PQA 08 - PQA 08 Genitourinary Cancer, Patient Safety, and Nursing/Supportive Care Poster Q&A
3309 - Factors Associated with Completion of Treatment Course with Lutetium-177 Vipivotide Tetraxetan in Men with Metastatic Castration-Resistant Prostate Cancer at a Single Institution
Detroit Medical Center/Wayne State University Detroit, MI
A. L. Kieft1, P. Whatts1, and S. R. Miller II2; 1Detroit Medical Center - Wayne State University, Detroit, MI, 2Wayne State University, Detroit, MI
Purpose/Objective(s):Lutetium-177 vipivotide tetraxetan (Lu-177vipivotide) is a recentlyFDA-approvedradiopharmaceutical therapy option for patients diagnosed with metastatic castration-resistant prostate cancer (mCRPC). A clinical trialhas demonstrated an overall survival benefit for patients who received this radiopharmaceutical after progression on androgen deprivation therapy (ADT) and docetaxel compared to standard of care. Careful selection in these heavily pretreated patientsmay help to predict the tolerability of Lu-177 vipivotide, as multiple comorbidities often preclude patients from completing a full course of therapy. In this retrospective review, we assess which factors were associated with early discontinuation of treatment.Materials/
Methods: Patients with mCRPC who had progressed on ADT and docetaxel with disease that had positive uptake in prostate specific membrane antigen (PSMA) PET imaging were evaluated. Patients also underwent pre-procedure laboratory evaluation that demonstrated a white blood cell count (WBC) > 2.5 x 10e9/L, platelets =100 × 10e9/L, hemoglobin (Hg) =9 g/dL, Total bilirubin <1.5 x the upper limit of normal (ULN), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) =3.0 x ULN OR × =5.0 ULN for patients with liver metastases, serum creatinine =1.5 x ULN or creatinine clearance =50 mL/min. Data was gathered from review of electronic medical records. Patients were prescribed 200mCi dose every 6 weeks for 6 cycles. Laboratory evaluations were completed 1 or 2 weeks prior to each infusion of Lu-177 vipivotide. We compared the group of patients that completed all six cycles with those that did not. The Mann-Whitney U test was used for ordinal Karnofsky Performance Scale score (KPS), and the student T-test was used for all other variables. Results: Eighteen patients were initiatedon therapy with Lu-177.Five patients completed treatment while 13did not complete treatment. Patients who did not complete therapy completed a median of 3 cycles.The average age was 74 years,with no difference between those who completed therapy and those who did not (71 vs 75 years, p=0.26).There was also no difference ininitialmean Hg (11 g/dL vs 9.5 g/dL, p</span> = 0.12). There was a difference between the median KPS at consultation of those who completed compared to those that did not (80 vs 70, p=0.048) and platelet count (347× 10e9/L vs 219 × 10e9/L p=0.041). Conclusion: Within the limitations of our small sample size and retrospective study design, we found that careful attention must be paid to KPS and platelet counts, as low values of either of these variables were associated with patients who did not complete the prescribed course.
