Therapy

2024 UCSF-UCLA PSMA Conference Videos

Publications
Articles and Abstracts
177Lu-PSMA therapy is an effective treatment in patients with metastatic castration-resistant prostate cancer. SUVmean is a valuable screening biomarker to assess the suitability for 177Lu-PSMA therapy but requires quantitative software.

68Ga-gozetotide (68Ga-PSMA-11) is used to identify prostate-specific membrane antigen (PSMA)-positive tumors on PET scans. In the VISION study, 68Ga-PSMA-11 was used to determine the eligibility of patients with metastatic castration-resistant prostate cancer for treatment with 177Lu-vipivotide tetraxetan (177Lu-PSMA-617), based on predefined read criteria.

The pivotal phase 3 VISION study used [68Ga]Ga-PSMA-11 (also known as 68Ga-PSMA-11) imaging to identify patients with metastatic castration-resistant prostate cancer eligible for [177Lu]Lu-PSMA-617 radioligand therapy, based on predefined read criteria. In this substudy of VISION, the inter-reader variability and intra-reader reproducibility of visual assessments of 68Ga-PSMA-11 positron emission tomography scans using the VISION read criteria were evaluated.
BACKGROUND
Metastatic castration-resistant prostate cancer remains fatal despite recent advances. Prostate-specific membrane antigen (PSMA) is highly expressed in metastatic castration-resistant prostate cancer. Lutetium-177 (177Lu)–PSMA-617 is a radioligand therapy that delivers beta-particle radiation to PSMA-expressing cells and the surrounding microenvironment.

Purpose of the study: To report the safety evaluation of 177Lu-PSMA-617 derived from the cohort of 64 patients exposed to 177Lu-PSMA-617 in the RESIST-PC trial NCT03042312 Methods: RESIST-PC was a prospective multicenter phase 2 trial.

Objective: To determine prospectively the efficacy profile of 2 activity regimens of Lu-PSMA therapy in patients with progressive metastatic castrate resistant prostate cancer (mCRPC): 6.0 vs 7.4 GBq.

Physician-Scientist Review Articles
State of the Evidence Review Articles
Written by Zachary Klaassen, MD, MSc, Medical College of Georgia, Augusta, Georgia
August 24, 2021
In spite of the rapid progress and many exciting advances in the treatment of metastatic castration-resistant prostate cancer over the past few years, the disease remains incurable with a median overall survival of 12-35 months.1-4
Conference Coverage
Conference Highlights Written by Physician-Scientist
Presented by Jiarou Wang, MD
At the 2024 SNMMI annual meeting Dr. Jiarou Wang discussed the diagnostic performance of 68Ga-P16-093 in newly diagnosed prostate cancer. 68Ga-P16-093 is a novel PSMA-targeted radiopharmaceutical that has a labeling reaction compatible with various Ge/Ga generators and has a simple labeling method of heating at 95 degrees Celsius for 5 minutes, leading to high radiochemical purity. As a targeting agent in prostate cancer patients,
Presented by Jean-Mathieu Beauregard, MD, MSc, FRCPC
The 2024 SNMMI annual meeting featured a session on prostate cancer, and a presentation by Dr. Jean-Mathieu Beauregard discussing a sub-analysis of the 3TMPO study assessing eligibility for PSMA radioligand therapy based on dual FDG/PSMA-PET. Eligibility criteria for PSMA radioligand therapy are currently debated, particularly with respect to the role of FDG-PET in patient selection.
Presented by Linlin Li, PhD
The 2024 SNMMI annual meeting featured a session on prostate cancer, and a presentation by Dr. Linlin Li discussing the dosimetry and pilot therapy study of novel PSMA-targeting agents, 177Lu-P17-087 and 177Lu-P17-088, in metastatic castration-resistant prostate cancer patients. 
Presented by Thomas Hope, MD
The 2024 SNMMI annual meeting was host to the session Novel Approaches and Combination Therapies; Pre-Targeting Approaches. Dr. Thomas Hope discussed the combination treatment of prostate cancer using Pembrolizumab with PSMA-based radioligands.
Presented by Nat Lenzo, MD, EMBA, FRACP, FAANMS, GAICD
At the 2024 SNMMI annual meeting, Dr. Nat Lenzo presented preliminary results of ProstACT SELECT, specifically the safety, tolerability, and dosimetry of TLX591 with best standard of care in patients with PSMA-expressing metastatic castration resistant prostate cancer.
Presented by Michael S. Hofman, MBBS (Hons), FRACP, FAANMS, FICI
The 2024 SNMMI annual meeting featured the Therapy Center of Excellence Saul Hertz Lecture and Award, and a presentation by Dr. Michael Hofman discussing bridging evidence-based medicine and precision oncology. Saul Hertz (1905-1950) conceived and brought from bench to bedside radioactive iodine for medical uses based on the 1936 question “Could iodine be made radioactive artificially?” This was followed by the 1937 radioactive iodine studies assessing thyroid physiology, tracer qualities, dosimetry, and thyroid carcinoma. 
Presented by James Buteau, MD, FRACP, FRCPC
Th SNMMI 2024 Annual Meeting was host to a prostate cancer novel approaches and combination therapies session. Dr. James Buteau discussed novel approaches of combination PSMA-based radiopharmaceutical treatments for prostate cancer.
Presented by David Chen, PhD
At the SNMMI 2024 Annual Meeting, David Chen presented the results of a prospective analysis of the ProsTIC registry evaluating the oncologic and quality-of-life outcomes of metastatic castration-resistant prostate cancer (mCRPC) patients with a stable or poor initial PSA response to [177Lu]Lu-PSMA-617, and the prognostic value of baseline imaging biomarkers and dosimetry.
Presented by Meryam Losee, BS
At the SNMMI 2024 Annual Meeting, Dr. Meryam Losee presented the results of a study evaluating the effect of bone marrow disease on hematologic toxicity and PSA response to 177Lu-PSMA-617 therapy. 
Presented by Fuad Novruzov, MD, PhD
At the SNMMI 2024 Annual Meeting Dr. Fuad Novruzov presented the results of a prospective phase 3 randomized study from Azerbaijan evaluating 225Ac-PSMA + 177Lu-PSMA tandem therapy for metastatic castration-resistant prostate cancer (mCRPC).
Presented by Vishnu Murthy
At the SNMMI 2024 Annual Meeting Vishnu Murthy presented the results of a US expanded access program evaluating the efficacy and toxicity of 177Lu-PSMA-617 for metastatic castration-resistant prostate cancer (mCRPC) in a real-world setting and compared these results to those from the phase 3 VISION trial.
Presented by Oliver Sartor, MD
The SNMMI 2024 Annual Meeting was host to a prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) tumor board session. Dr. Oliver Sartor discussed whether earlier use of PSMA RLT in earlier settings is of clinical benefit.
Presented by Johann S. De Bono, MD, MSc, PhD, FRCP, FMedSci
The 2024 ASCO annual meeting featured a session on prostate cancer, and a presentation by Dr. Johann De Bono discussing baseline ctDNA analyses and associations with outcomes in taxane-naive patients with metastatic castration-resistant prostate cancer (mCRPC) treated with 177Lu-PSMA-617 versus change of androgen receptor pathway inhibitor in PSMAfore.
Presented by Karim Fizazi, MD, PhD
The 2024 ASCO featured a session on prostate cancer, and a presentation by Dr. Karim Fizazi discussing results from PSMAfore, specifically health-related quality of life and pain among taxane-naïve metastatic castration-resistant prostate cancer (mCRPC) patients treated with 177Lu-PSMA-617. 
Presented by Xiao Wei, MD, MAS
The 2024 AUA annual meeting featured a plenary session, and a presentation by Dr. Xiao Wei discussing results from PSMAfore assessing the efficacy of 177Lu-PSMA-617 versus ARPI change in taxane naïve patients with metastatic castration resistant prostate cancer (mCRPC) stratified by pre-randomization ARPI.
Presented by Ridvan Arda Demirci, MD
The 2024 GU ASCO annual meeting featured a prostate cancer session and a presentation by Dr. Ridvan Demirci discussing the association between PET-based TheraP eligibility and 177Lu-PSMA-617 outcomes in VISION-eligible patients with metastatic castration-resistant prostate cancer (mCRPC).
Presented by Ken Herrmann, MD
The 2024 ASCO GU cancers symposium was host to a prostate cancer poster session. Dr. Ken Herrmann presented the preliminary results of a predictive model for treatment outcomes with [177Lu]Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC), using data from the phase III VISION trial.
Presented by Michael Morris, MD
The 2024 PSMA conference featured a presentation by Dr. Michael Morris discussing the VISION1 and TheraP2 trials. Dr. Morris started by discussing the VISION trial, an international, randomized, open-label phase III study evaluating 177Lu-PSMA-617 in men with PSMA-positive mCRPC who had previously received treatment with a next-generation androgen receptor signaling inhibition (abiraterone, enzalutamide, etc) and one or two prior lines of taxane chemotherapy.
Presented by Christopher Sweeney, MBBS
The 2023 ESMO annual meeting included a Presidential session, featuring a discussant presentation by Dr. Christopher Sweeney discussing the PSMAfore phase 3 trial. Dr. Sweeney started by highlighting that there are several clear strengths of the PSMAfore trial
Presented by A. Oliver Sartor, MD
The 2023 ESMO annual meeting included a Presidential session, featuring a presentation by Dr. Oliver Sartor discussing results of PSMAfore, a phase 3 trial of 177Lu-PSMA-617 in taxane-naive patients with metastatic castration-resistant prostate cancer (mCRPC).
Presented by Xiao X. Wei, MD, MAS
The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Xiao Wei discussing a post hoc analysis of the VISION trial assessing the prognostic value of neutrophil-to-lymphocyte ratio and lymphopenia in patients with metastatic castration-resistant prostate cancer (mCRPC) treated with 177Lu-PSMA-617.
Presented by Michael Morris, MD
The 2023 ESMO annual meeting included a session on prostate cancer, featuring a presentation by Dr. Michael Morris discussing the association of health-related quality of life with efficacy outcomes in the VISION study of patients with metastatic castration-resistant prostate cancer (mCRPC).  
Presented by Isabel Rauscher, MD
The 2023 SNMMI annual meeting included a prostate cancer session, featuring a presentation by Dr. Isabel Rauscher discussing the extension of a 68Ga-PSMA PET-based nomogram for outcome prediction of 177Lu-PSMA radioligand therapy for the use of 18F-rhPSMA -7.3.
Presented by Anushna S. Babu, MD
The 2023 SNMMI annual meeting included a prostate cancer session, featuring a presentation by Dr. Anushna Babu discussing dual PSMA/FDG PET/CT for assessing eligibility and predicting response in mCRPC patients undergoing 177Lu-PSMA-617 radioligand therapy.
Presented by Scott T. Tagawa, M.D., MS, FACP
The 2023 ASCO annual meeting included a prostate cancer session, featuring a trials in progress presentation by Dr. Scott Tagawa discussing PSMAddition, a phase 3 trial comparing 177Lu-PSMA-617 + standard of care and standard of care alone in patients with metastatic hormone-sensitive prostate cancer (mHSPC).
Presented by Ken Herrmann, MD
The 2023 ASCO annual meeting included a prostate cancer session, featuring a presentation by Dr. Ken Herrmann discussing preliminary results of building a predictive model for outcomes with 177Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC) using VISION data.
Presented by Prof. Bernd J. Krause
The 2023 ASCO annual meeting included a prostate cancer session, featuring a presentation by Dr. Bernd Krause discussing a VISION trial sub-study analysis assessing tumor dosimetry of 177Lu-PSMA-617 for the treatment of metastatic castration-resistant prostate cancer (mCRPC).
Presented by Yu Yang Soon, NHMRC
The 2023 ASCO annual meeting included a prostate cancer session, featuring a presentation by Dr. Yu Yang Soon discussing an exploratory analysis of the effects of 177Lu-PSMA-617 (LuPSMA) on overall survival in TheraP versus VISION randomized trials.
Presented by Ken Herrmann, MD
 The 2023 ASCO annual meeting included a prostate cancer session, featuring a presentation by Dr. Ken Herrmann discussing preliminary results of building a predictive model for outcomes with 177Lu-PSMA-617 in patients with metastatic castration-resistant prostate cancer (mCRPC) using VISION data.
Presented by Joseph Earl Thomas, MD
The 2023 ASCO GU cancers was host to a prostate cancer poster session. Dr. Joseph Thomas presented his group’s study evaluating the increased utilization of prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy (PSMA-TRT) in African American (AA) patients at their Academic Medical Center.
Presented by Michael Morris, MD
In the Prostate Cancer poster session of the ESMO Annual Congress, Dr. Morris presented a post-hoc analysis of the VISION trial aimed at assessing earlier maturing time-to-event endpoints.
Presented by Scott T. Tagawa, MD
At the 2022 ASCO Annual Meeting, the poster session focused on Prostate, Testicular, and Penile cancers on Monday afternoon included a presentation from Dr. Scott T. Tagawa discussing the tolerability of theranostic treatment with 177Lu-PSMA among men with metastatic castration-resistant prostate cancer (mCRPC), stratified by their treatment exposure, in men treated within the VISION trial.
Presented by Masatoshi Hotta, MD, PhD
At the 2022 ASCO Annual Meeting, the poster session focused on Prostate, Testicular, and Penile cancers and included a presentation from Dr. Masatoshi Hotta discussing outcomes of theranostic treatment with 177Lu-PSMA, among patients who would be deemed ineligible for therapy according to criteria used for inclusion in the VISION trial.
Presented by Nitin Vaishampayan, MD, BA
At the 2022 ASCO Annual Meeting, the oral abstract session focused on Prostate, Testicular, and Penile cancers on Sunday morning included a presentation from Dr. Nitin Vaishampayan discussing subgroup analyses of the VISION trial examining 177Lu-PSMA-617 in men with heavily pre-treated metastatic castration-resistant prostate cancer (mCRPC).
Presented by Andrew J. Armstrong, MD, MSc
At the 2022 ASCO Annual Meeting,  the oral abstract session focused on Prostate, Testicular, and Penile cancers on Sunday morning included a presentation from Dr. Andrew J. Armstrong discussing the prognostic value of baseline [68Ga]Ga-PSMA-11 PET imaging in men undergoing theranostic treatment with 177Lu-PSMA-617 for heavily pre-treated metastatic castration-resistant prostate cancer (mCRPC) in the VISION trial.
Presented by A. Oliver Sartor, MD
A. Oliver Sartor presented the rationale and design of the PSMAfore trial. PSMAfore is a multicenter, open-label, randomized phase 3 trial in adult men with progressive mCRPC and confirmed PSMA expression by [68Ga]Ga-PSMA-11 PET/CT. Eligible patients must be taxane-naïve in the metastatic setting and have received one prior ARPI and be a candidate for a change in ARPI.
Presented by Ajeet Gajra FACP, MD
Dr. Garja presented a poster focused on understanding how community-based medical oncologists plan to integrate 177Lu-PSMA-617 into patient management. How 177Lu-PSMA-617 approval will affect the treatment landscape of mCRPC depends on how community-based medical oncologists uptake this new treatment approach.
Presented by Ken Herrmann, MD, MBA
During the 2022 GU ASCO Cancer Symposium, Dr. Herrmann presented a poster assessing [177Lu]Lu-PSMA-617 (177Lu-PSMA-617) dosimetry among patients treated on the phase 3 VISION trial (NCT03511664).
Presented by Brian Gonzalez PhD
During the ASCO GU Symposium 2022, Dr. Gonzalez presented work on patient-reported quality of life metrics among men receiving prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) for the treatment of metastatic castration-resistant prostate cancer (mCRPC).
Presented by Michael J. Morris, MD
(UroToday.com) The Society of Urologic Oncology (SUO) annual winter meeting included an advanced prostate cancer session and a presentation by Dr. Michael Morris discussing the VISION trial and integration of PSMA-targeted therapy for advanced prostate cancer.
Presented by Scott T. Tagawa
(UroToday.com) PSMA-targeted radionuclide therapy (TRT) is one of the most promising investigational therapies in prostate cancer currently. In the phase II TheraP trial and the phase III VISION trial, 177-lutetium-PSMA-617 has demonstrated better outcomes compared to the current standard of care treatment options for patients who have received many lines of therapy for metastatic castration resistant prostate cancer (mCRPC).
Presented by Eleni Efstathiou, MD

The APCCC 2021 meeting session discussing PSMA in diagnostics and therapy included a presentation by Dr. Eleni Efstathiou discussing the contagious enthusiasm of PSMA-driven therapeutics. 

 

Presented by Charles Ryan, MD
The Advanced Prostate Cancer Consensus Conference 2021 virtual meeting session discussing PSMA in diagnostics and therapy included a presentation by Dr. Charles Ryan discussing the best use of Lutetium-PSMA and where to place it when sequencing therapies, including treatment monitoring.
Presented by Michael J. Morris, MD
(UroToday.com) Lutetium-177 is a radioligand that when bound to a prostate-specific membrane antigen (PSMA) targeting molecule delivers beta-particle radiation to PSMA-expressing cells and their local microenvironment.
Presented by Karim Fizazi, MD, PhD
 The ESMO 2021 annual meeting’s prostate cancer mini oral session included a presentation by Dr. Karim Fizazi discussing health-related quality of life, pain, and safety outcomes in the phase 3 VISION study. [177Lu]Lu-PSMA-617 (177Lu-PSMA-617) delivers β-particle radiation to prostate-specific membrane antigen (PSMA) expressing cells and the surrounding microenvironment.
Presented by Brian D. Gonzalez, PhD
(UroToday.com) The European Society of Medical Oncology (ESMO) 2021 annual meeting’s prostate cancer session included a presentation by Dr. Brian Gonzalez discussing patient-reported outcomes in prostate cancer patients receiving prostate-specific membrane antigen (PSMA) radionuclide therapy. PSMA targeted radionuclide therapy is a promising investigational therapy for patients with progressive metastatic castration-resistant prostate cancer (mCRPC), conjugating a radionuclide emitting alpha radiation (e.g., Actinium-225) or beta radiation (e.g., Lutetium-177) to a small molecule ligand (e.g., PSMA-617) or a monoclonal antibody (e.g., J591) that has an affinity for PSMA. 
Presented by Michael Morris, MD
In the on-demand poster session of the ESMO Annual Congress, Dr. Morris provided a summary of the PSMAfore trial in progress (NCT04689828). This study examines the role of [177Lu]Lu-PSMA-617 (177Lu-PSMA-617) in taxane-naïve patients with mCRPC.
Presented by Scott T. Tagawa, MD
(UroToday.com) In the on-demand poster session of the European Society for Medical Oncology (ESMO) Annual Congress, Dr. Scott Tagawa reported results of a phase I/II study of dose-escalation study of a fractionated (dose-dense) treatment regime of 177Lu-PSMA-617 for metastatic castration-resistant prostate cancer (mCRPC). Previously reported, the initial phase I data from this study demonstrated no evidence of short-term dose-limiting toxicity.
Presented by Scott T. Tagawa, MD
(UroToday.com) In the on-demand poster session of the European Society for Medical Oncology (ESMO) Annual Congress, Dr. Scott Tagawa presented a trial in poster summary of the PSMAddition trial. This trial was launched given the proven benefits of [177Lu]Lu-PSMA-617 (177Lu-PSMA-617). 177Lu-PSMA-617 is a high-affinity prostate-specific membrane antigen (PSMA)-targeted radioligand therapy that delivers β-particle radiation to cells that express PSMA, as well as the surrounding microenvironment.
Presented by Scott Tagawa, MD
(UroToday.com) The advanced prostate cancer session at the 2021 American Urologic Association (AUA) annual meeting included a presentation by Dr. Scott Tagawa who discussed long-term follow-up and prognostic factor analysis among men with mCRPC who received 177Lu-PSMA therapy. PSMA-targeted radionuclide therapy has recently emerged as a promising treatment modality for advanced prostate cancer. 
Presented by Silke Gillessen, MD
Silke Gillessen discussed the recently published TheraP1 and VISION2 trials. Dr. Gillessen notes that in the metastatic castration-resistant prostate cancer (mCRPC) setting, we now have several treatment options that offer a survival benefit, including abiraterone, cabazitaxel, docetaxel, enzalutamide, radium-223, sipuleucel-T, olaparib, and now 177Lu-PSMA-617.
Presented by Karim Fizazi, MD, Ph.D
Dr. Karim Fizazi finished off the thematic session of Treatment Sequencing in Metastatic Prostate Cancer with a presentation on the role of PSMA in diagnostics and treatment of metastatic prostate cancer.
Presented by Gero Kramer, MD
(UroToday.com)  Dr. Gero Kramer reviews the systemic treatment options for metastatic castration-resistant prostate cancer (mCRPC) and highlights some recent developments.
Presented by Johann De Bono, MD, MSc, Ph.D., FRCP, FMedSci
The EAU 2021 Annual Meeting included a presentation by Johann De Bono discussing the VISION trial, a phase 3 study of 177Lu-PSMA-617 in patients with mCRPC. As PSMA is highly expressed in prostate cancer and mCRPC lesions, the combination of PSMA-617 with the beta-emitter lutetium allows for the targeted delivery of ß-particle radiation to PSMA-expressing cells and the surrounding microenvironment.
Presented by Michael Morris, MD
(UroToday.com) There has been a dramatic and rapid proliferation of systemic therapy options in advanced prostate cancer since the introduction of docetaxel for metastatic castration resistant prostate cancer (mCRPC) in 2004. These newer treatments have included a number of novel hormonal therapies (including abiraterone acetate and enzalutamide),
Presented by Madhav P. Yadav, MD
(UroToday.com) Beginning with the introduction of docetaxel for metastatic castration resistant prostate cancer (mCRPC) in 2004, there has been a dramatic and rapid proliferation of systemic therapy options in advanced prostate cancer including a number of novel hormonal therapies (including abiraterone acetate and enzalutamide), second-line chemotherapy (cabazitaxel), bone-targeting agents (radium-223) and other targeted agents (including olaparib, rucaparib, and pembrolizumab), each of which has proven survival benefits.
Presented by Hossein Jadvar, MD
(UroToday.com) The Society of Nuclear Medicine & Molecular Imaging (SNMMI) 2021 annual meeting included a metastatic castrate-resistant prostate cancer (mCRPC) session and a presentation by Dr. Hossein Jadvar discussing alpha-emitting PSMA molecular radiotherapy in mCRPC. Dr. Jadvar notes that the lethal potency of alpha particles includes
Presented by Mary-Ellen Taplin, MD
(UroToday.com)  Dr. Taplin began her discussion of the VISION trial by first reviewing the current therapeutic landscape of prostate cancer. While there are many life-prolonging options, unfortunately, the duration of response to these therapies in sequence is often short. The VISION trial was set up to evaluate the use of lutetium-PSMA in late-stage advanced prostate cancer
Presented by Michael J. Morris, MD
(UroToday.com) In this presentation, Dr. Michael Morris presented the results of the phase 3 VISION trial evaluating the radiopharmaceutical lutetium-PSMA (Lu-PSMA) in patients with metastatic castration-resistant prostate cancer.
Presented by Mary-Ellen Taplin, MD
Following Micheal Morris’s presentation of the results of the phase III VISION trial of lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer in the Plenary Session of the 2021 ASCO, Dr. Mary-Ellen Taplin from the Dana Farber Cancer Institute provided a discussant overview of these data and helped to contextualize how we may apply them to our practices.
Presented by Micheal Morris, MD
In a plenary presentation at the 2021 ASCO Annual Meeting, Dr. Morris presented the first results of the VISION trial, a phase III study assessing lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer.
Presented by Mike Machaba Sathekge, MD, Ph.D
In a plenary presentation in the Progress and Promise in Treatment Personalization for Advanced Prostate Cancer session at the 2021 American Society of Clinical Oncology Genitourinary (Cancers Symposium (ASCO GU), Dr. Sathekge provided a talk examining the role of Lutetium in prostate cancer.