177Lu-PSMA radioligand therapy in patients with metastatic castration-resistant prostate cancer: Update 2023 - systematic review

Wolf S, Al Froukh RF
Record ID 32018004889
Authors' objectives: Prostate cancer was the second most common incident cancer in men in 2020. Approximately 10-50% of cases develop metastatic castration-resistant prostate cancer (mCRPC). This systematic review aimed to re-evaluate the evidence about the efficacy and safety of the 177Lutetium prostate-specific membrane antigen radioligand therapy (177Lu-PSMA-RLT) compared to standard care in adult males with PSMA-positive mCRPC.
Authors' results and conclusions: Three randomised controlled trials (RCTs) were included for the evidence synthesis. The evidence of moderate certainty regarding overall survival indicates superiority of 177Lu-PSMA-617 in combination with standard care (without cytotoxic chemotherapy) versus standard care alone. In addition, the evidence shows a potential superiority of the 177Lu-PSMA-617 combination therapy for progression-free survival and health-related quality of life. However, the results should be interpreted with caution owing to the low certainty of the evidence for these outcomes.
Authors' recommendations: Against this background, including 177Lu-PSMA-RLT combined with standard care (without cytotoxic chemotherapy) in the hospital benefit catalogue should be restricted to selected patients and limited to specialised centres. In addition, "self-synthesised" 177Lu-PSMA-RLTs of radiopharmaceutical units could be considered. A re-evaluation is recommended not before 2025 after further RCTs have been published.
Project Status: Completed
Year Published: 2023
URL for additional information: https://eprints.aihta.at/1453/
English language abstract: An English language summary is available
Publication Type: Full HTA
Country: Austria
MeSH Terms
  • Prostatic Neoplasms
  • Lutetium
  • Prostatic Neoplasms, Castration-Resistant
  • Radiopharmaceuticals
  • Radioisotopes
  • Metastatic castration-resistant prostate cancer
  • 177Lu-PSMA
  • efficacy
  • safety
  • Radioligand therapy
Organisation Name: Austrian Institute for Health Technology Assessment
Contact Address: Garnisongasse 7/20, A-1090 Vienna, Austria
Contact Name: office@aihta.at
Contact Email: office@aihta.at
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.