“Nuclear therapy” with radioligands is gaining momentum in the treatment of metastatic prostate cancer that does not respond to hormone therapy. After the results presented at the congress of the American Society of Oncology (Asco) last June, new data are now arriving from the European congress of oncology (ESMO) which is taking place in virtual mode from 16 to 21 September 2021. In particular, the evidence concerns quality of patients participating in the Phase III VISION study, which evaluates 177Lu-PSMA-617, an experimental radioligand targeted therapy, in addition to standard of care versus standard of care alone. The addition of the new therapy, in fact, leads to a delay in the worsening of physical disability and pain, symptoms that many patients experience.
ASCO 2021
Prostate cancer, new hope from nuclear medicine
by Tiziana Moriconi
The new data
The ad hoc analysis of the health-related quality of life showed, in the 177Lu-PSMA-617 arm in addition to the standard of care, an estimated 54% reduction in the risk of worsening conditions related to quality of life. In addition, the combination of the standard of care with radioligand therapy showed an estimated 55% reduction in the risk of increased pain intensity. “As with other oncological diseases in the past, prostate cancer is also experiencing today. his entry into a new era of therapies in the name of precision medicine and less disabling, capable of guaranteeing in addition to survival also a good tolerability and an improvement in the quality of life – says Giuseppe Procopio, head of genitourinary medical oncology of the IRCCS Foundation National Cancer Institute (INT) of Milan -. A non-negligible component of metastatic prostate cancer is the particularly debilitating symptoms that cause further complications for the patient’s state of health and psycho-physical well-being. The marked impact on the daily life of patients – observes Procopio – confirms the importance of the data presented today: even in the presence of a complex pathology, with advanced stage neoplasia and metastases, radioligand therapy opens a new perspective, revealing itself to be effective therapeutic option, able to offer patients a favorable prognosis in terms of duration and also of quality of life “.
Prostate Cancer Radiotherapy: Do We Trust Artificial Intelligence?
by Tina Simoniello
A promising way
“Patients with castration-resistant metastatic prostate cancer are prone to numerous complications associated with advanced disease, which can affect their quality of life,” said Jeff Legos, Executive Vice President, Global Head of Oncology & Hematology Development, Novartis. “These new data underscore the potential quality-of-life benefit that the 177Lu-PSMA-617 trial may offer as a possible new therapeutic option, in addition to the already reported improvements in overall survival and radiographically detected progression-free survival.” The road outlined is promising: two further studies of radioligand therapy 177Lu-PSMA-617 are underway in the treatment of early stages of metastatic prostate cancer, which analyze the potential clinical utility in metastatic castration-resistant prostate cancer in the pre-setting setting. taxane (PSMAfore) and hormone-sensitive metastatic (PSMAddition). Novartis is also considering investigating 177Lu-PSMA-617 radioligand therapy in the early stages of prostate cancer.
Neuroendocrine prostate cancer. Is the future in BET inhibitors?
by Tina Simoniello
A precision therapy
“Prostate cancer has become, in the last decade, the most frequent cancer in the male population of Western countries. The numbers describe a still worrying reality, even if in recent years we have obtained excellent results in terms of reducing mortality rates – comments Marcello Tucci, Director of SC Oncology Cardinal Massaia Hospital in Asti and Board Member AIOM (Italian Association of Medical Oncology) – . Now it is possible to start thinking about personalizing therapeutic choices in an extremely precise way, allowing a better prognosis even to the most complex patients, for whom all this translates into an increase in the duration and quality of life. For patients with metastatic prostate cancer the scenario is completely different today than it was very recently and is still in continuous, very rapid evolution as in few other sectors of oncology. The VISION study opens the doors to the era of precision medicine in prostate cancer – explains Tucci -. For the first time, the selective antitumor action of a radiopharmaceutical, Lutetium 177, is demonstrated in patients with disease in the phase of resistance to castration. The last ASCO presented the efficacy and safety data from the VISION study in which cancer therapy with radioligand in addition to the best standard of care achieved a 38% reduction in the risk of death (OS) and a 60% risk reduction. of disease progression (PFS). The data that will be presented to ESMO – concludes Tucci – will underline the positive results on the quality of life, confirming the potential of this treatment “.
Advanced prostate cancer
Prostate cancer is a form of cancer that develops in the prostate gland, a small, walnut-shaped gland found in the pelvic region of men. In castration-resistant prostate cancer (CRPC), the tumor shows signs of growth, such as increased serum levels of prostate specific antigen (PSA), despite the use of hormone treatments that lower testosterone. In castration-resistant metastatic prostate cancer (mCRPC), the cancer spreads to other sites in the body, such as adjacent organs or bones, and does not respond to hormone treatment. The 5-year survival rate of patients with metastatic prostate cancer is approximately 30%.
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