[177Lu]Lu-PSMA-617 (177Lu-PSMA-617) plus protocol-permitted standard of care (SOC) prolonged overall survival (OS) and radiographic progression-free survival (rPFS) versus SOC in patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) in the phase 3 VISION study, in addition to beneficial effects on symptomatic skeletal events (SSEs) and health-related quality of life (HRQOL).
Post hoc analyses used the full analysis set from the VISION study (N = 831) overall and by randomized treatment arm (177Lu-PSMA-617 plus SOC, n = 551; SOC, n = 280). Correlations were determined between OS and rPFS and between rPFS or OS and time to SSE or to worsening HRQOL (Functional Assessment of Cancer Therapy-Prostate [FACT-P] and 5-level EQ-5D [EQ-5D-5L]). Correlation analyses used an iterative multiple imputation copula-based approach (correlation coefficients [rho] of <0.3 were defined as weak, ≥0.3 and <0.5 as mild, ≥0.5 and <0.7 as moderate, and ≥0.7 as strong).
In the overall population, rPFS correlated strongly with OS (rho, ≥0.7). Correlations between rPFS or OS and time to SSE without death were weak or mild. Time to worsening in the FACT-P total score and emotional and physical well-being domains correlated mildly or moderately with rPFS and moderately with OS. Correlation coefficients for time-to-worsening EQ-5D-5L scores were mild to moderate for both rPFS and OS. Correlation coefficients were similar between treatment arms.
In this analysis of the VISION study, rPFS correlated strongly with OS but not with time to SSE or worsening HRQOL. These findings require further investigation.
Cancer. 2024 Jun 21 [Epub ahead of print]
Michael J Morris, Johann de Bono, James Nagarajah, Oliver Sartor, Xiao X Wei, Luke T Nordquist, Vadim S Koshkin, Kim N Chi, Bernd J Krause, Ken Herrmann, Kambiz Rahbar, Adrian Vickers, Osvaldo Mirante, Ray Ghouse, Karim Fizazi, Scott T Tagawa
Memorial Sloan Kettering Cancer Center, New York, New York, USA., The Institute of Cancer Research and Royal Marsden Hospital, London, UK., Radboud University Medical Center, Nijmegen, the Netherlands., Mayo Clinic, Rochester, Minnesota, USA., Dana-Farber Cancer Institute, Boston, Massachusetts, USA., XCancer, Omaha, Nebraska, USA., Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, San Francisco, California, USA., University of British Columbia, Vancouver, British Columbia, Canada., Rostock University Medical Center, Rostock, Germany., University Hospital Essen, Essen, Germany., University Hospital Muenster, Muenster, Germany., RTI Health Solutions, Manchester, UK., Advanced Accelerator Applications, a Novartis company, Geneva, Switzerland., Institut Gustave Roussy, University of Paris-Saclay, Villejuif, France., Weill Cornell Medicine, New York, New York, USA.