New Hope for Advanced Prostate Cancer: Delivering Radiation at The Cellular Level
- The FDA has approved a drug called Pluvicto (lutetium Lu 177 vipivotide tetraxetan) for certain men with advanced prostate cancer. The drug delivers small doses of radiation to specific cells that contain a biological marker called PSMA.
- The targeted treatment approach showed significant improvement in overall survival for patients that had until now very limited treatment options. Experts in the field have called the approval a “major step” for personalized medicine for advanced prostate cancer.
- PSMA testing is essential. Pluvicto is approved for men after what’s called PSMA testing, in which a PET scan looks for the presence of a biological marker called PSMA, which is an important biomarker that helps doctors assess the presence of advanced prostate cancer
If you have prostate cancer that has spread beyond the prostate and has not responded to hormone therapy, the Food and Drug Administration’s new drug approval may be helpful for you.
Read More“The approval of lutetium is a major step in the development of personalized treatment for advanced prostate cancer,” Dr. David Penson, of Vanderbilt University Medical Center, tells SurvivorNet. “This agent specifically targets PSMA-positive metastasis and represents the first theranostic agent for use in castration-resistant metastatic prostate cancer.”
RELATED: New Developments in Treating Late-Stage Prostate Cancer
What You Need to Know About The Approval
The approval was based on the results of a landmark study called the VISION trial.
The results of the trial showed:
- That adding the drug to the current standard of care led to a nearly 40% reduction in the risk of death for patients with PSMA-positive mCRPC.
- That adding the drug led to a 60% reduced risk of progression for these same patients.
Dr. Ghassan El-Haddad, associate member of the Diagnostic Imaging and Interventional Radiology Department of Moffitt Cancer Center, oversaw the VISION trial at the cancer center. He spoke to SurvivorNet to explain how the medication works.
He explained that in order to use the drug, patients are first given a PET scan using a special imaging agent which aids in the detection of cancer cells in the body that are PSMA positive.
“The use of Pluvicto is coupled with a PET imaging agent that detects the PSMA-positive metastatic lesions throughout the body. If the patients have PSMA-positive metastatic lesions on PET, then they would be eligible for the therapy. This combination of a (therapy that can deliver radiation to target cells) with an imaging biomarker positivity is a great example of precision medicine or what we call in nuclear medicine, theranostics (therapeutics + diagnostics).”
How PARP Inhibitors Treat Metastatic Prostate Cancer
A ‘Major Step’ for Personalized Treatment
Currently, metastatic prostate cancer has a 5-year survival rate of less than 30%, but there is hope that with new targeted therapies — which aim to find and destroy cancer cells without killing other cells in the body — that rate can be improved. Until this new approval, mCRPC patients who continued to progress, despite different types of therapies, had very limited options.
Dr. Anthony Corcoran, a urologic oncologist at NYU Langone’s Perlmutter Cancer Center, said that the new approval of Pluvicto for men with mCRPC “will revolutionize their treatment as it can target only prostate cancer cells with a radiation emitting molecule. This is precision medicine at its finest and this drug will expand the options for patients with more severe disease.”
Side Effects of Pluvicto
The most common adverse reactions were:
- Fatigue
- Dry mouth
- Nausea
- Anemia
- Decreased appetite
- Constipation
Which Options Are Available for Advanced Disease?
Treatments available to men with advanced prostate cancer vary depending on the person’s current health status, type of disease, and how aggressive the cancer appears. However, other new treatments options such as PARP inhibitors and new androgen depravation drugs have led to a lot of hope in the field.
PARP inhibitors work to stop the activity of poly (ADP-ribose) polymerase, a protein involved in DNA repair. PARP inhibitors prevent DNA from repairing itself in cancer cells, which eventually leads to cell death. Currently, there are two PARP inhibitors available to treat metastatic castration-resistant prostate cancer: Lynparza (olaparib) and Rubraca (rucaparib).
Dr. Stephen Freedland explains how hormonal therapy is used to treat advanced prostate cancer.
Hormone therapies may also be used to manage advanced prostate cancer to prevent it from growing and spreading further. Androgen deprivation therapy is a type of hormone therapy that works by inhibiting androgen production, including testosterone, or blocking androgen receptors which can slow tumor growth. Two newer androgen deprivation therapies for late-stage prostate cancer include Xtandi (enzalutamide) and Erleada (apalutamide). You can read more about treatment for advanced prostate cancer here.
What To Ask Your Doctor
- What type of prostate cancer do I have?
- Do I qualify for the use of Pluvicto?
- Would the use of Pluvicto help treat my cancer?
- Are there risks associated with taking Pluvicto?
- How will I know if Pluvicto is working for me?
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