We aimed to evaluate the efficacy and safety of lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC) following approval in the real-world Canadian clinical context.
Data on the first 50 patients with mCRPC who were treated with lutetium-177-PSMA-617 at a single center in Quebec, Canada, were retrospectively analyzed. Patients were treated with 7.4 GBq of lutetium-177-PSMA-617 administered every six weeks for up to six cycles.
Median (95% confidence interval [CI]) patient age and pre-radioligand therapy prostate-specific antigen levels were 72.55 (65.92-76.77) years and 49.19 (15.61-180.65) ng/mL, respectively. Median (95% CI) time between oncologist referral for radioligand therapy and nuclear medicine consultation or first dose of lutetium-177-PSMA-617 were 12 (7.0-32.0) and 42 (28.0-54.0) days, respectively. Overall, 26.0% of patients completed six radioligand therapy cycles. Declines in prostate-specific antigen levels of 25%, 50%, and 90% were reached in 57%, 51%, and 17% of patients, after a median of two, two, and three cycles, respectively. At last followup, after a mean followup time of 8.5 months, 61% (25/41) of patients not on ongoing therapy were alive, with an estimated median overall survival of 13.0 months (95% CI 8.0-not reached).
Real-world data show that use of lutetium-177-PSMA-617 in patients with mCRPC is feasible in a universal healthcare system, with comparable oncologic activity to that observed in the phase 3 VISION trial. The study is limited by the short followup and its retrospective nature.
Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 2026 Feb 13 [Epub ahead of print]
Frédéric Pouliot, Michele Lodde, Marjorie Besançon, Vincent Castonguay, Antoine Morin-Coulombe, Vincent Fradet, Yves Fradet, Louis Lacombe, Éric Lévesque, Nicolas Marcoux, Paul Toren, Geneviève April, Frédéric Arsenault, Alexis Beaulieu, Narcisse Singbo, Céline Veilleux, Mélanie Tremblay-Boily, Vincent Tremblay, François-Alexandre Buteau, Jean-Mathieu Beauregard
Centre hospitalier universitaire de Québec-Université Laval, Quebec City, QC, Canada.