Micah Ostrowski: Thank you so much. I'm excited to share our results.
Neeraj Agarwal: So tell us first, what was the patient population where you looked at the efficacy of lutetium therapy in various settings?
Micah Ostrowski: Of course. So, we looked at patients with mCRPC who have been treated with prior ARPI, but had not yet received taxane therapy. And this is relevant with the recent approval of lutetium in taxane-naive patients based on the results of the PSMA-4 trial.
Neeraj Agarwal: So, where these patients came from?
Micah Ostrowski: These patients... So we use the Flatiron Health Research Database. It's an EHR-derived database that uses patient-level data from about 800 sites across the United States. It primarily uses community-based sites.
Neeraj Agarwal: How many patients were there?
Micah Ostrowski: So, in total, we had about 850 patients that we included.
Neeraj Agarwal: So very large number of patients, almost equal to large phase three trials.
Micah Ostrowski: Yes. Yeah.
Neeraj Agarwal: So in these patients, if I understood correctly, you looked at receipt of lutetium after docetaxel chemotherapy in the mCRPC setting, then receipt of lutetium before docetaxel chemotherapy and in the mCRPC setting.
Micah Ostrowski: That's correct. So we divided our patients into three cohorts based on the timing of taxane receipt. The first cohort was patients that received taxane chemotherapy before lutetium. The second cohort was patients that received taxane after lutetium. And then the third cohort was patients who received lutetium, but never received taxane.
Neeraj Agarwal: Very nice, which reflects the real-world practice for many of our patients. So, please tell us more about the results.
Micah Ostrowski: Of course. So our primary outcomes were time to next treatment, which was the time from the first receipt of lutetium until the first receipt of next line of therapy as a surrogate for progression-free survival. And our second outcome was overall survival. And in this study, so going through our three cohorts, overall survival was 16 months in patients who received taxane after lutetium. It was 14 months in patients who received lutetium but never received taxane. And it was 12 months in patients who received taxane before lutetium. This order was slightly different in when you look at real-world time to next therapy. This was longest in patients who never received taxane at 10 months, followed by those who received taxane before lutetium, which was eight months, and then finally six months in patients who received taxane after lutetium.
Neeraj Agarwal: So very similar overall survival data. If you take into account the receipt of prior therapies and time to next therapy, which is a surrogate for progression-free survival in this big real-world data set, regardless of where you give lutetium, looks like the efficacy is maintained and patients derive benefit from lutetium, regardless of whether they receive it before docetaxel or after docetaxel chemotherapy, or if they never receive docetaxel chemotherapy. Is that a correct conclusion?
Micah Ostrowski: I think that's exactly right. And I think what's striking is, in our dataset, 41% of patients who were treated with lutetium never were treated with taxane. And I think that reflects the desire in this real world study of what providers are doing and what patients are asking for is an option to hopefully avoid or delay taxane chemotherapy. And I think now that approval has moved to the taxane-naive patients, the question arises, is it reasonable to use lutetium this early in therapy? And I think based on this study with a similar survival that you alluded to, I think it is a reasonable option.
Neeraj Agarwal: So, more options for our patients, which is always a great news.
Micah Ostrowski: Yeah, fortunately, yes.
Neeraj Agarwal: Yes. Thank you, Micah, for sharing your results with us, and congratulations again for presenting your finding in this national meeting.
Micah Ostrowski: Of course. Yeah. Thank you. It's always a pleasure to speak with you.