{"id":27206,"date":"2021-06-29T12:00:00","date_gmt":"2021-06-29T12:00:00","guid":{"rendered":"https:\/\/www.cancer.gov\/news-events\/cancer-currents-blog\/2021\/prostate-cancer-psma-radiopharmaceutical-vision"},"modified":"2024-11-03T15:14:51","modified_gmt":"2024-11-03T15:14:51","slug":"for-advanced-prostate-cancer-radiopharmaceutical-improves-survival","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/for-advanced-prostate-cancer-radiopharmaceutical-improves-survival\/","title":{"rendered":"For Advanced Prostate Cancer, Radiopharmaceutical Improves Survival"},"content":{"rendered":"
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PSMA-based PET scans of a man with prostate cancer at the beginning of treatment with 177Lu-PSMA-617 (a) and after 6 cycles of the therapy (d).<\/p>\n

Credit: Tijdschrift voor Urologie. August 2020. https:\/\/doi.org\/10.1007\/s13629-020-00300-z. CC-BY-4.0<\/p>\n<\/div>\n<\/figcaption><\/figure>\n<\/div>\n

A type of cancer therapy that delivers radiation directly to cancer cells may represent the newest advance in the treatment of prostate cancer, according to results from a large clinical trial. The trial included participants with a hard-to-treat form of advanced prostate cancer, called metastatic castration<\/a>-resistant prostate cancer, that had gotten worse despite treatment with standard therapies<\/a>.<\/p>\n

In the study, participants who received the drug, called 177<\/sup>Lu-PSMA<\/a>-617, along with other standard treatments lived longer than those who received only standard therapies<\/a>: a median<\/a> of 15.3 months versus 11.3 months.<\/p>\n

Treatment with 177<\/sup>Lu-PSMA-617\u2014one of an emerging group of cancer therapies called radiopharmaceuticals<\/a>\u2014did lead to more side effects. In addition, several deaths were attributed to treatment with the radiopharmaceutical<\/a>. However, the researchers reported that the most common side effects, such as fatigue and dry mouth, were rarely serious and that participants generally appeared to handle the side effects well.<\/p>\n

The results from the trial, called VISION, were presented on June 6 at the annual meeting of the American Society of Clinical Oncology (ASCO) and published June 23 in the New England Journal of Medicine<\/em>.<\/p>\n

The study\u2019s findings support making 177<\/sup>Lu-PSMA-617 a \u201cnew treatment option for this patient population,\u201d said the trial\u2019s lead investigator, Michael Morris, M.D., of Memorial Sloan Kettering Cancer Center, during a press briefing at the ASCO meeting.<\/p>\n

Several other experts on treating prostate cancer agreed. <\/p>\n

Mary-Ellen Taplin, M.D., who specializes in treating prostate cancer at the Dana-Farber Cancer Institute in Boston, called VISION \u201ca very positive trial\u201d and said she believes there will be strong interest among patients and clinicians for 177<\/sup>Lu-PSMA-617.<\/p>\n

However, Dr. Taplin, who was an investigator on the trial, also said she was disappointed that adding 177<\/sup>Lu-PSMA-617 to treatment only improved patient survival by several months. \u201cI had hoped for more,\u201d she said.<\/p>\n

177<\/sub><\/sup>Lu-PSMA-617 is not yet approved by the Food and Drug Administration (FDA), but Novartis, which manufactures the drug and funded the VISION trial, said that it plans to submit an approval application to the agency later this year.<\/p>\n

Targeting PSMA: Not Just for Imaging<\/h2>\n

Like a number of other radiopharmaceuticals, 177<\/sub><\/sup>Lu-PSMA-617 has two components: a drug that delivers the therapy to cancer cells and a radioactive particle. In the case of 177<\/sup>Lu-PSMA-617, the delivery vehicle is PSMA-617, a drug that latches onto a protein<\/a> called PSMA that is often found at high levels on the surface of prostate cancer cells. The radioactive component is lutetium-177, which is being tested as a part of multiple radiopharmaceutical drugs.<\/p>\n

As Dr. Morris explained, PSMA-617 is extremely adept at finding and locking on to the PSMA protein on cells. Once it binds to PSMA on a cancer cell, \u201cthe whole molecule is internalized by the cell and the cell is exposed to a lethal dose of radiation\u201d from lutetium-177, he said.<\/p>\n

The PSMA protein is also at the heart of a new type of imaging procedure called PSMA PET<\/a>. This form of PET imaging is just starting to be used in men with prostate cancer to determine whether their cancer has spread, or metastasized, beyond the prostate. In the last several months, FDA has approved two such drugs, known as radiotracers, for PSMA PET imaging. (See box.)<\/p>\n