A new real-world study from the FRAMCAP database confirms that 177-Lutetium Prostate-Specific Membrane Antigen (Lu-PSMA) therapy offers significantly better outcomes than cabazitaxel chemotherapy in metastatic castration-resistant prostate cancer (mCRPC) patients. While Lu-PSMA is still under investigation, these findings support its growing role as a key treatment option for advanced disease.

In this study of 373 mCRPC patients, about 65% (roughly 242 patients) received Lu-PSMA therapy, 14% (around 52 patients) were treated with cabazitaxel, and 21% (about 78 patients) received both therapies.
Patients on Lu-PSMA were older (median age 72 vs. 66 years) and had a higher percentage with poorer performance status (12% vs. 5% with ECOG ≥2).

In terms of tumor response, 32% of Lu-PSMA patients achieved a 50% or greater PSA reduction (PSA50), whereas no cabazitaxel patients did.

The median progression-free survival was 13.4 months with Lu-PSMA compared to just 7.1 months for cabazitaxel—a 62% reduction in progression risk (HR: 0.38). Overall survival was 16.5 months for Lu-PSMA versus 14.7 months for cabazitaxel, while patients receiving both treatments had a median OS of 29.6 months.

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