Concomitant treatment with 2nd generation hormone therapy and 177Lut PSMA versus 177Lut PSMA alone: Does it improve PSA response rates?

Abstract

e17081 Background: Prostate cancer is the most common cancer in men. In early localized disease, surgery represents the mainstay treatment. However, management of metastatic and advanced stages requires multidisciplinary approach. The prognosis in metastatic prostate cancer has improved recently due to advanced pharmaceutical and interventional methods of treatment with modern diagnostic methods. In our study, we aim to investigate the impact of concomitant treatment with 2nd generation hormonal therapy and 177Lut PSMA on PSA response in patients with metastatic CRPC Methods: In a retrospective observation study including 91male patients with metastatic CRPC treated with 177Lut PSMA, we divided our cohort into 2 groups depending on whether they had 2nd generation hormonal therapy alongside their treatment with 177Lut PSMA. 43 patients received 177Lut PSMA (group A). While the other 48 patients (group B) had 2 nd generation hormone therapy with 177Lut PSMA. Primary endpoint was PSA response after they complete their therapy. Favorable PSA response was defined by PSA reduction more than 50% from baseline PSA before treatment Results: Statistical analysis identified 91 male patients, median (IQR) age of 61.5 years (56,67.75). Median (IQR) Gleason score 8 (7 - 9). Pre-177Lut PSMA PSA had a median of 2 (0.255 - 99), post-177Lut PSMA had a median of 0.15 (0.1 - 2.7). Median (IQR) 177Lut PSMA 6 (5 - 6). There was no significant change in PSA response in patients who received 177Lut PSMA alone versus 177Lut PSMA with concomitant 2 nd generation hormonal therapy. Of that, 54.17% of group B had favorable PSA response compared to 48.84% of group A (P value 0.6115). In multivariable analysis, concomitant treatment with 2nd generation hormone therapy and 177Lut PSMA has no impact on PSA response rates. Conclusions: This data suggests that concomitant treatment with 2nd generation therapy and 177Lut PSMA did not demonstrate superior PSA response than treatment with 177Lut PSMA alone. This data contributes to the current literature and serve in patients counseling. Further studies are warranted.