ASCO 2022 | VISION: 177Lu-PSMA-617 in PSMA-positive mCRPC
Andrew J. Armstrong, MD, Duke Cancer Center, Durham, NC, provides an overview of the phase III VISION trial (NCT03511664) of 177Lu-PSMA-617 in patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have progressed on androgen receptor (AR) antagonists. 177Lu-PSMA-617 provided the most benefit in patients who had brighter PSMA PET scans in terms of response rate and progression-free survival (PFS). Patients with weaker scans also responded to treatment and 177Lu-PSMA-617 is found to be superior to an additional AR antagonist. This interview took place at the American Society of Clinical Oncology (ASCO) 2022 Annual Meeting in Chicago, IL.
Transcript (edited for clarity)
So in the VISION study PSMA lutetium-177, a radio ligand therapy directed as PSMA, extended survival and delayed progression and men with PSMA PET positive mCRPC. These patients had progressed on an AR inhibitor and at least one taxane.
The purposes of the oral abstract that I will be presenting tomorrow show that PSMA PET characteristics are very important at determining the relative benefits of PSMA lutetium-177...
So in the VISION study PSMA lutetium-177, a radio ligand therapy directed as PSMA, extended survival and delayed progression and men with PSMA PET positive mCRPC. These patients had progressed on an AR inhibitor and at least one taxane.
The purposes of the oral abstract that I will be presenting tomorrow show that PSMA PET characteristics are very important at determining the relative benefits of PSMA lutetium-177. The brighter the PET scan, the better the outcomes basically is the bottom line. This standardized uptake value SUV, the brighter that is, the higher the SUV, the more the PSMA target is present. The patients that have the highest quartile, basically an SUV mean whole body of about 10 or higher, have an extraordinary response to this therapy. With progression free survivals that are much longer than those patients with more dim PSMA expression, as well as longer survivals, better objective and PSA response rates. However, even patients with fairly weak PSMA uptake probably still have a better outcome with this therapy than a second AR inhibitor suggesting that we should be perhaps reporting this for prognostic purposes, but not necessarily to exclude patients from the life prolonging benefits of this therapy.
Read more...
