ASCO 2022 | Is there are role for 177Lu-PSMA-617 in earlier lines of treatment for mCRPC?
Scott T. Tagawa, MD, MS, Weill Cornell Medicine, New York, NY, discusses the utilization of 177Lu-PSMA in earlier lines of treatment. The Phase III VISION (NCT03511664) trial investigated the advantages of 177Lu-PSMA-617 over best supportive care in improving overall-survival (OS) in patients with metastatic castration-resistant prostate cancer (mCRPC). There was a demonstrated improvement in overall-survival, however, patients included in the trial were heavily pre-treated, raising the question of whether 177Lu-PSMA-617 is beneficial in earlier lines of treatment, and whether it is better or worse than existing therapies. This interview took place at the American Society of Clinical Oncology (ASCO) 2022 Annual Meeting in Chicago, IL.
Transcript (edited for clarity)
So sticking with Lutetium PSMA 617, or actually if broadening that to PSMA targeted radionuclide therapy in general, one of the major questions is what about earlier disease states? The VISION trial was designed for those that had literally every single therapy that was known to benefit them prior to coming in.
So it’s nice to know that it works there, but what about in early lines of therapy? And in early lines of therapy, does it work better or the same or worse than some of the existing therapy? So that’s an unknown question, as well as combinations...
So sticking with Lutetium PSMA 617, or actually if broadening that to PSMA targeted radionuclide therapy in general, one of the major questions is what about earlier disease states? The VISION trial was designed for those that had literally every single therapy that was known to benefit them prior to coming in.
So it’s nice to know that it works there, but what about in early lines of therapy? And in early lines of therapy, does it work better or the same or worse than some of the existing therapy? So that’s an unknown question, as well as combinations.
The three drugs that are in phase three trials all use the beta emitter Lutetium 177. I’m very interested in looking at alphas, which are more potent, although a shorter range. So we’ll see if those will pan out, because it does look like they have activity, even those that had prior Lutetium PSMA treatment.
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