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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Finding the Right Patient for Lutetium-177 PSMA Treatment
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Kara Cossis, PA-C, MPH
Phillip Koo converses with Kara Cossis about the critical aspect of patient selection for PLUVICTO® (lutetium Lu 177 vipivotide tetraxetan) treatment. Ms. Cossis outlines the criteria for identifying suitable candidates, emphasizing the role of castrate-resistant metastatic prostate cancer, disease burden, and eligibility based on scans.
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Patient Selection for Radioligand Therapy: Case Study Discussion
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Amir Iravani, MD, and Evan Yu, MD
Phillip Koo hosts a discussion on patient selection for radioligand therapy (RLT) in prostate cancer, featuring Amir Iravani and Evan Yu. The conversation delves into complex clinical decisions involving advanced prostate cancer management.
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| PSMA-Targeted Radionuclide Therapy in the Pre- and Post-Chemotherapy Settings in Prostate Cancer |
| Louise Emmett, MD, MBChB, FRACP, FAANMS |
| In a conversation with Phillip Koo, Louise Emmett unpacks the complexities of PSMA-targeted diagnostics and treatments in prostate cancer. They explore the significance of key trials such as ENZA-p, VISION, TheraP, PSMAfore, SPLASH, and ECLIPSE. |
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| Evaluation of Response to 177Lu-PSMA-617 by Site Specific Disease in Metastatic Castrate-Resistant Prostate Cancer |
| Mohamed E. Ahmed, MD |
| Mohamed Ahmed presents a study evaluating site-specific responses to 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer. A retrospective analysis of 273 patients revealed that those with lymph node-only disease experienced more durable responses, including higher PSA50 response rates and less radiographic progression, compared to patients with bone-only disease. |
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| Radioligand Theranostics in Prostate Cancer: Status Quo and New Developments
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| Ken Herrmann, MD
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| Ken Herrmann highlights the growing role of radioligand theranostics in prostate cancer, emphasizing pivotal trials like VISION, TheraP, and PSMAfore that demonstrate the clinical efficacy of 177Lu-PSMA-617 in mCRPC. He discussed advances in earlier treatment lines (PSMAddition, Lu-Tectomy), novel radionuclides (225Ac, 212Pb), and combination therapies (Enza-P, UpFrontPSMA). Dr. Herrmann concluded by underscoring imaging’s predictive power and the expanding therapeutic landscape targeting PSMA and other novel biomarkers.
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| ctDNA Fraction as a Predictor of Treatment Efficacy in a Randomized Phase 2 Trial of [177Lu] Lu-PSMA-617 Versus Cabazitaxel in mCRPC Progressing After Docetaxel |
| Edmond Michael Kwan, PhD, MBBS, FRACP |
| Edmond Kwan presented an exploratory analysis from the TheraP ANZUP 1603 trial, assessing circulating tumor DNA fraction (ctDNA%) as a predictor of treatment efficacy in mCRPC progressing after docetaxel. Results showed that patients with ctDNA <2% had significantly better outcomes with [177Lu] Lu-PSMA-617, achieving higher PSA50 response rates and an 8.7-month PFS advantage compared to cabazitaxel. |
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| UpFrontPSMA : A Randomized Phase II Study of Sequential 177Lu-PSMA-617 and Docetaxel versus Docetaxel in Metastatic Hormone-Sensitive Prostate Cancer |
| Arun Azad, PhD, MBBS, FRACP |
| Arun Azad discusses the UpFrontPSMA trial, presented at ESMO 2024 and published in The Lancet Oncology, is a pivotal phase II study exploring the benefit of integrating 177Lu-PSMA-617 with docetaxel compared to docetaxel alone in patients with metastatic hormone-sensitive prostate cancer (mHSPC). The trial’s design and findings highlight new potential in expanding the use of radioligand therapy earlier in the disease course. |
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| Hematologic Impact of [177Lu]Lu-PSMA-617 Versus ARPI Change in Patients with Metastatic Castration-Resistant Prostate Cancer in PSMAfore |
| Kim N. Chi, MD |
| The PSMAfore trial compared the hematologic safety of 177Lu-PSMA-617 versus androgen receptor pathway inhibitor (ARPI) change in taxane-naive patients with metastatic castration-resistant prostate cancer (mCRPC). Results showed that hematologic treatment-emergent adverse events (TEAEs) were more common with 177Lu-PSMA-617 compared to ARPI change, including higher rates of anemia, thrombocytopenia, and neutropenia. |
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