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A radioactive drug that homes to the PSMA protein on prostate cancer cells helped men with heavily pretreated metastatic prostate cancer live about four months longer, launching radioligand therapy as a mainstream treatment.
Open-label phase 3 trial of 831 men with PSMA-PET-positive metastatic castration-resistant prostate cancer previously treated with at least one androgen-receptor pathway inhibitor and one or two taxanes, randomised 2:1 to 177Lu-PSMA-617 (7.4 GBq every six weeks for up to six cycles) plus protocol-permitted standard care, or standard care alone. Primary endpoints were radiographic PFS and OS.
Median OS was 15.3 vs 11.3 months (HR 0.62) and median rPFS 8.7 vs 3.4 months (HR 0.40). It led to FDA and EMA approval of Pluvicto in 2022, the first radioligand therapy to show a survival benefit in a common cancer, and made PSMA PET a theranostic gatekeeper.
Men with metastatic castration-resistant prostate cancer that has progressed after hormonal therapy and chemotherapy, and whose tumours show PSMA on a PET scan, can now receive lutetium-PSMA, which extends life, controls pain and is usually better tolerated than further chemotherapy. It has established a new treatment class in which a scan decides who gets the matching radioactive drug, and it is now being tested earlier in the disease (PSMAfore, PSMAddition).
Shares VISION, Theranostics, Lutetium-177 vipivotide tetraxetan, PSMA.
Shares [ 177 Lu]Lu-PSMA-617 versus cabazitaxel in patients with metastatic castration-resistant prostate cancer (TheraP): a randomised, open-label, phase 2 trial, PSMAfore, VISION, Lutetium-177 vipivotide tetraxetan.
Shares Ken Herrmann, Dosimetry, Theranostics, Lutetium-177 vipivotide tetraxetan.
Shares Dosimetry, Theranostics, Progression-free survival (PFS), PET/CT.
Shares PSMAfore, Dosimetry, VISION, Lutetium-177 vipivotide tetraxetan.
Shares Dosimetry, Theranostics, Lutetium-177 vipivotide tetraxetan, PSMA.
Shares PSMAfore, Dosimetry, VISION, Lutetium-177 vipivotide tetraxetan.
Shares Dosimetry, Theranostics, Lutetium-177 vipivotide tetraxetan, PSMA.