ASCO Perspective
“This novel targeted radiotherapy could fill a significant need for patients with metastatic castration-resistant prostate cancer that has progressed despite chemotherapy and targeted antiandrogen therapy. The success of this treatment highlights the importance of investigating alternatives to traditional types of cancer therapies,” said ASCO President Lori J. Pierce, MD, FASTRO, FASCO.
ALEXANDRIA, Va. – The investigational therapy 177Lu-PSMA-617 significantly improved radiographic progression-free survival (rPFS) and overall survival (OS) when added to standard of care treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) compared with standard of care alone, according to new research. The study will be presented at the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting.
Study at a Glance
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Focus |
Efficacy of targeted radiotherapy 177 Lu-PSMA-617 |
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Population |
831 patients previously treated with androgen receptor pathway inhibitors and 1–2 taxane chemotherapy regimens. Patients also had prostate-specific membrane antigen (PSMA)- positive disease. |
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Findings |
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Significance |
177 Lu-PSMA-617 could fill a significant need for patients with mCRPC that has progressed despite chemotherapy and androgen receptor pathway inhibitors. It may become a new therapy option in this patient population, pending regulatory review and approval. |
Key Findings
Despite recent therapeutic advances, mCRPC remains incurable. Current treatment options include chemotherapy, androgen receptor blockers, and targeted therapies.
Prostate-specific membrane antigen (PSMA) is a transmembrane protein that is highly expressed in approximately 80% of patients with prostate cancer, including in metastatic disease. With that high expression, PSMA is an attractive therapeutic target, the researchers explain.
Lutetium-labeled PSMA-617 (177Lu PSMA-617) is a radioactive compound that binds to prostate cancer cells expressing PSMA, enabling targeted delivery of radiation to the tumor and surrounding microenvironment.
In the VISION trial the addition of 177Lu-PSMA-617 to standard of care significantly improved radiographic PFS, compared with standard of care alone, with a median of 8.7 months, compared with 3.4 months, respectively. OS was also significantly improved, with the median 15.3 months versus 11.3 months.
“The findings suggest that 177Lu-PSMA-617 warrants consideration as a new standard of care in this patient population, pending regulatory review and approval,” said lead author Michael J. Morris, MD, who is the head of the Prostate Cancer Section at Sloan Kettering Cancer Center in New York.
More high-grade treatment-emergent adverse events were seen with 177Lu-PSMA-617, 52.7%, versus standard of care, 38.0%. There were no unexpected or concerning safety signals.
About the Study
VISION is a phase III international, open-label trial of 177Lu-PSMA-617 for the treatment of mCRPC that expresses PSMA. All patients were previously treated with androgen receptor pathway inhibitors and 1–2 taxane chemotherapy regimens.
A total of 831 patients were randomized 2:1 to receive 177Lu-PSMA-617 plus standard of care, or standard of care only. The primary endpoints were PFS determined by radiography and OS.
Next Steps
Drug maker Novartis plans to submit these data to regulatory authorities.
For your readers:
View the disclosures for the 2021 Cancer Communications Committee: https://www.asco.org/sites/new-www.asco.org/files/content-files/about-asco/pdf/2021-am-news-planning-team-disclosures.pdf
View the disclosures for Dr. Gralow: https://coi.asco.org/share/CKD-HYVM/Julie%20Gralow
View the disclosures for Dr. Pierce: https://coi.asco.org/share/Z2M-8YDX/Lori
ATTRIBUTION TO THE AMERICAN SOCIETY OF CLINICAL ONCOLOGY ANNUAL MEETING IS REQUESTED IN ALL COVERAGE.
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About ASCO:
Founded in 1964, the American Society of Clinical Oncology, Inc. (the Society) is committed to the principle that knowledge conquers cancer. Together with the Association for Clinical Oncology, ASCO® represents nearly 45,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of high quality and equitable patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. Conquer Cancer, the ASCO Foundation, supports the Society by funding groundbreaking research and education across cancer’s full continuum. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, Instagram, and YouTube.