{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T14:42:02Z","timestamp":1793457722801,"version":"4.5.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,7]],"date-time":"2025-04-07T00:00:00Z","timestamp":1743984000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Universit\u00e4tsklinikum Frankfurt"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Purpose<\/jats:title>\n            <jats:p>Radium- 223 and Lutetium- 177 prostate-specific membrane antigen radioligand therapy (Lu- 177-PSMA) are approved for the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC). Data on cancer-control outcomes of sequential therapy of Lu- 177-PSMA after radium- 223 are rare.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Using the Frankfurt Metastatic Cancer database of the Prostate (FRAMCAP) database, we analyzed progression-free (PFS) and overall (OS) survival of patients after radium- 223 pretreatment vs. radium- 223-na\u00efve controls undergoing Lu- 177-PSMA radioligand within 1\u2009st- 7\u2009th line mCRPC treatment.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Of 329 Lu- 177-PSMA mCRPC patients 19% were radium- 223 pretreated, while 81% radium- 223-na\u00efve. The median number of administered mCRPC systemic treatment administrations were significantly higher for radium- 223 pretreated patients (4 vs. 3, <jats:italic>p<\/jats:italic>\u2009&lt; 0.01). No difference in further baseline or cancer characteristics were observed, similar to PSA response under Lu- 177-PSMA treatment. In PFS analyses, no significant difference between radium- 223 pretreated vs. radium- 223-na\u00efve Lu- 177-PSMA mCRPC patients were observed, with median PFS of 16 vs. 12 months (hazard ratio [HR]: 0.73, confidence interval [CI]: 0.52\u20131.02, p\u2009= 0.063). In OS analysis, also no significant differences were observed with median OS of 18 vs. 15 months for radium- 223 pretreated vs. radium- 223-na\u00efve Lu- 177-PSMA mCRPC patients (HR: 0.99, CI: 0.71\u20131.37, p\u2009&gt; 0.9). Finally, after additional multivariable adjustment, no differences in PFS and OS outcomes between both groups were observed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Sequential treatment with radium- 223 prior to Lu- 177-PSMA does not affect PFS or OS outcomes in mCRPC patients. Therefore, this real-world cohort suggests that both radiopharmaceuticals can be administered within mCRPC treatment algorithm.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00259-025-07256-5","type":"journal-article","created":{"date-parts":[[2025,4,6]],"date-time":"2025-04-06T23:20:25Z","timestamp":1743981625000},"page":"4025-4032","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Cancer-control outcomes of Radium- 223-pretreated lutetium- 177-PSMA Radioligand vs. Radium- 223-na\u00efve mCRPC patients"],"prefix":"10.1007","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4338-0889","authenticated-orcid":false,"given":"Mike","family":"Wenzel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lena","family":"Theissen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Groener","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maximilian","family":"Kriegmair","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Graefen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Maurer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georg","family":"Salomon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Hoeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Siech","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Severine","family":"Banek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix K. 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Ethics approval was granted by the Ethics Committee of Goethe University Hospital Frankfurt, number: SUG- 5\u20132024.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"Written informed consent not obtained due to retrospective design.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"Mike Wenzel receives speaker honoraria or is consultant for Accord, Johnsen&Johnsen, Pfizer, MSD, Astra Zeneca, Ipsen, Markus Graefen receives speaker honoraria or is consultant for Intuitive Surgical, Metronic, Ipsen, Astellas, Johnson & Johnson und Takeda, Tobias Maurer reports speaker fees from ABX, Astellas, Bayer, Sanofi-Aventis and Phillips, consultant fees from ABX, Advanced Accelerator Applications International S.A., Ascenian, Astellas, Axiom, Blue Earth Diagnostics, GEMoAb, Novartis, ROTOP Pharma and Telix, and research funding from ABX, Brainlab, Intuitive Surgical and Telix, Felix Chun receives speaker honoraria or is consultant for Astellas, AstraZeneca, Bayer, Johnson & Johnson, Lumenis, Molecular Health, Olympus, Pfizer, Philipp Mandel receives speaker honoraria or is consultant for AMGEN, Astellas, AstraZeneca, Bayer, IPSEN, Johnson & Johnson, MSD, Novartis, Orion, Pfizer.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Not applicable.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Clinical trial number"}}]}}