An innovative treatment extends survival for patients with metastatic prostate cancer
A new radioligand therapy that specifically targets cancer cells significantly improves the management of men with advanced prostate cancer. This treatment uses lutetium-177 combined with a molecule that binds to a protein called PSMA, which is present in large quantities on the surface of prostate tumor cells. This approach delivers radiation directly to the heart of tumors while sparing healthy tissue, thereby reducing side effects.
The study involved 43 Brazilian patients with this aggressive form of cancer, who had already been treated with other therapies without success. The median age of participants was 74 years, and nearly half had visceral metastases, meaning tumors that had spread to organs such as the liver, lungs, or central nervous system. These metastases are often associated with a poorer prognosis and a less favorable response to treatments.
The results show that nearly 45% of patients saw their prostate-specific antigen levels—a key marker of disease progression—drop by 50% or more after treatment. Among those with visceral metastases, this response rate was 33%. The median overall survival reached 13.9 months for all patients, with a 12-month survival rate of 55.5%. These figures are comparable to those observed in previous clinical trials, despite a patient profile that was older and more heavily pretreated.
Patients who responded well to treatment—that is, those whose prostate-specific antigen levels decreased significantly—benefited from a longer median survival, reaching 19.2 months. In contrast, those without a favorable response had a median survival of only 9.6 months. This difference highlights the importance of biological response in predicting treatment efficacy.
The treatment was generally well tolerated, with only 16% of patients experiencing serious adverse effects, primarily hematological complications such as a significant drop in blood platelets or white blood cells. Two cases of neurological complications, related to cerebral edema, were also reported in patients with metastases in the skull or central nervous system.
More than half of the patients were able to receive subsequent therapies after disease progression, with a median delay of 2.9 months before starting a new treatment. This shows that this treatment can also serve as a bridge to other therapeutic options.
This study confirms that lutetium-177 combined with the PSMA-targeting molecule offers an effective alternative for patients who have failed other therapies, even in real-world contexts where resources and access to care may be limited. It also highlights the need to develop more active treatment combinations for patients with visceral metastases, whose response remains insufficient.
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Official Study Source
DOI: https://doi.org/10.1186/s41824-026-00305-8
Title: 177Lutetium-PSMA-I&T therapy for metastatic castration-resistant prostate cancer (mCRPC): the first multicenter real-world study of 177Lu-PSMA-I&T in Brazil
Journal: EJNMMI Reports
Publisher: Springer Science and Business Media LLC
Authors: Helena F. Bruzzi; Gabriela C. K. Lopes; Hannah B. V. Bekierman; Sergio Altino de Almeida; José Alexandre Pedrosa; Camila Mosci; Haonne S. Abboud; Christiane Magalhães; Isabella Palazzio; Laura Fernandes; Vinicius Freire da Silva; Juliana Tarouquella da Silva Andrade; Daniel Herchenhorn