Can Advanced Prostate Cancer Be Treated Without Radiology?

Can Advanced Prostate Cancer Be Treated Without Radiology?


When you think about radiation therapy, you probably imagine external machines nuking your tumors. However, a new treatment might mean that you can receive radiation treatment that’s far less invasive and damaging, even if you have advanced prostate cancer. This new treatment involves radioactive particles injected into the bloodstream, where they conduct a “seek and destroy” mission on individual cancer cells while sparing your healthy cells.

Enter Lu-PSMA-617 (Pluvicto), a radioligand available for certain prostate cancer patients. This groundbreaking drug carries a potent payload of radioactive atoms, binding specifically to a cell protein called prostate-specific membrane antigen (PSMA), prevalent in prostate cancer cells but absent in most normal cells. Upon binding, Lu-PSMA-617 delivers its radioactive cargo, leading to the demise of the targeted cancer cell.

Currently approved for a specific scenario—patients with metastatic castration-resistant prostate cancer (mCRPC) who have undergone chemotherapy—Lu-PSMA-617 raises the question: Can men with mCRPC skip chemotherapy and opt for Lu-PSMA-617 from the start? This query was explored in a recently completed clinical trial.

The PSMAfore phase 3 trial enrolled 468 men with mCRPC, all with PSMA-positive tumors and having received second-line testosterone blockers. The study randomized participants into two groups: one receiving Lu-PSMA-617 infusions and the other switching to a second testosterone blocker not previously administered.

After a year and a half of follow-up, the results were promising. Those treated with Lu-PSMA-617 experienced a significant delay in cancer progression—six months longer on average than the control group. PSA levels, a marker for prostate cancer, also saw notable reductions in the Lu-PSMA-617 group, with 58% experiencing a decline of half or more, compared to 20% in the control group. The treatment was well-tolerated, with dry mouth and minor gastrointestinal symptoms as the most common side effects.

While further follow-up is required to demonstrate prolonged survival, researchers are optimistic about Lu-PSMA-617’s potential as an early treatment option for advanced prostate cancer. 

Dr. Marc B. Garnick from Harvard Medical School expresses anticipation for longer-term follow-up, highlighting the study’s significance in expanding treatment options for advanced prostate cancer. The findings underscore the systematic progression of pharmaceutical development and the potential for Lu-PSMA-617 to be applied in earlier stages of advanced prostate cancer.

What do you think of the new research about prostate cancer treatment? Leave your thoughts in the comments below.

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