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ASCO 2021: Radiolabeled Antibody Plus Standard of Care for PSMA-Positive Prostate Cancer

By: Julia Fiederlein
Posted: Friday, June 4, 2021

Patients with advanced prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer may benefit from treatment with the radiolabeled antibody lutetium-177–PSMA-617 (177-Lu–PSMA-617) plus the standard of care versus the standard of care alone, according to Michael J. Morris, MD, of the Memorial Sloan Kettering Cancer Center, New York, and colleagues. The results of the phase III VISION trial, which were presented during a presscast in advance of the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract LBA4, Plenary), support the adoption of this targeted radioligand therapy as a standard of care.

“PSMA is highly expressed in metastatic castration-resistant prostate cancer lesions,” the investigators commented. “177-Lu–PSMA-617…delivers ß particle radiation to PSMA-expressing cells and [the] surrounding microenvironment.”

Between June 4, 2018, and October 23, 2019, a total of 831 patients who were previously treated with next-generation androgen receptor signaling inhibition and taxane-based chemotherapy were randomly assigned in a 2:1 ratio to receive a standard of care regimen with or without 177-Lu–PSMA-617. Follow-up data will be provided for a median of 20.9 months.

Compared with the standard of care alone, 177-Lu–PSMA-617 plus the standard of care was reported to have significantly prolonged the median duration of radiographic progression-free survival (8.7 vs. 3.4 months; hazard ratio = 0.40; P < .001) and overall survival (15.3 vs. 11.3 months; hazard ratio = 0.62; P < .001). The objective response rate (29.8% vs. 1.7%), disease control rate (89.0% vs. 66.7%), and time to first symptomatic skeletal event (median, 11.5 vs. 6.8 months; hazard ratio = 0.50) also appeared to favor 177-Lu–PSMA-617 plus the standard of care versus the standard of care alone.

A higher rate of high-grade treatment-emergent adverse events was observed with 17-7Lu–PSMA-617 (52.7% vs. 38.0%). However, according to the investigators, this therapy was well tolerated.

Disclosure: For full disclosures of the study authors, visit coi.asco.org.



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