Outcomes for Patients with Metastatic Castration-Resistant Prostate Cancer and Liver Metastasis Receiving...

Area of Science:

• Oncology
• Nuclear Medicine
• Prostate Cancer Research

Background:

• Metastatic castration-resistant prostate cancer (mCRPC) with liver involvement often shows limited response to systemic therapies.
• Data on outcomes for patients with liver metastases treated with lutetium-177 PSMA (LuPSMA) are limited.
• Previous trials reported hazard ratios but not absolute survival durations for this specific patient subgroup.

Purpose of the Study:

• To evaluate prostate-specific antigen (PSA) response and overall survival (OS) in patients with mCRPC and liver metastases treated with LuPSMA.
• To compare outcomes between patients with and without liver metastases receiving LuPSMA.
• To identify prognostic factors, including liver metastasis, associated with survival in LuPSMA-treated patients.

Main Methods:

• Retrospective analysis of real-world clinical data from 273 patients treated with LuPSMA at a single institution.
• Patients categorized based on the presence or absence of liver metastasis on pretreatment PSMA PET/CT.
• Comparison of PSA response rates (χ² testing) and OS (Kaplan-Meier, Cox regression) between groups.

Main Results:

• 15.75% of patients had liver metastasis; they received fewer LuPSMA cycles (median 3 vs. 5).
• Lower PSA response rates were observed in patients with liver metastasis (30.23% vs. 49.77%, P=0.019).
• Median OS was significantly shorter for patients with liver metastasis (8.35 months vs. not reached, P<0.001); liver metastasis was an independent predictor of shorter survival (HR, 4.06; P<0.001).

Conclusions:

• The presence of liver metastasis is a significant predictor of poorer outcomes in patients treated with LuPSMA.
• Current LuPSMA therapy demonstrates reduced efficacy in patients with liver metastases.
• Further research into alternative or combination therapies is crucial to improve outcomes for this patient subgroup.