Treatment Patterns and Survival Outcomes in a Real-World Cohort of Lutetium 177 Vipivotide Tetraxetan (LuPSMA)-Experienced Patients With Metastatic Castration-resistant Prostate Cancer (mCRPC).

Authors

Ben Tran, Tanya Dorff, Madeline Richey, Eunice Hankinson, Patrick Olsen, Smriti Karwa, Jason Sharpe, Megan Braunlin, Christopher Kim

Published in

Clinical genitourinary cancer. Volume 24. Issue 6. Pages 102609. Jul 10, 2026. Epub Jul 10, 2026.

Abstract

To evaluate treatments and survival in patients with metastatic castration-resistant prostate cancer (mCRPC) who received subsequent treatment after Lutetium 177 vipivotide tetraxetan (LuPSMA) in the real-world.
This retrospective cohort study included patients with mCRPC who initiated subsequent treatment after LuPSMA up to 07/31/2024 in the US-based Flatiron Health Research Database (FHRD) with follow-up through 07/31/2025. Overall survival was measured from initiation of systemic treatment after LuPSMA until death using the Kaplan-Meier method. Key subgroups were prior taxane exposure in mCRPC (taxane-naïve/post-taxane).
Among 743 patients treated with LuPSMA in the FHRD, 339 (46%) died prior to initiating subsequent therapy and 161(22%) initiated subsequent therapy during the study period. Of the 161 patients who initiated subsequent therapy, 65% (n = 105) had prior taxane therapy. Patients received 43 distinct regimens after LuPSMA; half were chemotherapy-based. The most common regimens were cabazitaxel (19%), cabazitaxel-carboplatin (12%), and enzalutamide (9%). Median duration of post-LuPSMA therapy was 2.4 months. Median overall survival was 8.0 (95% CI: 6.8-11.5) months overall and 6.8 (95% CI: 5.5-9.3) months in post-taxane subgroup (median 4 prior lines of therapy).
The study population reflects real-world LuPSMA use and includes a heterogeneous group of heavily pretreated patients. Systemic therapies after LuPSMA were primarily chemotherapy-based. The short duration of treatments and limited survival highlights the need for novel treatments and sequencing strategies in the post-LuPSMA setting.

PMID:
42546405
Bibliographic data and abstract were imported from PubMed on 04 Aug 2026.

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