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Combination Metastasis-Targeted External Beam Radiation Therapy With 177Lu-PSMA-617 in Patients With Advanced

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Metastasis-targeted external beam radiation therapy (M-EBRT) effectively controls localized disease and manages symptoms when combined with lutetium-177 PSMA (177Lu-PSMA) therapy for metastatic prostate cancer. This combination shows good tolerability and may facilitate continued treatment.

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Area of Science:

  • Oncology
  • Radiopharmaceutical Therapy
  • Radiation Oncology

Background:

  • 177Lu-PSMA is effective for metastatic castration-resistant prostate cancer (mCRPC).
  • Localized control of metastatic disease may be needed alongside systemic therapy.
  • Metastasis-targeted external beam radiation therapy (M-EBRT) can complement LuPSMA.

Purpose of the Study:

  • To evaluate the indications, efficacy, and safety of combining M-EBRT with LuPSMA.
  • To assess M-EBRT's role in local disease control and symptom palliation in patients receiving LuPSMA.

Main Methods:

  • Retrospective review of patients treated with LuPSMA and M-EBRT.
  • Analysis of clinical factors driving M-EBRT use.
  • Evaluation of M-EBRT timing relative to LuPSMA therapy.

Main Results:

  • M-EBRT was administered for intracranial/epidural disease, bone pain palliation, and fracture prevention.
  • Most patients (62%) experienced symptom relief post-M-EBRT.
  • Prostate-specific antigen (PSA)50 response was 41%, with heterogeneous magnitude.

Conclusions:

  • M-EBRT is an effective adjunct to LuPSMA for local tumor control and symptom management, particularly for osseous and CNS lesions.
  • The combination therapy demonstrated good tolerability.
  • M-EBRT may facilitate the initiation or continuation of LuPSMA therapy.