{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T08:12:19Z","timestamp":1778314339863,"version":"3.51.4"},"reference-count":48,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T00:00:00Z","timestamp":1778025600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Anhui Provincial Department of Education University Research Project","award":["2025AHGXZK20248"],"award-info":[{"award-number":["2025AHGXZK20248"]}]},{"name":"the Education Foundation of Wannan Medical College","award":["HXKT2022016"],"award-info":[{"award-number":["HXKT2022016"]}]},{"name":"The Scientific Research StartupFund Project forHigh-level Talents of the Second Affiliated Hospital of WannanMedical College","award":["GRK202501"],"award-info":[{"award-number":["GRK202501"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer Biotherapy and Radiopharmaceuticals"],"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>\n                      To investigate the treatment response status in elderly patients with metastatic castration-resistant prostate cancer (mCRPC) receiving\n                      <jats:sup>177<\/jats:sup>\n                      Lu-PSMA-617 radioligand therapy within a precision oncology framework, analyze the incidence, depth, and influencing factors of PSA and radiological response, and provide scientific evidence for developing individualized treatment selection and optimization strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A cross-sectional survey study was conducted, including 182 elderly patients (age \u226565 years, having completed \u22652 cycles of\n                      <jats:sup>177<\/jats:sup>\n                      Lu-PSMA-617 therapy) with prostate-specific membrane antigen (PSMA)-positive mCRPC confirmed by\n                      <jats:sup>68<\/jats:sup>\n                      Ga-PSMA-11 Positron emission tomography\/Computed tomography (PET\/CT). Standardized assessment tools, including the Functional Assessment of Cancer Therapy-Prostate (FACT-P), Brief Pain Inventory-Short Form, and Hospital Anxiety and Depression Scale, were used to evaluate treatment response, quality of life, and mental health. The Common Terminology Criteria for Adverse Events was applied to grade treatment-related toxicities. Univariate analysis was performed to screen influencing factors, and multivariate logistic regression analysis was conducted to identify independent predictors of treatment response.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The overall PSA50 response rate (\u226550% PSA decline) was 63.7% (116\/182). Moderate response (50%\u201389% PSA decline) accounted for 39.6%, and deep response (\u226590% PSA decline) accounted for 24.2%. Radiological partial or complete response was achieved in 42.3% of patients. Patients in the response group showed significantly higher FACT-P total scores (115.6 \u00b1 18.4 versus 84.2 \u00b1 17.8,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001) and lower anxiety, depression, and pain scores compared with the nonresponse group. Multivariate analysis identified baseline hemoglobin &lt; 100 g\/L (OR = 2.19, 95% CI: 1.05\u20134.57), prior docetaxel exposure (OR = 2.18, 95% CI: 1.07\u20134.44), high tumor burden \u2265 10 lesions (OR = 2.35, 95% CI: 1.18\u20134.67), PSMA SUVmax &lt; 12 (OR = 2.39, 95% CI: 1.11\u20135.14), and baseline alkaline phosphatase (ALP) &gt; 200 U\/L (OR = 2.13, 95% CI: 1.03\u20134.37) as independent predictors of treatment nonresponse. PSA50 response rate showed a significant increasing trend with the number of therapy cycles administered (\u03c7\n                      <jats:sup>2<\/jats:sup>\n                      trend = 5.214,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.022).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>\n                      Elderly mCRPC patients undergoing\n                      <jats:sup>177<\/jats:sup>\n                      Lu-PSMA-617 radioligand therapy achieve meaningful PSA50 response rates, with baseline hemoglobin, prior docetaxel exposure, tumor burden, PSMA expression level, and ALP being independent predictors of response. Treatment response is closely associated with improved quality of life and mental health outcomes, with response rates improving with additional therapy cycles. These findings provide evidence-based guidance for precision patient selection, treatment monitoring, and individualized optimization strategies for\n                      <jats:sup>177<\/jats:sup>\n                      Lu-PSMA-617 therapy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10849785261447847","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T05:43:32Z","timestamp":1778132612000},"source":"Crossref","is-referenced-by-count":0,"title":["Precision Oncology with\n                    <sup>177<\/sup>\n                    Lu-PSMA-617 Radionuclide Therapy in Elderly Patients with Metastatic Castration-Resistant Prostate Cancer"],"prefix":"10.1177","author":[{"given":"Fayou","family":"Zhou","sequence":"first","affiliation":[{"name":"Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical University, Wuhu City, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongqing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, 967 Hospital of the Joint Logistics Support Force of PLA, Dalian, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liang","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, 967 Hospital of the Joint Logistics Support Force of PLA, Dalian, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaolei","family":"Tang","sequence":"additional","affiliation":[{"name":"Translational Medicine Center, The Second Affiliated Hospital of Wannan Medical University, Wuhu City, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liwei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, The Second Affiliated Hospital of Wannan Medical University, Wuhu City, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6106-4828","authenticated-orcid":false,"given":"Sheng","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Urological Surgery, Qingpu Traditional Chinese Medicine Hospital, Shanghai, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2019.08.005"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21763"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2024.03.027"},{"key":"e_1_3_2_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000003491"},{"key":"e_1_3_2_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1704174"},{"key":"e_1_3_2_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00237-3"},{"key":"e_1_3_2_8_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.116.178673"},{"key":"e_1_3_2_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107322"},{"key":"e_1_3_2_10_1","unstructured":"9.FDA approves lutetium Lu 177 vipivotide tetraxetan for metastatic castration-resistant prostate cancer. FDA News Release. March 23 2022."},{"issue":"3","key":"e_1_3_2_11_1","first-page":"e115","article-title":"177Lu-PSMA therapy for mCRPC: Systematic review","volume":"24","author":"Sandhu S","year":"2023","unstructured":"10.Sandhu S, , Herrmann K, , Beheshti M, et al. 177Lu-PSMA therapy for mCRPC: Systematic review. Lancet Oncol 2023;24(3):e115\u2013e125.","journal-title":"Lancet Oncol"},{"issue":"4","key":"e_1_3_2_12_1","first-page":"488","article-title":"Lutetium 177 PSMA radionuclide therapy for men with prostate cancer","volume":"61","author":"Emmett L","year":"2017","unstructured":"11.Emmett L, , Willowson K, , Violet J, et al. Lutetium 177 PSMA radionuclide therapy for men with prostate cancer. J Med Imaging Radiat Oncol 2017;61(4):488\u2013493.","journal-title":"J Med Imaging Radiat Oncol"},{"key":"e_1_3_2_13_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.119.236414"},{"issue":"8","key":"e_1_3_2_14_1","first-page":"2483","article-title":"Elderly patients with mCRPC treated with 177Lu-PSMA: Multicentric retrospective analysis","volume":"50","author":"Bauckneht M","year":"2023","unstructured":"13.Bauckneht M, , Siri A, , Rais M, et al. Elderly patients with mCRPC treated with 177Lu-PSMA: Multicentric retrospective analysis. Eur J Nucl Med Mol Imaging 2023;50(8):2483\u20132494.","journal-title":"Eur J Nucl Med Mol Imaging"},{"key":"e_1_3_2_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000002391"},{"key":"e_1_3_2_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30198-0"},{"issue":"10440","key":"e_1_3_2_17_1","first-page":"2023","article-title":"177Lu-PSMA-617 versus a change in androgen-receptor pathway inhibition in taxane-na\u00efve patients with progressive mCRPC (PSMAfore)","volume":"403","author":"Morris MJ","year":"2024","unstructured":"16.Morris MJ, , Castellano D, , Herrmann K, et al. 177Lu-PSMA-617 versus a change in androgen-receptor pathway inhibition in taxane-na\u00efve patients with progressive mCRPC (PSMAfore). Lancet 2024;403(10440):2023\u20132033.","journal-title":"Lancet"},{"key":"e_1_3_2_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2021.10.004"},{"issue":"10","key":"e_1_3_2_19_1","first-page":"3316","article-title":"Lutetium-177-PSMA therapy and quality of life","volume":"49","author":"Herrmann K","year":"2022","unstructured":"18.Herrmann K, , Rahbar K, , Segbers M, et al. Lutetium-177-PSMA therapy and quality of life. Eur J Nucl Med Mol Imaging 2022;49(10):3316\u20133325.","journal-title":"Eur J Nucl Med Mol Imaging"},{"issue":"7","key":"e_1_3_2_20_1","first-page":"1042","article-title":"Dosimetric analysis in VISION","volume":"63","author":"Sartor O","year":"2022","unstructured":"19.Sartor O, , de Bono JS, , Chi KN, et al. Dosimetric analysis in VISION. J Nucl Med 2022;63(7):1042\u20131049.","journal-title":"J Nucl Med"},{"key":"e_1_3_2_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00259-019-04485-3"},{"key":"e_1_3_2_22_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.115.170720"},{"key":"e_1_3_2_23_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.118.214379"},{"key":"e_1_3_2_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(97)00459-7"},{"issue":"2","key":"e_1_3_2_25_1","first-page":"129","article-title":"Pain assessment: Global use of the Brief Pain Inventory","volume":"23","author":"Cleeland CS","year":"1994","unstructured":"24.Cleeland CS, , Ryan KM. Pain assessment: Global use of the Brief Pain Inventory. Ann Acad Med Singap 1994;23(2):129\u2013138.","journal-title":"Ann Acad Med Singap"},{"key":"e_1_3_2_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"},{"key":"e_1_3_2_27_1","volume-title":"Common Terminology Criteria for Adverse Events (CTCAE) v5.0","author":"National Cancer Institute","year":"2017","unstructured":"26.National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v5.0. Bethesda, MD: NCI; 2017."},{"issue":"23","key":"e_1_3_2_28_1","first-page":"2580","article-title":"Quality of life in VISION trial of 177Lu-PSMA-617 for mCRPC","volume":"40","author":"de Bono J","year":"2022","unstructured":"27.de Bono J, , Sartor O, , Fizazi K, et al. Quality of life in VISION trial of 177Lu-PSMA-617 for mCRPC. J Clin Oncol 2022;40(23):2580\u20132592.","journal-title":"J Clin Oncol"},{"issue":"6","key":"e_1_3_2_29_1","first-page":"763","article-title":"Overall survival with 177Lu-PSMA-617 versus cabazitaxel in progressive mCRPC: Long-term follow-up of TheraP randomised trial","volume":"25","author":"Hofman MS","year":"2024","unstructured":"28.Hofman MS, , Emmett L, , Sandhu S, et al. Overall survival with 177Lu-PSMA-617 versus cabazitaxel in progressive mCRPC: Long-term follow-up of TheraP randomised trial. Lancet Oncol 2024;25(6):763\u2013774.","journal-title":"Lancet Oncol"},{"issue":"9","key":"e_1_3_2_30_1","first-page":"1269","article-title":"Results of a prospective phase 2 pilot trial of 177Lu-PSMA-617 therapy for metastatic castration-resistant prostate cancer including imaging predictors","volume":"60","author":"Emmett L","year":"2019","unstructured":"29.Emmett L, , Crumbaker M, , Ho B, et al. Results of a prospective phase 2 pilot trial of 177Lu-PSMA-617 therapy for metastatic castration-resistant prostate cancer including imaging predictors. J Nucl Med 2019;60(9):1269\u20131273.","journal-title":"J Nucl Med"},{"issue":"7","key":"e_1_3_2_31_1","first-page":"783","article-title":"Post-hoc analysis: Depth of PSA response as a predictor of survival in VISION","volume":"42","author":"Sartor O","year":"2024","unstructured":"30.Sartor O, , Bono JS, , Chi KN, et al. Post-hoc analysis: Depth of PSA response as a predictor of survival in VISION. J Clin Oncol 2024;42(7):783\u2013793.","journal-title":"J Clin Oncol"},{"issue":"4","key":"e_1_3_2_32_1","first-page":"678","article-title":"PSMA expression and radioligand therapy response","volume":"26","author":"Soltani A","year":"2023","unstructured":"31.Soltani A, , Shahzad N, , Majeed U, et al. PSMA expression and radioligand therapy response. Prostate Cancer Prostatic Dis 2023;26(4):678\u2013686.","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"e_1_3_2_33_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.77.6880"},{"issue":"5","key":"e_1_3_2_34_1","first-page":"1428","article-title":"PSMA-targeted radioligand therapy in high-burden disease","volume":"13","author":"Barbato F","year":"2023","unstructured":"33.Barbato F, , Fendler WP, , Herrmann K, et al. PSMA-targeted radioligand therapy in high-burden disease. Theranostics 2023;13(5):1428\u20131439.","journal-title":"Theranostics"},{"key":"e_1_3_2_35_1","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.118.219352"},{"issue":"3","key":"e_1_3_2_36_1","first-page":"398","article-title":"Hematologic toxicity of 177Lu-PSMA therapy: Predictors and management","volume":"64","author":"Emmett L","year":"2023","unstructured":"35.Emmett L, , George A, , Tang E, et al. Hematologic toxicity of 177Lu-PSMA therapy: Predictors and management. J Nucl Med 2023;64(3):398\u2013405.","journal-title":"J Nucl Med"},{"key":"e_1_3_2_37_1","first-page":"103267","article-title":"Anemia in prostate cancer: Causes, mechanisms, and management","volume":"160","author":"Lippi G","year":"2021","unstructured":"36.Lippi G, , Favaloro EJ. Anemia in prostate cancer: Causes, mechanisms, and management. Crit Rev Oncol Hematol 2021;160:103267.","journal-title":"Crit Rev Oncol Hematol"},{"issue":"4","key":"e_1_3_2_38_1","first-page":"459","article-title":"Prior taxane exposure and 177Lu-PSMA outcomes","volume":"82","author":"Aggarwal R","year":"2022","unstructured":"37.Aggarwal R, , Loriot Y, , Hoffmann JM, et al. Prior taxane exposure and 177Lu-PSMA outcomes. Eur Urol 2022;82(4):459\u2013468.","journal-title":"Eur Urol"},{"issue":"3","key":"e_1_3_2_39_1","first-page":"e1","article-title":"Sequential 177Lu-PSMA therapy versus taxane: A systematic review","volume":"42","author":"Calopedos R","year":"2024","unstructured":"38.Calopedos R, , Ali A, , Yin Z, et al. Sequential 177Lu-PSMA therapy versus taxane: A systematic review. Urol Oncol 2024;42(3):e1\u2013e11.","journal-title":"Urol Oncol"},{"key":"e_1_3_2_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62344-6"},{"key":"e_1_3_2_41_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2008.00409.x"},{"issue":"11","key":"e_1_3_2_42_1","first-page":"1563","article-title":"Therapy of prostate cancer with PSMA-targeted radionuclides","volume":"61","author":"Herrmann K","year":"2020","unstructured":"41.Herrmann K, , Haberkorn U, , Krause BJ. Therapy of prostate cancer with PSMA-targeted radionuclides. J Nucl Med 2020;61(11):1563\u20131568.","journal-title":"J Nucl Med"},{"issue":"14","key":"e_1_3_2_43_1","first-page":"1529","article-title":"Dose optimization and cycle completion of 177Lu-PSMA-617","volume":"42","author":"Tagawa ST","year":"2024","unstructured":"42.Tagawa ST, , Antonarakis ES, , Gjyrezi A, et al. Dose optimization and cycle completion of 177Lu-PSMA-617. J Clin Oncol 2024;42(14):1529\u20131540.","journal-title":"J Clin Oncol"},{"key":"e_1_3_2_44_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-19-1050"},{"issue":"22","key":"e_1_3_2_45_1","first-page":"2429","article-title":"Cardio-oncology in prostate cancer: Bone metastasis management","volume":"40","author":"Shore ND","year":"2022","unstructured":"44.Shore ND, , Hussain A, , Bhatt DL, et al. Cardio-oncology in prostate cancer: Bone metastasis management. J Clin Oncol 2022;40(22):2429\u20132444.","journal-title":"J Clin Oncol"},{"issue":"4","key":"e_1_3_2_46_1","first-page":"512","article-title":"Optimal sequencing of PSMA RLT in the mCRPC treatment algorithm","volume":"10","author":"Chen RC","year":"2024","unstructured":"45.Chen RC, , Chang P, , Vetter RJ, et al. Optimal sequencing of PSMA RLT in the mCRPC treatment algorithm. JAMA Oncol 2024;10(4):512\u2013521.","journal-title":"JAMA Oncol"},{"issue":"9","key":"e_1_3_2_47_1","first-page":"1328","article-title":"Nomograms to predict outcomes after 177Lu-PSMA radionuclide therapy","volume":"62","author":"Gafita A","year":"2021","unstructured":"46.Gafita A, , Calais J, , Grogan TR, et al. Nomograms to predict outcomes after 177Lu-PSMA radionuclide therapy. J Nucl Med 2021;62(9):1328\u20131335.","journal-title":"J Nucl Med"},{"issue":"8","key":"e_1_3_2_48_1","first-page":"EVIDoa2300023","article-title":"Rucaparib plus enzalutamide for metastatic CRPC","volume":"2","author":"Fizazi K","year":"2023","unstructured":"47.Fizazi K, , Piulats JM, , Reaume MN, et al. Rucaparib plus enzalutamide for metastatic CRPC. NEJM Evid 2023;2(8):EVIDoa2300023.","journal-title":"NEJM Evid"},{"issue":"1","key":"e_1_3_2_49_1","first-page":"8","article-title":"LuPSMA combination studies with PARP inhibitors and immunotherapy","volume":"25","author":"Dhiantravan N","year":"2022","unstructured":"48.Dhiantravan N, , Emmett L, , Violet J, et al. LuPSMA combination studies with PARP inhibitors and immunotherapy. Prostate Cancer Prostatic Dis 2022;25(1):8\u201318.","journal-title":"Prostate Cancer Prostatic Dis"}],"container-title":["Cancer Biotherapy and Radiopharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10849785261447847","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10849785261447847","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10849785261447847","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,9]],"date-time":"2026-05-09T07:48:24Z","timestamp":1778312904000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10849785261447847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,6]]},"references-count":48,"alternative-id":["10.1177\/10849785261447847"],"URL":"https:\/\/doi.org\/10.1177\/10849785261447847","relation":{},"ISSN":["1084-9785","1557-8852"],"issn-type":[{"value":"1084-9785","type":"print"},{"value":"1557-8852","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,6]]},"article-number":"10849785261447847"}}