Clinical outcomes of Lutetium-177–PSMA-617 in a racially diverse cohort of patients with metastatic castration-resistant prostate cancer

This retrospective study analyzed outcomes of lutetium-177 PSMA-617, an approved radioligand therapy for metastatic castration-resistant prostate cancer, in a racially diverse cohort of 163 patients treated at Emory Winship Cancer Institute, where 40.5% of patients self-identified as Black. Black patients demonstrated progression-free survival and overall survival comparable to non-Black patients, with a trend toward improved outcomes in multivariate analysis. Notably, Black patients had significantly greater odds of achieving a PSA50 response, defined as a 50% or greater reduction in prostate-specific antigen, with odds 2.45 times higher than non-Black patients.

These findings carry meaningful implications for a disease where Black men bear a disproportionately high burden yet have historically been underrepresented in the pivotal trials that established lutetium-177 PSMA-617 as a standard of care. The study provides real-world evidence that the therapy is effective in Black patients and challenges the assumption that trial-derived efficacy data generalizes equitably across racial groups without dedicated investigation. The authors underscore the urgent need for improved representation in prospective studies to draw more definitive conclusions and ensure that treatment advances reach all patients who stand to benefit.