Decline in PSA levels is associated with improved survival

Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy (RLT) is inceasingly included in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC). 

In this analysis, 184 patients were treated with ¹⁷⁷Lu-PSMA RLT. Response to treatment was defined as decrease in PSA levels 8 weeks after the first cycle of RLT. Any decline of more than 50% was compared in responders and non-responders. A total of 114/184 patients showed any PSA decline, results found individuals exhibiting a PSA decline of more than 50% had overall survival of 19 months as compared with only 8 months in the non-responders.

In mCRPC patients scheduled for radioligand therapy, early biochemical response was tightly linked to prolonged survival irrespective of the magnitude of PSA decline. RLT therapy should be continued even in patients with PSA decrease of less than 50%.

The Prostate. 2022, July 21;https://doi.org/10.1002/pros.24414