Adoption of Lutetium-177 PSMA radioligand therapy for metastatic castration resistant prostate cancer: a total population analysis in Germany from 2016 to 2020

Abstract

Purpose This study is to investigate the adoption and current trends of Lutetium-177 PSMA RLT for mCRPC in Germany. Methods We analyzed data from the reimbursement.INFO tool based on German hospitals’ quality reports for Lutetium-177 PSMA RLT from 2016 to 2020 and from the nationwide German hospital billing database (Destatis) for general therapy with open radionuclides in combination with prostate cancer from 2006 to 2020. For validation of these billing data, we included the 177Lu-PSMA RLT cycles from two participating institutions from 2016 to 2020. For detection of trends over time we applied linear regression models. Results General therapy with open radionuclides increased from 2006 to 2020. We identified a total of 12,553 177Lu-PSMA RLT cycles. The number of 177Lu-PSMA RLTs steadily increased from a total of 1026 therapies in 2016 to 3328 therapies in 2020 (+ 576 RLT/year; p < 0.005). In 2016, 25 departments of nuclear medicine offered this treatment, which increased to 44 nuclear medicine departments in 2020. In 2016, 16% of nuclear medicine departments (4/25) performed more than 100 177Lu-PSMA RLTs, which increased to 36% (16/44) in 2020 (p < 0.005). In 2016, 88% (22/25) of 177Lu-PSMA RLTs were performed at a university hospital, which decreased to 70% (31/44) in 2020. The proportion of patients older than 65 years receiving 177Lu-PSMA RLT increased from 78% in 2016 to 81% in 2020. Conclusion Treatment of mCRPC with 177Lu-PSMA RLT has been rapidly increasing in Germany in the recent years providing an additional therapy option. This development is remarkable, because of outstanding formal EMA approval.

Diffuse Pneumonitis after Lutetium-177-PSMA-617 Treatment in a Patient with Metastatic Castration-Resistant Prostate Cancer

“…The management of advanced prostate cancer presents a formidable challenge due to the inherent variability in its clinical and pathological behaviour. However, the expanding field of theragnostics, which fuses therapeutic interventions with dedicated imaging procedures to identify biological targets, holds significant promise in addressing this issue 2…”

“…177 Lu -PSMA-617, a PSMA-targeting ligand labelled with a beta-emitting radioisotope, has demonstrated increased overall survival and imaging-based progression-free survival for patients with mCRPC when added to the standard of care (SOC) as demonstrated by the VISION trial and has become rapidly adopted for the treatment of mCRPC 2 4. However, this combination is associated with an increased incidence of grade 3 or higher adverse events (52.7%) compared with SOC alone (38.0%).…”

Hand in Hand – die Zukunft der SPECT- und PET-Bildgebung

“…Deutschland nimmt hierbei eine führende Rolle in der nuklearmedizinischen Forschung und Entwicklung ein. Zukunftsfelder wie Alzheimer-Diagnostik (ENABLE-Studie), Prostatakarzinom-Theranostik [4] und nicht zuletzt die kontinuierliche Entwicklung weiterer spezifischer Radiopharmaka sind erfolgreich besetzt und werden auch von der radiopharmazeutischen Industrie aufgegriffen. Entsprechend zeigt sich eine vermehrte öffentliche Wahrnehmung, wachsende Akzeptanz und Inanspruchnahme radionuklidgestützter Untersuchungsverfahren sowie eine verbesserte Finanzierung u. a. durch die Beurteilung des Gemeinsamen Bundesausschuss (G-BA).…”