Lutetium-177-PSMA-617: A Vision of the Future

Cancer Biol Ther. 2022 Dec 31;23(1):186-190. doi: 10.1080/15384047.2022.2037985.

Abstract

In the last decade, many life-prolonging therapeutic options have emerged for metastatic castration-resistant prostate cancer (mCRPC). The recent VISION trial is the first to demonstrate a survival benefit of Lutetium-177[177Lu]Lu-PSMA-617 in post-chemotherapy mCRPC. This journal club reviews the VISION trial in the context of the earlier TheraP trial of [177Lu]Lu-PSMA-617 in mCRPC post docetaxel and androgen pathway inhibition, to provide direction for the real-world application of [177Lu]Lu-PSMA-617. Treatment in the control groups differed significantly between both trials and may have influenced outcomes: TheraP mandated cabazitaxel whereas VISION's design could not allow it. In both trials, [177Lu]Lu-PSMA-617 had a good safety profile, with common adverse events being fatigue, nausea, dry mouth, marrow suppression and diarrhea. Given its efficacy and favorable safety even in heavily pre-treated patients, [177Lu]Lu-PSMA-617 provides hope to mCRPC patients and may be applied to earlier disease stages in future investigations.

Keywords: FDG PET-CT; PSMA; Prostate cancer; cabazitaxel; lutetium; mCRPC; radioligand therapy.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Dipeptides / adverse effects
  • Heterocyclic Compounds, 1-Ring
  • Humans
  • Lutetium / therapeutic use
  • Male
  • Prostate-Specific Antigen / therapeutic use
  • Prostatic Neoplasms, Castration-Resistant* / drug therapy
  • Prostatic Neoplasms, Castration-Resistant* / radiotherapy
  • Radioisotopes
  • Radiopharmaceuticals
  • Treatment Outcome

Substances

  • Dipeptides
  • Heterocyclic Compounds, 1-Ring
  • PSMA-617
  • Radioisotopes
  • Radiopharmaceuticals
  • Lutetium
  • Lutetium-177
  • Prostate-Specific Antigen