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Peer-reviewedCC BY-NC-ND 4.0European Journal of Nuclear Medicine and Molecular Imaging

Baseline serum carcinoembryonic antigen (CEA) is an independent prognostic biomarker for metastatic castration-resistant prostate cancer (mCRPC) patients receiving 177Lu-PSMA therapy

  • Emilio Francesco Giunta1
  • Irene Marini2
  • Ilaria Grassi2
  • Silvia Nicolini2
  • Flavia Foca3
  • Monica Celli2
  • Paola Caroli2
  • Anna Sarnelli2
  • Nicole Brighi1
  • Giuseppe Schepisi1
  • Manuela Monti3
  • Ugo De Giorgi4
2 more authors
  • Cristian Lolli1
  • Maddalena Sansovini2
4 affiliations
  1. 1Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
  2. 2Department of Nuclear Medicine, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
  3. 3Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy
  4. 4Department of Experimental Medicine, University of Salento, Lecce, Italy
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Abstract

Purpose: 177Lu-PSMA is currently approved for metastatic castration-resistant prostate cancer (mCRPC). However, only a subset of eligible patients derives a meaningful clinical benefit from treatment. To date, there is a lack of validated biomarkers that could help find the best candidates for this radioligand therapy (RLT).

Methods: 142 patients undergoing 177Lu-PSMA therapy were enrolled in a biological observational prospective study, with blood samples collected at baseline for analysis. Clinical characteristics and routinely available laboratory biomarkers – including hemoglobin, alkaline phosphatase, prostate-specific antigen (PSA), and carcinoembryonic antigen (CEA) – were evaluated by uni- and multivariable Cox regression analyses for their association with progression-free survival (PFS) and overall survival (OS).

Results: At a median follow-up of 44.0 months, median PFS and OS were 7.0 and 16.8 months, respectively. Elevated baseline CEA was independently associated with shorter PFS (p = 0.026) and OS (p = 0.003). Moreover, combining CEA with PSA improved prognostic discrimination compared with PSA alone.

Conclusion: Baseline CEA was independently associated with shorter PFS and OS, supporting its role as a promising prognostic biomarker for patients with mCRPC undergoing 177Lu-PSMA therapy. Further studies are warranted to validate its prognostic value and determine whether it also has predictive utility.

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Cite

BibTeXRIS
BibTeX
@article{giunta2026baseline,
  title = {{Baseline serum carcinoembryonic antigen (CEA) is an independent prognostic biomarker for metastatic castration-resistant prostate cancer (mCRPC) patients receiving 177Lu-PSMA therapy}},
  author = {Emilio Francesco Giunta and Irene Marini and Ilaria Grassi and Silvia Nicolini and Flavia Foca and Monica Celli and Paola Caroli and Anna Sarnelli and Nicole Brighi and Giuseppe Schepisi and Manuela Monti and Ugo De Giorgi and Cristian Lolli and Maddalena Sansovini},
  journal = {European Journal of Nuclear Medicine and Molecular Imaging},
  year = {2026},
  month = sep,
  doi = {10.1007/s00259-026-08173-x},
  url = {https://doi.org/10.1007/s00259-026-08173-x},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Baseline serum carcinoembryonic antigen (CEA) is an independent prognostic biomarker for metastatic castration-resistant prostate cancer (mCRPC) patients receiving 177Lu-PSMA therapy
AU  - Emilio Francesco Giunta
AU  - Irene Marini
AU  - Ilaria Grassi
AU  - Silvia Nicolini
AU  - Flavia Foca
AU  - Monica Celli
AU  - Paola Caroli
AU  - Anna Sarnelli
AU  - Nicole Brighi
AU  - Giuseppe Schepisi
AU  - Manuela Monti
AU  - Ugo De Giorgi
AU  - Cristian Lolli
AU  - Maddalena Sansovini
PY  - 2026
DA  - 2026/09/11
JO  - European Journal of Nuclear Medicine and Molecular Imaging
DO  - 10.1007/s00259-026-08173-x
UR  - https://doi.org/10.1007/s00259-026-08173-x
AB  - Purpose: 177Lu-PSMA is currently approved for metastatic castration-resistant prostate cancer (mCRPC). However, only a subset of eligible patients derives a meaningful clinical benefit from treatment. To date, there is a lack of validated biomarkers that could help find the best candidates for this radioligand therapy (RLT).  Methods: 142 patients undergoing 177Lu-PSMA therapy were enrolled in a biological observational prospective study, with blood samples collected at baseline for analysis. Clinical characteristics and routinely available laboratory biomarkers – including hemoglobin, alkaline phosphatase, prostate-specific antigen (PSA), and carcinoembryonic antigen (CEA) – were evaluated by uni- and multivariable Cox regression analyses for their association with progression-free survival (PFS) and overall survival (OS).  Results: At a median follow-up of 44.0 months, median PFS and OS were 7.0 and 16.8 months, respectively. Elevated baseline CEA was independently associated with shorter PFS (p = 0.026) and OS (p = 0.003). Moreover, combining CEA with PSA improved prognostic discrimination compared with PSA alone.  Conclusion: Baseline CEA was independently associated with shorter PFS and OS, supporting its role as a promising prognostic biomarker for patients with mCRPC undergoing 177Lu-PSMA therapy. Further studies are warranted to validate its prognostic value and determine whether it also has predictive utility.
SN  - 1619-7070
SN  - 1619-7089
ER  -