Multinational retrospective study of actinium-225-PSMA radioligand therapy for metastatic castration-resistant prostate cancer
Actinium-225 prostate-specific membrane antigen (225Ac-PSMA) is a novel radioligand therapy for metastatic castration-resistant prostate cancer (mCRPC). The retrospective WARMTH Act study, at seven centers in four countries, evaluated safety and activity of 225Ac-PSMA for mCRPC in patients who had received taxane-based chemotherapy, androgen-receptor-axis inhibitors, lutetium-177 PSMA, or radium-223 dichloride. The figure shows the effect of 225AC-PSMA on PSA value. The median overall survival was 15.5 months (95% CI 13.4-18.3) and the median progression-free survival was 7.9 months (6.8-8.9). Xerostomia was a common side effect. No serious adverse events or treatment-related deaths were recorded. The authors conclude that 225Ac-PSMA radioligand therapy showed a substantial antitumor effect in mCRPC, and is a viable option in patients treated with previous lines of approved agents.