Radioligand Therapy Plus Standard Care for Metastatic Castration-Resistant Prostate Cancer
Posted: Wednesday, August 18, 2021
Radioligand therapy with lutetium-177–prostate-specific membrane antigen-617 (LuPSMA) extended survival when used with standard care in patients with advanced PSMA-positive metastatic castration-resistant prostate cancer, according to findings presented in The New England Journal of Medicine. The patients in the phase III VISION trial had previously received one or more androgen receptor–pathway inhibitor and one or two taxane regimens, noted Oliver Sartor, MD, of Tulane University, New Orleans, and colleagues.
“Treatment with lutetium-177–PSMA-617 was associated with toxic effects that were mainly of grade 3 or lower, and this therapy also extended the time to symptomatic skeletal events, prolonged the time to worsening of health-related quality of life and pain, and delayed biochemical progression,” the authors concluded.
In this international, open-label trial, the authors enrolled 813 patients with metastatic castration-resistant prostate cancer who had previously received at least one androgen receptor–pathway inhibitor and one or two taxane regimens. Patients received either LuPSMA plus protocol-permitted standard care or standard care alone.
After a median follow-up of 20.9 months, those patients treated with the radioligand therapy plus standard care had longer imaging-based progression-free survival (8.7 months) compared with those who received standard care alone (3.4 months). Overall survival was also longer for patients who received radioligand therapy than those who did not (15.3 months vs. 11.3 months).
All the key secondary endpoints also favored treatment with LuPSMA, the authors noted. There were more incidences of grade 3 or higher adverse events for patients who received the radioligand therapy versus those who received standard care alone (52.7% vs. 38.0%), but the authors found that quality of life for these patients was not adversely affected.
Disclosure: For full disclosures of the study authors, visit nejm.org.
