A systematic review and meta-analysis on safety and efficacy of Lu-177 PSMA-617 and standardized treatment in mCRPC from randomized phase II/III trials.
Rattachement africain : us, pk, in. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
e17069 Background: Lu-177 PSMA-617 delivers targeted β-radiation to prostate cancer cells, offering a distinct mechanism beyond androgen-signaling inhibition in metastatic castration-resistant prostate cancer (mCRPC). Pivotal trials have shown improved progression-free survival with favorable tolerability. As its clinical use expands, comparative evidence with established systemic therapies remains limited. This meta-analysis evaluates the pooled efficacy and safety outcomes. Methods: A systematic review and meta-analysis were performed according to PRISMA guidelines to evaluate Lu-177 PSMA-617 in mCRPC. Of 456 studies screened, seven met eligibility criteria and were included in the final analysis. Data on progression-free survival (PFS), overall survival (OS), and grade ≥3 adverse events (AEs) were extracted and pooled using a random-effects model (REML method). Hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed using the I² statistic, and publication bias was evaluated using both Egger’s regression and Begg’s rank correlation. Results: A total of 2,526 patients from seven randomized trials were analyzed, including 1,365 in the Lu-177 PSMA-617 arms and 1,161 in the standard-of-care arms. Lu-177 PSMA-617 significantly improved PFS compared with control (pooled HR = 0.64; 95% CI 0.50–0.81; p < 0.001). No significant difference was observed in OS (HR = 0.91; 95% CI 0.66–1.25; p = 0.55). The pooled RR for grade ≥ 3 AEs was 0.98 (95% CI 0.83–1.14; p = 0.75). Conclusions: Across contemporary randomized trials, Lu-177 PSMA-617 consistently prolongs PFS with no significant difference in AEs. OS benefit remains unconfirmed, likely reflecting post-progression and salvage use of Lu-177 PSMA-617 in control arms in some trials, as well as disease and trial heterogeneity. The data collectively reinforce Lu-177 PSMA-617 as a well-tolerated, effective radioligand option for advanced mCRPC, warranting continued integration into earlier disease settings and combination strategy. Pooled Overall Survival comparing Lu-177 PSMA-617 and standard of care. Study HR OS for Lu-177 PSMA-617 vs standard PSMAFore 0.98 (0.75-1.28) SPLASH 1.11(0.73-1.69) VISION 0.62 (0.52-0.74) TheraP 0.97 (0.70-1.35) Enza-P 0.55 (0.36-0.84) CCT Group 1.64 (1.14-2.35) Pooled Results 0.91 (0.66-1.25)
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A systematic review and meta-analysis on safety and efficacy of Lu-177 PSMA-617 and standardized treatment in mCRPC from randomized phase II/III trials.
- Date Crossref
- 01/06/2026
- Éditeur
- American Society of Clinical Oncology (ASCO)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Miami Heart Research Institute pays non établi dans la noticeÉtablissement de santé
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Baptist Hospital of Miami pays non établi dans la noticeÉtablissement de santé
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Miami Heart Research Institute, Baptist Hospital of Miami et Baptist Health South Florida, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.