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SUO 2023: Toxicity Trends With Radioligand Therapy for Prostate Cancer

By: Julia Fiederlein Cipriano, MS
Posted: Tuesday, December 5, 2023

Although mild to moderate short-term side effects are not uncommon during or shortly after treatment with the radiolabeled antibody lutetium-177–PSMA (177-Lu–PSMA) among patients with metastatic castration-resistant prostate cancer, the majority may be managed in an outpatient setting, according to Mohamed E. Ahmed, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues. The results of their real-world retrospective analysis, which were presented during the 2023 Society of Urologic Oncology (SUO) Annual Meeting (Poster 27), also revealed an association between high Eastern Cooperative Oncology Group (ECOG) performance status scores and increased incidences of both emergency room visits and hospital admissions.

The investigators focused on 185 patients who received 177-Lu–PSMA between April 2022 and November 2022. The median patient age and prostate-specific antigen level was 70 years and 11.8 ng/mL, respectively, at the time of the first cycle of treatment. Among the side effects known to be attributed to this radioligand therapy, those observed most frequently during or shortly after were gastrointestinal: nausea (19.5%), vomiting (19.5%), abdominal pain (9.2%), and constipation (8.6%). Fatigue (29.2%) and dry mouth (4.9%) were also documented.

A total of 16 patients (8.6%) visited the emergency room within 30 days after receiving 177-Lu–PSMA. Among this population, two had anemia and thrombocytopenia (1.1% of all patients), two had pneumonia and acute respiratory failure (1.1%), two had abdominal pain and vomiting (1.1%), two had sepsis and septic shock (1.1%), and one had an intestinal obstruction and perforated appendicitis (0.5%). Two patients (1.1%) were hospitalized within 30 days after receiving this radioligand therapy because of severe anemia. High ECOG performance status scores were found to be associated with increased incidences of both emergency room visits (P = .017) and hospital admissions (P = .007).

“Larger studies are warranted to further characterize the real-world intensification of care following treatment with 177-Lu–PSMA,” the investigators concluded.

Disclosure: No information regarding conflicts of interest was provided.

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