{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:01:13Z","timestamp":1772150473238,"version":"3.50.1"},"reference-count":17,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prostate-specific membrane antigen (PSMA) is a key target in metastatic castration resistance prostate cancer (mCRPC). Enzalutamide, an androgen receptor pathway inhibitor (ARPi), increases PSMA expression, potentially enhancing 177Lu-PSMA-617 radioligand therapy. This study evaluates the impact of prior ARPi (enzalutamide vs abiraterone acetate [AA]) on PSMA expression, PFS, and OS.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>A retrospective analysis of 214 mCRPC patients treated with 177Lu-PSMA-617 across six Turkish centers (2015-2025) was conducted. Patients were grouped by prior ARPi therapy. PFS and OS were analyzed using Kaplan-Meier and Cox regression methods.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 103 patients receiving ARPi before 177Lu-PSMA-617, 59 (57%) had enzalutamide and 44 (43%) AA. Median PFS was 7.6\u2009months for enzalutamide versus 5.3\u2009months for AA (P\u2009=\u2009.068). Median OS was significantly longer with enzalutamide (12.8 vs 6.9\u2009months, P\u2009=\u2009.021). Patients with Eastern Cooperative Oncology Group Performance Scores (ECOG PS) 0-1 had significantly longer OS (27.6 vs 6.9\u2009months for PS 2-3, P\u2009&amp;lt;\u2009.0001). Higher PSMA SUVmax (&amp;gt;20) correlated with longer OS (15.1 vs 7.8\u2009months, P\u2009=\u2009.016). Among 86 patients with detectable PSMA SUVmax, 53 had SUVmax &amp;gt; 20; 66% had prior enzalutamide and 34% AA. Median OS was four months longer with enzalutamide (18.1 vs 13.9\u2009months P\u2009=\u2009.120). Multivariate analysis identified ARPi type (HR: 2.24, P\u2009=\u2009.033) and ECOG PS (HR: 5.22, P\u2009&amp;lt;\u2009.0001) as independent OS predictors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Enzalutamide prior to 177Lu-PSMA-617 significantly improves OS and enhances PSMA expression compared to AA. These findings highlight the importance of treatment sequencing in mCRPC and warrant further prospective studies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/oncolo\/oyaf213","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T16:35:45Z","timestamp":1753202145000},"source":"Crossref","is-referenced-by-count":1,"title":["Enhancing outcomes in mCRPC: the impact of androgen receptor inhibitor sequencing before 177Lu-PSMA-617 therapy"],"prefix":"10.1093","volume":"30","author":[{"given":"Sat\u0131 Co\u015fkun","family":"Yazgan","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Ankara University School of Medicine , Ankara 06620,","place":["Turkey"]},{"name":"Ankara University Cancer Institute , Ankara, 06620,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamil","family":"Kaya\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gaziantep University School of Medicine , Gaziantep 27310,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c7a\u011fatay","family":"Arslan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Izmir University of Economics, Medical Point Hospital , Izmir 35330,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caner","family":"Kapar","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ko\u00e7 University School of Medicine , Istanbul 34010,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u015eura","family":"\u00d6ztekin","sequence":"additional","affiliation":[{"name":"Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Health Sciences University , Ankara 06200,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Furkan","family":"Ceylan","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bilkent City Hospital , Ankara 06800,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hatice","family":"B\u00f6lek","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University School of Medicine , Ankara 06620,","place":["Turkey"]},{"name":"Ankara University Cancer Institute , Ankara, 06620,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umut","family":"Elbo\u011fa","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Gaziantep University \u015eahinbey Training and Research Hospital , \u015eahinbey, Gaziantep 27310,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00d6zt\u00fcrk","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Dr Abdurrahman Yurtaslan Ankara Oncology Education and Research Hospital, Health Sciences University , Ankara 06200,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deniz","family":"Tural","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ko\u00e7 University School of Medicine , Istanbul 34010,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T\u00fclay","family":"Ku\u015f","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Gaziantep University School of Medicine , Gaziantep 27310,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehmet Ali Nahit","family":"\u015eendur","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Bilkent City Hospital , Ankara 06800,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emre","family":"Yeked\u00fcz","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University School of Medicine , Ankara 06620,","place":["Turkey"]},{"name":"Ankara University Cancer Institute , Ankara, 06620,","place":["Turkey"]},{"name":"Dana-Farber Cancer Institute, Harvard Medical School , Boston, MA 02284,","place":["United States"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nuriye \u00d6zlem","family":"K\u00fc\u00e7\u00fck","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Ankara University School of Medicine , Ankara 06620,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elif","family":"\u00c7\u0131ng\u0131 \u00d6zdemir","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Ankara Bilkent City Hospital , Ankara 06800,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y\u00fcksel","family":"\u00dcr\u00fcn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Ankara University School of Medicine , Ankara 06620,","place":["Turkey"]},{"name":"Ankara University Cancer Institute , Ankara, 06620,","place":["Turkey"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"2025091815421412200_oyaf213-B1","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1002\/jcb.10661","article-title":"Tumor target prostate specific membrane antigen (PSMA) and its regulation in prostate cancer","volume":"91","author":"Ghosh","year":"2004","journal-title":"J Cell Biochem"},{"key":"2025091815421412200_oyaf213-B2","doi-asserted-by":"crossref","first-page":"1091","DOI":"10.1056\/NEJMoa2107322","article-title":"Lutetium-177-PSMA-617 for metastatic castration-resistant 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