{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T20:07:46Z","timestamp":1784837266950,"version":"3.55.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T00:00:00Z","timestamp":1783728000000},"content-version":"vor","delay-in-days":3,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institutes of Health\/National Cancer Institute","award":["P30CA138292"],"award-info":[{"award-number":["P30CA138292"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Lutetium-177(177Lu)\u2013PSMA-617 improves survival for patients with metastatic castration-resistant prostate cancer, but outcomes are heterogeneous and standardized risk stratification tools are lacking. We developed a novel risk stratification tool for patients treated with 177Lu\u2013PSMA-617.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of 163 patients at Emory Winship Cancer Institute. Four prognostic models using Cox proportional hazards models were constructed using best-subset variable selection and integrated into a composite model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 163 patients (52% White, 44% Black; 80% previous taxane use) body mass index decline during treatment was associated with shorter progression-free survival (PFS) and overall survival (OS) (HR\u2009=\u20091.75, P\u2009=\u2009.03; HR\u2009=\u20092.35, P\u2009=\u2009.031). Higher subcutaneous adipose tissue index (SATI)\/skeletal muscle index (SMI) was independently associated with improved OS (HR\u2009=\u20090.5, P\u2009=\u2009.019), whereas higher visceral adipose tissue index (VATI)\/SATI was independently associated with worse OS (HR\u2009=\u20092.62, P\u2009=\u2009.005). A body composition-based prognostic score identified VATI\/SATI, SMI, and total adiposity as the strongest OS predictors (C\u2009=\u20090.629). The composite score incorporating inflammatory biomarkers and body composition demonstrated good discrimination (C-index\u2009=\u20090.732) and effectively stratified patients by PFS and OS. For PFS, relative risks across increasing risk quartiles were 0.34, 0.40, and 0.62 in compared with the highest risk quartile (P\u2009=\u2009.034). For OS, corresponding hazard ratios were 0.15, 0.19, and 0.54 (P\u2009=\u2009.003).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A risk score incorporating body composition and inflammatory biomarkers demonstrates prognostic value for patients treated with 177Lu\u2013PSMA-617.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag269","type":"journal-article","created":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T11:51:54Z","timestamp":1783770714000},"source":"Crossref","is-referenced-by-count":0,"title":["Novel risk scoring system for patients with metastatic castration-resistant prostate cancer treated with lutetium-177\u2013PSMA-617"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-9002-7697","authenticated-orcid":false,"given":"Margo B","family":"Gerke","sequence":"first","affiliation":[{"name":"Emory 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