Review on the Increasing Role for PSMA-Based Radioligand Therapy in Prostate Cancer

Overview

Journal Cancers (Basel)

Publisher MDPI

Specialty Oncology

Date 2024 Jul 27

PMID 39061160

Authors

Finn Edler von Eyben

Irene Virgolini

Richard Baum

Affiliations

Soon will be listed here.

Abstract

Methods: Our review summarizes new RCTs that add to the use of radioligand therapy (RLT) for patients with high-risk prostate cancer (PCa).

Results: Four past and present RCTs included 1081 patients. An RCT, ENZA-p, studied first-line treatment of patients with metastatic castration-resistant PCa (mCRPC). A combination of enzalutamide (ENZA) and Lu-PSMA-617 gave longer progression-free survival than ENZA as monotherapy. Other RCTs of patients with mCRPC, including the PSMAfore, and SPLASH trials, showed Lu-PSMA-617 as second-line treatment gave better progression-free survival than androgen receptor pathway inhibitors (combined value < 6.9 × 10).

Conclusions: Patients with PCa gain if they are given PSMA-RLT early in the treatment of PCa and as part of combination therapies.

Citing Articles

PSMA-Guided Imaging and Therapy of Advanced Adenoid Cystic Carcinomas and Other Salivary Gland Carcinomas.

Trautwein N, Brendlin A, Reischl G, Mattke M, Paulsen F, Loewenheim H Cancers (Basel). 2024; 16(22).

PMID: 39594798 PMC: 11592976. DOI: 10.3390/cancers16223843.

References

von Eyben F, Kulkarni H, Baum R . Metastatic extent predicts survival as patients with metastatic castration-resistant prostate cancer are treated with Lu-PSMA radioligand therapy. Theranostics. 2020; 10(11):4900-4902. PMC: 7163457. DOI: 10.7150/thno.44568. View

Satapathy S, Yadav M, Ballal S, Sahoo R, Bal C . [Lu]Lu-PSMA-617 as first-line systemic therapy in patients with metastatic castration-resistant prostate cancer: a real-world study. Eur J Nucl Med Mol Imaging. 2024; 51(8):2495-2503. DOI: 10.1007/s00259-024-06677-y. View

Schulman C, Debruyne F, Forster G, Selvaggi F, Zlotta A, Witjes W . 4-Year follow-up results of a European prospective randomized study on neoadjuvant hormonal therapy prior to radical prostatectomy in T2-3N0M0 prostate cancer. European Study Group on Neoadjuvant Treatment of Prostate Cancer. Eur Urol. 2000; 38(6):706-13. DOI: 10.1159/000020366. View

von Eyben F, Bauman G, von Eyben R, Rahbar K, Soydal C, Haug A . Optimizing PSMA Radioligand Therapy for Patients with Metastatic Castration-Resistant Prostate Cancer. A Systematic Review and Meta-Analysis. Int J Mol Sci. 2020; 21(23). PMC: 7730994. DOI: 10.3390/ijms21239054. View

Chaiswing L, Weiss H, Jayswal R, St Clair D, Kyprianou N . Profiles of Radioresistance Mechanisms in Prostate Cancer. Crit Rev Oncog. 2018; 23(1-2):39-67. PMC: 6231577. DOI: 10.1615/CritRevOncog.2018025946. View

Stuparu A, Capri J, Meyer C, Le T, Evans-Axelsson S, Current K . Mechanisms of Resistance to Prostate-Specific Membrane Antigen-Targeted Radioligand Therapy in a Mouse Model of Prostate Cancer. J Nucl Med. 2020; 62(7):989-995. PMC: 8882874. DOI: 10.2967/jnumed.120.256263. View

Satapathy S, Sahoo R, Bal C . [Lu]Lu-PSMA-Radioligand Therapy Efficacy Outcomes in Taxane-Naïve Versus Taxane-Treated Patients with Metastatic Castration-Resistant Prostate Cancer: A Systematic Review and Metaanalysis. J Nucl Med. 2023; 64(8):1266-1271. DOI: 10.2967/jnumed.123.265414. View

Parker D, Zambelli J, Lara M, Wolf T, McDonald A, Lee E . Case Report: Long-term complete response to PSMA-targeted radioligand therapy and abiraterone in a metastatic prostate cancer patient. Front Oncol. 2023; 13:1192792. PMC: 10175697. DOI: 10.3389/fonc.2023.1192792. View

Sartor O, Fizazi K, Herrmann K, Morris M . Design Considerations in the PSMAfore Trial. J Nucl Med. 2024; 65(2):226-227. DOI: 10.2967/jnumed.123.267034. View

10.

Kostos L, Buteau J, Hofman M, Azad A . Determinants of outcome following PSMA-based radioligand therapy and mechanisms of resistance in patients with metastatic castration-resistant prostate cancer. Ther Adv Med Oncol. 2023; 15:17588359231179309. PMC: 10262652. DOI: 10.1177/17588359231179309. View

11.

Muller C, van der Meulen N, Schibli R . Opportunities and potential challenges of using terbium-161 for targeted radionuclide therapy in clinics. Eur J Nucl Med Mol Imaging. 2023; 50(11):3181-3184. DOI: 10.1007/s00259-023-06316-y. View

12.

Oprea-Lager D, MacLennan S, Bjartell A, Briganti A, Burger I, de Jong I . European Association of Nuclear Medicine Focus 5: Consensus on Molecular Imaging and Theranostics in Prostate Cancer. Eur Urol. 2023; 85(1):49-60. DOI: 10.1016/j.eururo.2023.09.003. View

13.

Barber T, Singh A, Kulkarni H, Niepsch K, Billah B, Baum R . Clinical Outcomes of Lu-PSMA Radioligand Therapy in Earlier and Later Phases of Metastatic Castration-Resistant Prostate Cancer Grouped by Previous Taxane Chemotherapy. J Nucl Med. 2019; 60(7):955-962. DOI: 10.2967/jnumed.118.216820. View

14.

McKay R, Ye H, Xie W, Lis R, Calagua C, Zhang Z . Evaluation of Intense Androgen Deprivation Before Prostatectomy: A Randomized Phase II Trial of Enzalutamide and Leuprolide With or Without Abiraterone. J Clin Oncol. 2019; 37(11):923-931. PMC: 7051849. DOI: 10.1200/JCO.18.01777. View

15.

Schaefer-Schuler A, Burgard C, Blickle A, Maus S, Petrescu C, Petto S . [Tb]Tb-PSMA-617 radioligand therapy in patients with mCRPC: preliminary dosimetry results and intra-individual head-to-head comparison to [Lu]Lu-PSMA-617. Theranostics. 2024; 14(5):1829-1840. PMC: 10945337. DOI: 10.7150/thno.92273. View

16.

von Eyben F, Singh A, Zhang J, Nipsch K, Meyrick D, Lenzo N . Lu-PSMA radioligand therapy of predominant lymph node metastatic prostate cancer. Oncotarget. 2019; 10(25):2451-2461. PMC: 6497435. DOI: 10.18632/oncotarget.26789. View

17.

Ahmadzadehfar H, Rahbar K, Baum R, Seifert R, Kessel K, Bogemann M . Prior therapies as prognostic factors of overall survival in metastatic castration-resistant prostate cancer patients treated with [Lu]Lu-PSMA-617. A WARMTH multicenter study (the 617 trial). Eur J Nucl Med Mol Imaging. 2020; 48(1):113-122. PMC: 7835179. DOI: 10.1007/s00259-020-04797-9. View

18.

Scher H, Morris M, Stadler W, Higano C, Basch E, Fizazi K . Trial Design and Objectives for Castration-Resistant Prostate Cancer: Updated Recommendations From the Prostate Cancer Clinical Trials Working Group 3. J Clin Oncol. 2016; 34(12):1402-18. PMC: 4872347. DOI: 10.1200/JCO.2015.64.2702. View

19.

Anton A, Pillai S, Semira M, Wong S, Shapiro J, Weickhardt A . Real-world first-line systemic therapy patterns in metastatic castration-resistant prostate cancer. BJUI Compass. 2022; 3(3):205-213. PMC: 9045563. DOI: 10.1002/bco2.129. View

20.

Kratochwil C, Fendler W, Eiber M, Hofman M, Emmett L, Calais J . Joint EANM/SNMMI procedure guideline for the use of Lu-labeled PSMA-targeted radioligand-therapy (Lu-PSMA-RLT). Eur J Nucl Med Mol Imaging. 2023; 50(9):2830-2845. PMC: 10317889. DOI: 10.1007/s00259-023-06255-8. View