Prostate cancer remains a significant health concern, especially in its metastatic castration-resistant form, which poses a formidable challenge for both patients and healthcare providers. Despite ongoing advancements in treatment options, the battle against this deadly disease continues. However, recent research has illuminated a ray of hope through the use of PSMA Lutetium therapy. In this article, we delve into the insights presented by Dr. Oliver Sartor at ESMO 2023 regarding the safety, efficacy, and potential benefits of PSMA Lutetium therapy in the treatment of metastatic castration-resistant prostate cancer.
Q1: Hi, Professor Sartor. First of all, thank you so much for attending this interview, and please introduce a little bit about yourself to our audience.
A: Sure. I’m Dr. Oliver Sartor. I’m a medical oncologist. I’ve been focusing on prostate cancer for over 30 years, and I’ve been involved with a large number of clinical trials over many years, and here at ESMO 2023 today. So glad to be here.
Q2: So our question is about your study this year. How does the use of Lu-PSMA therapy after 223Ra treatment affect the safety and survival outcomes of patients?
A: Interestingly, I’ve worked fairly extensively at Radiome 2 to 3, fairly extensively with the PISMA Lutitium, and we’ve published several articles that address sequence.
And in these sequencing articles, we look at Radiome 2 to 3 first, and then Lutitium later. And it turns out that being able to give the Radiome first does not seem to interfere much with Lutitium later.
So it would appear, obviously these are not randomized studies, but they’re reasonable studies, that you could give Radiome first and then Lutitium second and it still have a good effect from the Lutitium.
Q3: What are the potential benefits of using Lu-PSMA therapy earlier in the treatment sequence for mCRPC? Do you have any advice for patients with mCRPC or their families who might be considering Lu-PSMA therapy?
A: You know, the first trial we did with PISMA Lutitium was conducted in very advanced patients. So patients had to avail a novel hormone, mididemcellulose second novel hormone, everybody had to have failed at taxing chemotherapy.
Many of the patients failed two taxing chemotherapies. So in the vision trial, the patients were extremely heavily treated. Here at Esmeralda 2023, we’ve treated patients in a controlled clinical trial, PSMA4, but they weren’t nearly as advanced as those in vision.
These patients had failed hormonal therapy, that failed a novel hormone such as abradarone, insulutamide, derlutamide, apolutamide, and then they had progressive disease, but they were not previously treated with taxings.
And we found benefit here as well. So we had a very strong, what we call word, graphic progression for a survival, RPFS, has a ratio of 0 .43. That means we reduce the risk of progression by about 57% versus the alternative hormone.
Safety profile was excellent adverse event. profile excellent even compared to the hormones. And I’ll simply say that with these types of data, our hope is that the regulators will approve the use of PSMA lutetium earlier, and then we can bring PSMA lutetium to the patients at an earlier stage.
And I think that’ll be beneficial. You don’t have to undergo chemotherapy in order to get the PSMA. So more work to be done, and regulators need to be able to sign off. But nevertheless, we’ve presented some very nice data here at SMA 20. That’s a very good start.
Q4: so our final question, what are some of the ongoing challenge in the field, and how do you see future research addressing this?
A: You know, the variety of ongoing challenges.
You know, first of all, metastatic castor resistant prostate cancer is a fatal disease. We are losing the battle. And there are many men who get all the therapies that we know how to give, and they still progress and they still die.
And I’ll simply say that we need to do better. You know, research in the end is hopefully gonna help patients. So our research with the radiopharmaceuticals, our research with the inter receptor degraders, our research with the bi specifics, the immune therapies, there’s a lot of work that needs to be done in order to improve the survival of patients.
And that work will need to be ongoing because today we’re not curing people. We’re pushing it down the line. We’re getting better and better, but we’re not curing patients. And that’s what we need to strive for.
That’s our final purpose. That is our purpose. We would love to cure patients, even with advanced disease.
TAG: ESMO 2023, Mcrpc, Lu-PSMA therapy
