median healthcare contact days were 20 (IQR, 15-28), representing 9.5% (IQR, 6.4-13.9) of at-risk days. Fifteen patients (11%) experienced high time toxicity (>1 contact day per 5 days), while 42 (31%) had low time toxicity (≤1 contact day per 14 days). Among the 57 patients who received both cycle 1 and cycle 6, the mean per cycle healthcare contact days were 4 and 3.6, respectively (paired Wilcoxon signed-rank test, P = .04). Routine oncology visits comprised 32.7% of contact days, compared with 8.8% from hospitalizations. Lower baseline hemoglobin was independently associated with greater time toxicity (RR = 0.87; 95% CI, 0.79-0.96; P = .004).
CONCLUSION: In heavily pretreated patients, LuPSMA demonstrated relatively low time toxicity, supporting it as a time-efficient therapy.