[177Lu]Lu-PSMA-617 plus standard of care versus standard of care in patients with metastatic castration-resistant prostate cancer supported in phase 3 trial
In a phase-3 trial called VISION, researchers studied the effects of lutetium-177 [177Lu]Lu-PSMA-617
(vipivotide tetraxetan) in patients with metastatic castration-resistant prostate cancer. This treatment, when added to standard care, improved both radiographic progression-free survival and overall survival. The study also assessed health-related quality of life (HRQOL), pain, and symptomatic skeletal events (pathologic fractures). Patients from 84 centers in North
America and Europe were enrolled if they had progressive PSMA-positive cancer and had previously received certain treatments. They were randomly assigned to receive either [177Lu]Lu-PSMA-617 plus standard care or standard of care alone. The [177Lu]Lu-PSMA-617 group received infusions every 6 weeks for up to 6 cycles.
The key findings were:
1. The time to first symptomatic bone metastasis was significantly longer in the [177Lu] Lu-PSMA- 617 group compared to the control group.
2. The quality of life showed delayed worsening in the [177Lu]Lu- PSMA-617 group.
3. The pain intensity was also less severe in the [177Lu] Lu-PSMA- 617 group.
4. Adverse events, mostly related to low blood counts, were more frequent in the treatment group, with a few cases leading to death.
The authors concluded that [177Lu]Lu-PSMA-617 alongside standard care improves outcomes in patients with advanced prostate cancer, supporting its use after prior therapies.
Lancet Oncol. 2023 Jun;24(6):597-610. doi: 10.1016/S1470-2045(23)00158-4.PMID: 37269841 PMCID: PMC10641914DOI: 10.1016/S1470- 2045(23)00158-4
