Prostat kanserinde Lutetium-177-PSMA tedavisi: tek merkezli gerçek yaşam deneyimi

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Aim: Lutetium-177–labeled PSMA radioligand therapy has emerged as a promising option in metastatic castration-resistant prostate cancer (mCRPC), yet real-world data remain limited. This study aimed to evaluate clinical features, treatment patterns, and predictors of response in patients treated with Lutetium-177-PSMA therapy at a single academic center. Material and Methods: We retrospectively analyzed 49 patients with mCRPC who received Lutetium-177-PSMA between January 2020 and January 2025. Treatment response was defined as a ≥50% decline in PSA (PSA50). Associations between baseline variables and PSA50 were examined using Mann–Whitney U tests, and predictive biomarkers were evaluated by receiver operating characteristic (ROC) analysis. Results: The PSA50 response rate was 41.7%. Lower baseline PSA (p = 0.023), ALP (p = 0.037), and LDH (p = 0.004) levels, and higher hemoglobin (p = 0.024), were significantly associated with response. Hemoglobin demonstrated the highest discriminatory performance (AUC = 0.692), while PSA, ALP, and LDH showed significant but limited predictive value. Treatment was well tolerated, with only one case of grade 3-4 hematologic toxicity. Conclusion: Lutetium-177-PSMA therapy provides clinical benefit in real-world mCRPC patients. Lower tumor burden and preserved hematologic status may predict better biochemical response, with hemoglobin serving as a moderately accurate biomarker. Prospective validation is warranted.

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