COMPARATIVE EFFECTIVENESS OF RADIOLIGAND THERAPY IN PSMA-POSITIVE MCRPC: INSIGHTS FROM REAL-WORLD DATA
Author(s)
Vikash Kumar Verma, MBA, PharmD1, Louis Brooks Jr, MS2, Marissa Seligman, PharmD3, Abhimanyu Roy, MBA4, Abhinav Nayyar, MBA, MBBS5, Ankitkumar Arora, MPharm6, Anuj Gupta, MSc7, Vishan Khatavkar, MBA8, Shikha Anand, Other8, Ankita Bhagat, MS9, Prateek Kumar, Other10, Aditi Paul, MBA11, Ankita Gupta, MSc5.
1Optum Lifesciences, Boston, MA, USA, 2Optum, Bloomsbury, NJ, USA, 3Optum, Winchester, MA, USA, 4Optum, Gurgaon, India, 5Optum Life Sciences, Gurugram, India, 6Optum Global Solutions, Gurgaon, India, 7Optum Lifesciences, Noida, India, 8Optum Lifesciences, Gurugram, India, 9Optum, Guragon, India, 10Optum Global Solutions, Hyderabad, India, 11Optum Global Solution, Gurgaon, India.
1Optum Lifesciences, Boston, MA, USA, 2Optum, Bloomsbury, NJ, USA, 3Optum, Winchester, MA, USA, 4Optum, Gurgaon, India, 5Optum Life Sciences, Gurugram, India, 6Optum Global Solutions, Gurgaon, India, 7Optum Lifesciences, Noida, India, 8Optum Lifesciences, Gurugram, India, 9Optum, Guragon, India, 10Optum Global Solutions, Hyderabad, India, 11Optum Global Solution, Gurgaon, India.
OBJECTIVES: Radioligand therapy has emerged as a promising treatment option for PSMA‑positive metastatic castration‑resistant prostate cancer (mCRPC), a rapidly expanding therapeutic market. This study compared real‑world treatment effectiveness of radioligand therapy with other commonly used second‑line options to inform clinical decision‑making and optimize patient outcomes.
METHODS: A retrospective cohort analysis was conducted using de‑identified Optum® Market Clarity data (January 2023-December 2024). Incident PSMA‑positive mCRPC patients were identified using ICD‑10 and CPT/NDC codes. Eligible men (≥18 years) had prior exposure to androgen receptor pathway inhibitors (ARPIs) and taxane‑based therapies. Cohort 1 included patients completing ≥3 cycles of radioligand therapy; those receiving ARPI or taxanes within 28 days before radioligand initiation were excluded. Cohort 2 comprised patients initiating other second‑line treatments (PARP inhibitors, immunotherapy, or Radium‑223). The index date was the first observed claim for the assigned therapy. Continuous enrollment ≥1 month pre‑index and ≥6 months post‑index was required. Propensity score matching (1:1) was conducted on age, race, and Charlson Comorbidity Index (CCI). Effectiveness was measured using PSA response over 6 months, defined via PSA50 (≥50% decline) and PSA80 (≥80% decline).
RESULTS: Of 24,208 PSMA‑positive mCRPC patients, 620 radioligand‑treated and 347 comparator‑treated patients met eligibility after matching. Radioligand therapy demonstrated strong biochemical response: 66.6% achieved a PSA50 response, and among these responders, 62.5% reached PSA80. In contrast, only 11.1% of patients receiving alternative second‑line therapies achieved PSA50, while 88.9% showed no PSA decline from baseline.
CONCLUSIONS: Radioligand therapy was associated with markedly higher PSA response rates than other second‑line treatments in real‑world PSMA‑positive mCRPC populations. Ongoing analyses will evaluate overall survival and healthcare resource utilization to further characterize the clinical and economic value of radioligand therapy.
METHODS: A retrospective cohort analysis was conducted using de‑identified Optum® Market Clarity data (January 2023-December 2024). Incident PSMA‑positive mCRPC patients were identified using ICD‑10 and CPT/NDC codes. Eligible men (≥18 years) had prior exposure to androgen receptor pathway inhibitors (ARPIs) and taxane‑based therapies. Cohort 1 included patients completing ≥3 cycles of radioligand therapy; those receiving ARPI or taxanes within 28 days before radioligand initiation were excluded. Cohort 2 comprised patients initiating other second‑line treatments (PARP inhibitors, immunotherapy, or Radium‑223). The index date was the first observed claim for the assigned therapy. Continuous enrollment ≥1 month pre‑index and ≥6 months post‑index was required. Propensity score matching (1:1) was conducted on age, race, and Charlson Comorbidity Index (CCI). Effectiveness was measured using PSA response over 6 months, defined via PSA50 (≥50% decline) and PSA80 (≥80% decline).
RESULTS: Of 24,208 PSMA‑positive mCRPC patients, 620 radioligand‑treated and 347 comparator‑treated patients met eligibility after matching. Radioligand therapy demonstrated strong biochemical response: 66.6% achieved a PSA50 response, and among these responders, 62.5% reached PSA80. In contrast, only 11.1% of patients receiving alternative second‑line therapies achieved PSA50, while 88.9% showed no PSA decline from baseline.
CONCLUSIONS: Radioligand therapy was associated with markedly higher PSA response rates than other second‑line treatments in real‑world PSMA‑positive mCRPC populations. Ongoing analyses will evaluate overall survival and healthcare resource utilization to further characterize the clinical and economic value of radioligand therapy.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
CO178
Topic
Clinical Outcomes
Topic Subcategory
Comparative Effectiveness or Efficacy
Disease
SDC: Oncology