{"id":2312,"date":"2021-07-01T09:32:17","date_gmt":"2021-07-01T09:32:17","guid":{"rendered":"https:\/\/aceoncology.org\/?p=2312"},"modified":"2021-07-01T09:38:02","modified_gmt":"2021-07-01T09:38:02","slug":"asco21-plenary-survival-benefits-with-new-psma-targeted-radioligand-in-mcrpc","status":"publish","type":"post","link":"https:\/\/aceoncology.org\/zh-hans\/asco21-plenary-survival-benefits-with-new-psma-targeted-radioligand-in-mcrpc\/","title":{"rendered":"Survival Benefit With Novel PSMA-Targeted Radioligand in Metastatic CRPC"},"content":{"rendered":"\n

Despite advances in the management of castration-resistant prostate cancer (CRPC) and availability of several therapeutic options with the potential to prolong survival, patients with metastatic disease continue to have poor prognosis. A promising molecular target for diagnostic imaging and targeted therapy is prostate-specific membrane antigen (PSMA), a membrane-bound enzyme (carboxypeptidase) that is selectively overexpressed on prostate cancer cells. The radioligand 177<\/sup>lutetium (Lu)-PSMA-617 is a small molecule that targets PSMA with high affinity and delivers \u03b2-particle-emitting 177<\/sup>Lu via receptor-mediated endocytosis. This leads to DNA damage and cell death.<\/p>\n\n\n\n

During the plenary session at ASCO 2021, results from the randomized, open-label, phase III VISION study<\/a> of 177<\/sup>Lu-PSMA-617 in patients with mCRPC were presented by Dr Michael J Morris <\/em>(Memorial Sloan Kettering Cancer Center, New York, US). Results were also published in the New England Journal of Medicine on June 23<\/a><\/em>. In this trial, patients with PSMA-positive mCRPC (on gallium-68 PSMA PET-CT scans), previously treated with at least one second-generation androgen receptor signaling inhibitor and 1 \u2013 2 taxane regimens were randomly assigned to receive either 177<\/sup>Lu-PSMA-617 <\/a>(7.4 GBq every 6 weeks for 4 \u2013 6 cycles) plus standard of care (SOC), or SOC alone. SOC was the choice of treating physicians; however, it could not include chemotherapy, immunotherapy, radium-223 or investigational agents, due to safety concerns over combinations with 177<\/sup>Lu-PSMA-617. Median follow-up was 20.9 months. The co-primary endpoints were radiographic progression-free survival (rPFS analysis set; n=581) and overall survival (OS in all randomized patients; n=831). Among patients in the rPFS analysis set, the risk of radiographic progression or death was reduced by 60% with 177<\/sup>Lu-PSMA-617 treatment (hazard ratio [HR], 0.4; P<\/em><0.001); median rPFS was 8.7 versus 3.4 months. For OS, the risk of death was reduced by 38% (HR, 0.62; P<\/em><0.001), and median OS was prolonged from 11.3 months to 15.3 months. The survival benefits were generally consistent across all subgroups except in those that included a low number of patients, which resulted in wide confidence intervals. Response rates also significantly favored the 177<\/sup>Lu-PSMA-617 arm, with an independent review committee-determined overall response rate of 29.8% versus 1.7%. Furthermore, a decrease by \u226550% of prostate-specific antigen (PSA) levels was seen in 46% of the 177Lu-PSMA-617 arm and 7% of the SOC arm.\u201d. More grade \u22653 treatment-related adverse events (TRAEs) occurred in patients who received 177<\/sup>Lu-PSMA-617 plus SOC compared with SOC treatment (52.7% versus 38%), with the most common TRAEs being hematologic toxicity, in particular anemia (12.9%). The most frequent AEs of any grade related to 177<\/sup>Lu-PSMA-617 were fatigue, dry mouth, and nausea. Adverse events led to discontinuation of 177<\/sup>Lu-PSMA-617 in 11.9% of patients. Deaths related to TRAEs were reported in 5 patients (0.9%) in the 177<\/sup>Lu-PSMA-617 arm and none in the SOC arm.<\/p>\n\n\n\n

Dr Morris concluded that the findings from the VISION trial warrant the adoption of 177<\/sup>Lu-PSMA-617 as a new treatment option for patients with mCRPC who have progressed after androgen receptor pathway inhibitor therapy and chemotherapy. Dr Mary-Ellen Taplin <\/em>(Harvard Medical School, Boston, Massachusetts, US), the abstract discussant, noted this was a highly positive trial, although she had hoped for a longer survival improvement. Nevertheless, she concluded that if 177<\/sup>Lu-PSMA-617 receives FDA approval \u2018\u2019this therapy will add to our armamentarium of palliative systemic treatment options for mCRPC.\u2019\u2019<\/p>\n\n\n\n

References<\/strong><\/p>\n\n\n\n

Morris M, et al. ASCO 2021; Abstract LBA04.<\/p>\n\n\n\n

Sartor O, et al. N Engl J Med. <\/em>2021 June 23. [Online ahead of print].<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Despite advances in the management of castration-resist […]<\/p>\n","protected":false},"author":3,"featured_media":2318,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[18],"tags":[],"class_list":["post-2312","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-conference-news"],"acf":[],"yoast_head":"\nSurvival Benefit With Novel PSMA-Targeted Radioligand in Metastatic CRPC - ACE Oncology<\/title>\n<meta name=\"description\" content=\"Survival benefit with PSMA-targeted radioligand therapy in metastatic castration-resistant prostate cancer\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/aceoncology.org\/zh-hans\/asco21-plenary-survival-benefits-with-new-psma-targeted-radioligand-in-mcrpc\/\" \/>\n<meta property=\"og:locale\" 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