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Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer
Oliver Sartor1, Johann de Bono1, Kim N Chi1
1From the School of Medicine, Tulane University, New Orleans (O.S.); the Institute of Cancer Research and Royal Marsden Hospital, London (J.B.); the British Columbia Cancer Agency, Vancouver, Canada (K.N.C.); Gustave Roussy Institute, Paris-Saclay University, Villejuif, France (K.F.); the University of Duisberg-Essen and German Cancer Consortium, University Hospital Essen, Essen (K.H.), University Hospital Münster, Münster (K.R.), and Rostock University Medical Center, Rostock (B.J.K.) - all in Germany; Weill Cornell Medicine (S.T.T.) and Memorial Sloan Kettering Cancer Center (M.J.M.) - both in New York; the Urology Cancer Center, Omaha, NE (L.T.N.); the School of Medicine, Wayne State University, Detroit (N.V.); Moffitt Cancer Center and Research Institute, Tampa, FL (G.E.-H.); Norton Cancer Institute, Louisville, KY (C.H.P.); Knight Cancer Institute, Oregon Health and Science University, Portland (T.M.B.); Endocyte (a Novartis company), West Lafayette, IN (A.A.); Novartis Pharmaceuticals, East Hanover, NJ (W.J.P.-C., M.D., E.K., R.A.M.); and Novartis Pharma, Basel, Switzerland (G.G.).
Lutetium-177 (177Lu)-PSMA-617 radioligand therapy significantly improved progression-free and overall survival in patients with advanced prostate cancer. This treatment, when added to standard care, offers a new option for metastatic castration-resistant prostate cancer.
Area of Science:
- Oncology
- Nuclear Medicine
- Radiopharmaceutical Therapy
Background:
- Metastatic castration-resistant prostate cancer (mCRPC) has a poor prognosis despite advances.
- Prostate-specific membrane antigen (PSMA) is a key target in mCRPC.
- 177Lu-PSMA-617 is a targeted radioligand therapy delivering radiation to PSMA-expressing cells.
Purpose of the Study:
- To evaluate the efficacy and safety of 177Lu-PSMA-617 plus standard care versus standard care alone in patients with PSMA-positive mCRPC.
- To assess the impact on progression-free survival (PFS), overall survival (OS), and other key endpoints.
Main Methods:
- An international, open-label, phase 3 trial (VISION) randomized 831 patients with previously treated mCRPC.
- Patients received either 177Lu-PSMA-617 plus standard care or standard care alone.
- Primary endpoints were imaging-based PFS and OS.
Main Results:
- 177Lu-PSMA-617 significantly prolonged median imaging-based PFS (8.7 vs. 3.4 months) and OS (15.3 vs. 11.3 months).
- Hazard ratios for progression or death and death were 0.40 and 0.62, respectively (P<0.001).
- All secondary endpoints favored 177Lu-PSMA-617; quality of life was not adversely affected despite higher grade 3+ adverse events (52.7% vs. 38.0%).
Conclusions:
- 177Lu-PSMA-617 radioligand therapy is effective in improving PFS and OS in PSMA-positive mCRPC.
- This therapy represents a significant advancement in the treatment of advanced prostate cancer.
- The VISION trial results support 177Lu-PSMA-617 as a valuable treatment option for patients with mCRPC.
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