The oncologist · 2026
Clinical outcomes of lutetium-177-PSMA-617 in a racially diverse cohort of patients with metastatic castration-resistant prostate cancer.
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Gerke Margo Brooke, Bedmutha Akshay, Marra Angelo, Liu Yuan, Brown Jacqueline T, Nazha Bassel, Berchuck Jacob E, Parikh Ravi Bharat, Ahmed Shahid, Ciuro Jordan Alana, Hartman Caitlin, McClintock Greta Russler, Caulfield Sarah, Kucuk Omer, Carthon Bradley Curtis, Schuster David M, Muzahir Saima, Bilen Mehmet Asim
Аннотация
BACKGROUND: Lutetium-177 (177Lu)-PSMA-617 is a beta-emitting radioligand approved for treatment of metastatic castration-resistant prostate cancer (mCRPC), despite the underrepresentation of Black patients in pivotal trials. We analyzed outcomes of 177Lu-PSMA-617 in a racially diverse cohort.
METHODS: Retrospective analysis of patients with mCRPC treated with 177Lu-PSMA-617 was conducted at the Emory Winship Cancer Institute. Primary outcomes assessed were progression-free survival (PFS), overall survival (OS), and prostate-specific antigen (PSA) reduction ≥50% (PSA50). Cox proportional hazard models were used for univariate and multivariate OS and PFS, and logistic regression was used for PSA50 analysis.
RESULTS: Among 163 patients treated with 177Lu-PSMA-617, 97 (59.5%) self-identified as White or other racial groups and 66 (40.5%) self-identified as Black. On univariate analysis, Black patients had comparable OS, PFS, and PSA50 responses to non-Black patients, with a trend toward improved outcomes (OS HR: 0.82, P = .446; PFS HR 0.92, P = .655; PSA50 OR = 1.79, P = .088). Multivariate analysis demonstrated a non-significant prolonged PFS and reduction in mortality risk for Black patients (PFS HR: 0.65, P = .106; OS: HR 0.59, HR P-value .081). The odds of a PSA50 response were 2.45 times higher for Black patients (OR = 2.45, P = .027).
CONCLUSIONS: In our racially diverse cohort of patients with mCRPC, Black patients had PFS and OS comparable to non-Black patients, although wide confidence intervals limit definitive conclusions. Black patients had a significantly greater odds of achieving a PSA50 response. Our findings suggest efficacy of 177Lu-PSMA-617 among Black patients in real-world settings and underscore the importance of improved representation in prospective studies.
METHODS: Retrospective analysis of patients with mCRPC treated with 177Lu-PSMA-617 was conducted at the Emory Winship Cancer Institute. Primary outcomes assessed were progression-free survival (PFS), overall survival (OS), and prostate-specific antigen (PSA) reduction ≥50% (PSA50). Cox proportional hazard models were used for univariate and multivariate OS and PFS, and logistic regression was used for PSA50 analysis.
RESULTS: Among 163 patients treated with 177Lu-PSMA-617, 97 (59.5%) self-identified as White or other racial groups and 66 (40.5%) self-identified as Black. On univariate analysis, Black patients had comparable OS, PFS, and PSA50 responses to non-Black patients, with a trend toward improved outcomes (OS HR: 0.82, P = .446; PFS HR 0.92, P = .655; PSA50 OR = 1.79, P = .088). Multivariate analysis demonstrated a non-significant prolonged PFS and reduction in mortality risk for Black patients (PFS HR: 0.65, P = .106; OS: HR 0.59, HR P-value .081). The odds of a PSA50 response were 2.45 times higher for Black patients (OR = 2.45, P = .027).
CONCLUSIONS: In our racially diverse cohort of patients with mCRPC, Black patients had PFS and OS comparable to non-Black patients, although wide confidence intervals limit definitive conclusions. Black patients had a significantly greater odds of achieving a PSA50 response. Our findings suggest efficacy of 177Lu-PSMA-617 among Black patients in real-world settings and underscore the importance of improved representation in prospective studies.