To describe survival outcomes among patients with metastatic androgen pathway modulator–resistant prostate cancer treated with Lu-177 PSMA, by treatment line and timing of taxane exposure.
Approach:
Design and data: Retrospective cohort study using Flatiron Health electronic health record data from US community and academic oncology practices.
Participants: Included 850 patients with metastatic androgen pathway modulator–resistant prostate cancer who had received an androgen receptor pathway inhibitor before Lu-177 PSMA.
Analysis: Patients were grouped by treatment line and taxane exposure before, after, or not at all. Kaplan-Meier methods estimated clinical time to next treatment (TTNT) and overall survival (OS); analyses were descriptive, without hypothesis testing.
Key Findings:
Overall median clinical TTNT was 8.5 months (95% CI, 8.0-9.2), and median clinical OS was 13.0 months (95% CI, 12.0-14.0).
Lu-177 PSMA was given in the third or fourth treatment line to 434 patients (51.1%).
Taxane exposure preceded Lu-177 PSMA in 466 patients (54.8%); 35 (4.1%) received taxane afterward, and 349 (41.1%) had no taxane exposure.
For patients with prior taxane exposure, median TTNT was 8.0 months (95% CI, 7.4-9.0) and median OS was 12.0 months (95% CI, 11.0-13.0).
For patients with no taxane exposure, median TTNT was 10.0 months (95% CI, 9.2-11.0) and median OS was 14.0 months (95% CI, 13.0-17.0).
For patients receiving taxane after Lu-177 PSMA, median TTNT was 6.0 months (95% CI, 4.9-8.0) and median OS was 16.0 months (95% CI, 13.0 to not reached).
Interpretation:
The authors reported that outcomes were generally similar across treatment lines and taxane-sequencing groups. They noted that the observational findings are consistent with contemporary studies reporting survival with Lu-177 PSMA across lines of prior therapy.
Limitations:
The study was retrospective and based on electronic health record data.
Analyses were descriptive and did not include hypothesis testing.
The supplied context does not provide the full discussion of study limitations.
Conclusion:
The cohort provides descriptive estimates of clinical TTNT and OS after Lu-177 PSMA treatment across treatment-line and taxane-exposure groups.
Harold Burstein, MD, PhD, and Ana C. Garrido-Castro, MD discuss new results from the PANKU-Breast02 Study on a new dual-antibody drug conjugate, called izalontamab brengitecan (iza-bren), for metastatic triple-negative breast cancer.
