(UroToday.com) The 2025 GU ASCO annual meeting featured a prostate cancer session and a presentation by Dr. Lisa Marie Gudenkauf discussing the implementation and preliminary validity of the Functional Assessment of Cancer Therapy – Radionuclide Therapy (FACT-RNT) in patients receiving radionuclide therapy for prostate cancer.
FACT-RNT is used in trials and clinical practice to monitor patient-reported radionuclide therapy-relevant symptoms and toxicities in advanced metastatic castrate-resistant prostate cancer (mCRPC) patients receiving radionuclide therapy. As such, this study presented at GU ASCO 2025 examined FACT-RNT feasibility and preliminary validity for U.S. patients receiving radionuclide therapy.
Patients scheduled to start 177Lu-PSMA-617 for advanced mCRPC at Moffitt Cancer Center from October 2023 to March 2024 completed patient reported outcome measures before each cycle. On day 1 of each radionuclide therapy cycle, participants completed patient reported outcomes, included previously validated measures of prostate cancer specific-symptoms (NFPSI-17) and physical function (Scored Patient-Generated Subjective Global Assessment; PG-SGA), and the FACT-RNT, a 15-item measure of symptoms and toxicities with higher total scores (range: 0-60) indicating less symptom burden:
Correlations between the FACT-RNT and other patient reported outcomes were calculated.
There were 17 patients with a mean age of 69 years (SD 11, range: 43-90) at radionuclide therapy cycle 1 who were mostly non-Hispanic (76%) and White (82%). Gleason scores at diagnosis were 7-8 (30%) or 9-10 (71%). Patients had previously undergone
- Surgery: 35%
- Chemotherapy: 94%
- Radiation: 71%
- Hormone therapy: 94%
- Targeted therapy: 88%
- Immunotherapy: 29%
Of note, 15 patients (88%) received ≥2 radionuclide therapy infusions, and of these, 1 (6%) patient died and 1 (6%) discontinued radionuclide therapy prior to cycle 2. Thirteen (87% of those with ≥2 infusions) completed the FACT-RNT at ≥2 cycles. Cycle 1 FACT-RNT total scores ranged from 31-58 (M = 46.5, SD 8), with the FACT-RNT score positively associated with symptoms as assessed by NFPSI-17 at cycles 1-3 (p values ≤ 0.03) and negatively associated with physical function at cycles 1-2 (p values ≤ 0.05).
Dr. Gudenkauf concluded her presentation discussing the implementation and preliminary validity of the FACT-RNT in patients receiving radionuclide therapy for prostate cancer with the following take-home points:
- Preliminary results support FACT-RNT validity due to associations with validated patient reported outcome measures and the feasibility of FACT-RNT implementation in the United States
- The FACT-RNT may be helpful in clinical management and decision-making with radionuclide therapy recipients
- Future research will replicate and extend these findings in a larger longitudinal sample and examine validity with clinician-rated outcomes and radionuclide therapy dosimetry
Presented by: Lisa Marie Gudenkauf, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL
Written by: Zachary Klaassen, MD, MSc – Urologic Oncologist, Associate Professor of Urology, Georgia Cancer Center, Wellstar MCG Health, @zklaassen_md on Twitter during the 2025 Genitourinary (GU) American Society of Clinical Oncology (ASCO) Annual Meeting, San Francisco, CA, Thurs, Feb 13 – Sat, Feb 15, 2025.