177Lu-PSMA can be a promissor therapy in patients with metastatic castration resistant prostate cancer.

Investigate 177Lu-PSMA therapy in Brazilian patients with metastatic castration resistant prostate cancer (mCRPC).

Data for this retrospective multicentric study was collected from 9 Brazilian centers from 6 federative units (SP, PE, CE, RJ, SC and DF) that performed at least two cycles of 177Lu-PSMA therapy in mCRPC. Data with skewed distribution were reported as median (min-max). Primary outcome was overall survival. Secondary outcomes was the maximal PSA response and hematological adverse events (HAE).

A total of 100 males were included, median age = 74 years old (min-max: 54 - 96 years old). 177Lu-PSMA was the fifth (median) line of therapy (min-max 2-10). A total of 333 cycles were performed with a median of 4 cycles (min-max 1-10). The mean overall survival was 12.8 months. Among the 72 patients with data available for the maximal PSA response at any time, 65% presented any PSA decline. 42% presented PSA decline ≥ 50% from baseline. 89% of patients did not present HAE or presented grades 1 or 2 HAE. Only 11% of patients presented grade 3 HAE. 0% of patients presented grade 4 HAE.

177Lu-PSMA therapy was effective and safe in the Brazilian population even with a median of 5th line of therapy (maximum 10th line). Overall survival and PSA decline ≥ 50% from baseline were similar to the literature data. Only 11% of patients presented grades 3 or 4 hematological adverse events.