Race and Outcomes to [¹⁷⁷Lu]Lu-PSMA-617 in Advanced Prostate Cancer.

Area of Science:

• Oncology
• Radiopharmaceutical Therapy
• Health Disparities

Background:

• Metastatic prostate cancer disproportionately affects Black patients, leading to higher mortality rates compared to White patients.
• Existing data on [177Lu]Lu-PSMA-617 (LuPSMA) efficacy across racial groups in metastatic castration-resistant prostate cancer (mCRPC) is limited.
• Racial disparities in cancer outcomes necessitate investigation into novel treatment effectiveness across diverse populations.

Purpose of the Study:

• To evaluate the association between race and clinical outcomes in patients with mCRPC treated with LuPSMA.
• To compare prostate-specific antigen (PSA) response rates, PSA-progression-free survival (PSA-PFS), and overall survival (OS) between racial groups receiving LuPSMA.
• To identify potential disparities in LuPSMA treatment outcomes based on race.

Main Methods:

• A multi-institutional retrospective cohort study of consecutive mCRPC patients treated with LuPSMA.
• Analysis included 654 patients: 91% White, 7% Black, and 2% non-Black minority (NBM).
• Statistical models adjusted for age, prior therapies, metastatic sites, and baseline PSA to assess outcomes (PSA-50, PSA-PFS, OS) by race.

Main Results:

• No statistically significant differences were observed in PSA-50 rates between Black and White patients.
• [177Lu]Lu-PSMA-617 treatment demonstrated comparable PSA-PFS and OS in Black and White patient cohorts.
• Outcomes were similar across racial groups, including Black, White, and NBM patients, after adjusting for clinical covariates.

Conclusions:

• [177Lu]Lu-PSMA-617 shows similar efficacy in Black and White patients with mCRPC.
• Equitable access to LuPSMA and other life-prolonging therapies is crucial for Black and NBM patients to mitigate existing outcome disparities.
• Further research and policy interventions are needed to ensure equal access and reduce racial disparities in advanced prostate cancer treatment.