PSMA-Targeted Treatment Improves Bone-Related Pain in Metastatic, Castration-Resistant Prostate Cancer

Prostate cancer that spreads to the bones can cause patients to feel aches and pains, putting a major burden on their day-to-day life. However, recent research showed that patients treated with Lutetium-177 PSMA-617 tended to not only have better survival outcomes, but improved bone pain-related quality of life, too.

Researchers surveyed 50 men with metastatic, castration-resistant prostate cancer who were being treated with Lutetium-177 PSMA-617, a prostate-specific membrane antigen (PSMA)-targeted radionuclide, with a focus on their pain related to bone metastases and overall quality of life. Their findings were presented at the 2022 ASCO Genitourinary Cancers Symposium.

“We found that men who completed the survey on bone-metastasis-related pain and quality of life reported improvements, on average, in bone-metastasis-related pain and their ability to function despite that pain,” said study author Brian D. Gonzalez, a Health Outcomes and Behavior researcher at the Moffitt Cancer Center in Tampa, Florida, in an interview with CURE®’s sister publication, Urology Times®.

At the follow-up, which was six or 12 weeks after their final injection with Lutetium-177 PSMA-617, 37 patients were still alive, and 25 provided data that was able to be evaluated regarding bone metastasis-related pain. Ten patients (40%) said that they reported less functional interference from their pain, as well as lower pain consistency, intermittency and difficulty alleviating pain over time.

On average, patients saw the biggest increase in functional ability despite bone pain from baseline to the second cycle of treatment.

Not only did this study find an improvement in quality of life, but previous research has shown that treatment with Lutetium-177 PSMA-617 also tends to improve progression-free survival (defined as the time between treatment and a patient’s disease getting worse), overall survival and patient-reported outcomes. However, more work needs to be done since not all patients involved in the study were able to provide data on their pain.

“A caveat is that there were several patients who were unable to complete the survey in this longitudinal study because some of them had passed away, or some of them felt unwell or were unwilling or unable to attend visits,” Gonzalez mentioned.

Regardless of the type of treatment that they are undergoing, Gonzalez stressed that having open communication with the clinicians regarding bone pain or any other cancer-related symptoms is essential.

“The number one thing to do if patients are experiencing pain or any other symptom or toxicity during treatment is to let their medical team know,” he said. “To let the oncologist or provider know (about the pain) allows the provider to discuss whether this is expected or uncommon, but more importantly, what they can do about it.”

Gonzalez said that one of the main goals of this study was to ensure that patients were being open with their treatment team, which can lead to better management of symptoms.

“That’s the purpose of this and many other projects, which is to empower patients to report their symptoms and therefore get treatment for them and get those issues resolved,” he concluded.

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