Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2025 Feb;52(3):936-954.
doi: 10.1007/s00259-024-06932-2. Epub 2024 Oct 25.

Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis

Ludmila Santiago Almeida  1   2 , Irene García Megías  2 , Elba Cristina Sá Camargo Etchebehere  1   3 , Adriana K Calapaquí Terán  4   5   6 , Ken Herrmann  7   8 , Francesco Giammarile  9 , Giorgio Treglia  10   11   12 , Roberto C Delgado Bolton  13   14
Affiliations
Meta-Analysis

Assessment of the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer: A systematic review and meta-analysis

Ludmila Santiago Almeida et al. Eur J Nucl Med Mol Imaging. 2025 Feb.

Abstract

Introduction and aim: Radioligand therapy (RLT) with 177Lu-labelled prostate specific membrane antigen ([177Lu]Lu-PSMA-X, referring with "PSMA-X" to a generic PSMA chemical compound) inhibitors has emerged as a viable treatment option in metastatic castration resistant prostate cancer patients having previously progressed on taxane and androgen receptor inhibitors. The aim of this study was to perform a systematic review and meta-analysis to assess the therapeutic efficacy of [177Lu]Lu-PSMA-X compared to taxane chemotherapy in taxane-chemo-naïve patients with metastatic castration-resistant prostate cancer.

Materials and methods: Searches in several bibliographic databases were made using relevant key words, and articles published up to March 2024 were included. The endpoints included prostate specific antigen (PSA) response rate (RR), progression-free survival, and overall survival. Individual patient data were pooled when feasible. PSA50 was defined as the median proportion of patients achieving at least a 50% decline in serum PSA from baseline. A meta-analysis of the PSA50 response rate (proportion meta-analysis) was performed, generating pooled estimates and 95% confidence intervals (95% CI).

Results: From the initially selected 8,414 studies published between 2019 and 2023, 24 were included in the [177Lu]Lu-PSMA-X treated group and 17 in the taxane treated group. Our findings show that [177Lu]Lu-PSMA-X RLT yielded comparable PSA50 responses in taxane-naïve patients versus those receiving taxane chemotherapy, despite considerable study heterogeneity. Notably, the taxane-naïve group had more extensive pretreatment.

Conclusions: This meta-analysis combines the largest cohorts of taxane-naïve mCRPC patients treated with [177Lu]Lu-PSMA-X RLT and taxane-treated mCRPC. It underscores similar PSA50 response rates in both groups, suggesting a potential role for [177Lu]Lu-PSMA-X RLT in taxane-naïve patients who cannot or choose not to undergo chemotherapy.

Keywords: Chemo-naïve; Meta-analysis; PSMA; Prostate cancer; Radioligand; Systematic review; Theragnostic; Therapy; Trial.

PubMed Disclaimer

Conflict of interest statement

Declarations. Research involving human participants and/or animals: This study is a systematic review. Therefore, this is not applicable. Informed consent: This study is a systematic review. Therefore, this is not applicable. Conflicts of interest: LSA: This work was supported in part by the PrInt (Institutional Program for Internationalization) scholarship given to LSA (reference number: PRINT – 88887.716546/2022–00) by the CAPES (Coordination for the Improvement of Higher Education Personnel) Foundation, within the Brazilian Ministry of Education, Government of Brazil. KH: Reports personal fees from Bayer, personal fees and other from Sofie Biosciences, personal fees from SIRTEX, non-financial support from ABX, personal fees from Adacap, personal fees from Curium, personal fees from Endocyte, grants and personal fees from BTG, personal fees from IPSEN, personal fees from Siemens Healthineers, personal fees from GE Healthcare, personal fees from Amgen, personal fees from Fusion, personal fees from Immedica, personal fees from Onkowissen.de, personal fees from Novartis, personal fees from Molecular Partners, personal fees from ymabs, personal fees from Aktis Oncology, personal fees from Theragnostics, personal fees from Pharma15, personal fees from Debiopharm, personal fees from AstraZeneca, personal fees from Janssen. The rest of the authors (IGM, ECSCE, AKCT, FG, GT and RCDB) report they have no conflict of interest.

Similar articles

See all similar articles

Cited by

References

    1. IARC. WHO. Data visualization tools for exploring the global cancer burden in 2020. Access date December 2022. https://gco.iarc.fr/today/home Last Accessed May 1, 2024.
    1. Brausi M, Hoskin P, Andritsch E, Banks I, Beishon M, Boyle H, et al. ECCO Essential Requirements for Quality Cancer Care: Prostate cancer. Crit Rev Oncol Hematol. 2020;148:102861. https://doi.org/10.1016/j.critrevonc.2019.102861 . - DOI - PubMed
    1. EAU guidelines access date https://uroweb.org/guidelines/prostate-cancer/chapter/epidemiology-and-a... Last Accessed May 1, 2024.
    1. https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1459 Last Accessed May 1, 2024.
    1. Ingrosso G, Detti B, Scartoni D, Lancia A, Giacomelli I, Baki M, et al. Current therapeutic options in metastatic castration-resistant prostate cancer. Semin Oncol. 2018;45:303–15. https://doi.org/10.1053/j.seminoncol.2018.10.001 . - DOI - PubMed

MeSH terms

LinkOut - more resources