177 lu-psma radioligand therapy is favorable as third-line treatment of patients with metastatic castration-resistant prostate cancer. A systematic review and network meta-analysis of randomized controlled trials

Finn E. von Eyben, Kalevi Kairemo, Channing Paller, Manuela Andrea Hoffmann, Giovanni Paganelli, Irene Virgolini, Giandomenico Roviello

Research output: Contribution to journalReview articlepeer-review

Abstract

In this systematic review and network meta-analysis (NMA), we aimed to assess the benefits and harms of third-line (L3) treatments in randomized controlled trials (RCTs) of patients with metastatic castration-resistant prostate cancer (mCRPC). Two reviewers searched for publications from 1 January 2006 to 30 June 2021. The review analyzed seven RCTs that included 3958 patients and eight treatments. Treatment with prostate-specific membrane antigen (PSMA)-based radioligand therapy (PRLT) resulted in a 1.3-times-higher rate of median PSA decline ≥50% than treatment with abiraterone, enzalutamide, mitoxantrone, or cabazitaxel (p = 0.00001). The likelihood was 97.6% for PRLT to bring about the best PSA response, out of the examined treatments. PRLT resulted in a 1.1-times-higher six-month rate of median radiographic progression-free survival. Treatment with PRLT in the VISION trial resulted in 1.05-times-higher twelve-month median overall survival than L3 treatment with cabazitaxel in other RCTs. PRLT more often resulted in severe thrombocytopenia and less often in severe leukopenia than did cabazitaxel. In conclusion, for patients with mCRPC, L3 treatment with PRLT is highly effective and safe.

Original languageEnglish (US)
Article number1042
JournalBiomedicines
Volume9
Issue number8
DOIs
StatePublished - Aug 2021

Keywords

  • Advanced metastatic castration-resistant prostate cancer
  • Benefits and harms of treatments
  • Connected network
  • Frequentist analysis
  • Ranking of treatments

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Biochemistry, Genetics and Molecular Biology(all)

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