mCRPC in focus
Transcript: Radioligand therapy for patients
Dr Silke Gillessen
Interview recorded September 2024. All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
So, I guess the radioligand therapies for the moment is specifically Lutetium-PSMA. The 617 that has been shown in the VISION trial to be active, and to prolong overall survival for patients who had already, at least, one RP and at least one taxane. In reality, in the VISION study, the patients were really heavily pretreated also with three, and four and five lines before, and has shown an overall survival benefit. It has been approved for that indication. And I think it has a big value, because in the end, this is like a new mechanism of action. It's quite well tolerated, and, you know, it has shown an overall survival benefit. Of course, now we have the PSMAfore data, so that is using the same agent, but in an earlier setting after one RP, before chemotherapy, and also in that study. So here, the control arm were also the alternate RP, but these were quite selected patients. They were not suitable for a PARP inhibitor. They didn't want to have chemotherapy, or the investigators thought they don't need chemotherapy. So I guess that was a quite selected patient population. And what you saw here is also that the RPFS was clearly prolonged with the Lutetium-PSMA.
The overall survival was not different, but there was also a crossover allowed. So I guess, and the toxicity, of course, the quality of life seemed to be better in the Lutetium-PSMA arm. And at ESMO we saw a very similar study with another radioligand and also targeting PSMA. But this time, the compound is called PNT 2002. So that is the, another name is another small molecule. But again, it's also targeting the PSMA, and it's also with Lutetium-177, like also the substance that was used for the other two trials, and it was just used in another dose. Interestingly, the RPFS, or the hazard ratio didn't look as interesting as in PSMA four. But here, I really think it was also because that substance, that radioligand was given a bit differently every eight weeks, and only four cycles, and not six cycles like in the other trial. So I think for the, in total, so the radioligands for me, a very interesting new treatment. It's of course also very kind of interesting to think that you do a theranostic. So you do first a PET diagnostics, where you see the target, and then you target the target. So that's, that's quite, I think also a logical thing to do. And I really think this is the future, and we will see many more of them. For the moment, I guess we have still to find the best, the optimal dose, the optimal schedule. And that's something, I mean, work that's ongoing.
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