Almuradova E.Seyyar M.Arak H.Tamer F.Kefeli U.Koca S.Sen E.Telli T.A.Karatas F.Gokmen I.Turhal N.S.Sakalar T.Ayhan M.Ekinci F.Hafizoglu E.Kahraman S.Kesen O.Unal C.Alan O.Celik S.Yekeduz E.Omur O.Gokmen E.2024-07-222024-07-22202400207136http://akademikarsiv.cbu.edu.tr:4000/handle/123456789/11515Metastatic castration-resistant prostate cancer (mCRPC) remains a challenging condition to treat despite recent advancements. This retrospective study aimed to assess the activity and tolerability of Lutetium-177 (Lu-177) PSMA-617 radioligand therapy (RLT) in mCRPC patients across multiple cancer centers in Turkey. The study included 165 patients who received at least one cycle of Lu-177 PSMA-617 RLT, with the majority having bone metastases and undergone prior treatments. Prostate-specific antigen (PSA) levels were assessed before each treatment cycle, and the biochemical response was evaluated in accordance with the Prostate Cancer Work Group 3 Criteria. The PSA decline of ≥50% was classified as a response, while an increase of ≥25% in PSA levels was indicative of progressive disease. Neither response nor progression was considered as stable disease. The Lu-177 PSMA-617 RLT led to a significant PSA response, with 50.6% of patients achieving a >50% decrease in PSA levels. Median overall survival (OS) and progression-free survival were 13.5 and 8.2 months, respectively. Patients receiving Lu-177 PSMA-617 RLT in combination with androgen receptor pathway inhibitors (ARPIs) had a higher OS compared to those receiving Lu-177 PSMA-617 RLT alone (18.2 vs 12.3 months, P =.265). The treatment was generally well-tolerated, with manageable side effects such as anemia and thrombocytopenia. This study provides real-world evidence supporting the effectiveness and safety of Lu-177 PSMA-617 RLT in mCRPC patients, particularly when used in combination with ARPIs. These findings contribute to the growing body of evidence on the potential benefits of PSMA-targeted therapies in advanced prostate cancer. © 2023 UICC.EnglishAll Open Access; Bronze Open AccessDipeptidesHeterocyclic Compounds, 1-RingHumansLutetiumMaleProstate-Specific AntigenProstatic Neoplasms, Castration-ResistantRetrospective StudiesTreatment OutcomeTurkeycreatininevipivotide tetraxetan lutetium lu 177dipeptidelutetiumLutetium-177prostate specific antigenPSMA-617single heterocyclic ringsadultagedanemiaArticlebone metastasiscancer growthcontrolled studydrug safetydrug tolerabilityGleason scorehumanleukopeniamajor clinical studymalemetastatic castration resistant prostate cancermiddle agedmulticenter studymultiple cycle treatmentoverall survivalpatient selectionpHphase 3 clinical trialpositron emission tomography-computed tomographyprogression free survivalretrospective studyside effectsingle photon emission computed tomography-computed tomographythrombocytopeniatreatment outcometreatment responseTurkey (republic)very elderlycastration resistant prostate cancerclinical trialmetabolismtreatment outcometurkey (bird)Article10.1002/ijc.34749