EP. 5A: The VISION Trial Lutetium PSMA, and the Future of Theranostic Precision Medicine
In the fifth video of the series, Nicholas J. Vogelzang, MD, FASCO, FACP, of Comprehensive Cancer Centers considers implications of the VISION trial and reflects on the futures of lutetium PSMA and theranostic precision medicine more broadly.
The VISION trial was an exciting advance, but it also left us with a hard, cold reality[:]…these cancers are resistant to treatment as we expected.
[W]e were not considering lutetium-177 as a breakthrough drug for castrate-resistant prostate cancer…[I]t's a well-tolerated drug administered to patients, but it does not cure the patients. That being said, we're looking forward to using it, and it will be something that will again extend life for our patients.
It gets the cancer no matter where it is in the body, be it bone or lymph nodes. And it builds upon previous generations of radionucleotides such as radium-223, which, although very effective and life-extending, did not hit this off-tissue disease.
Some…patients are going to be PSMA-negative in certain metastatic sites, and that…heterogeneity is going to only be amplified as the tumor volume gets larger....[T]hat's going to negatively impact use of lutetium-177 and the other radioisotopes.
…I think Novartis is right to link their PSMA scanning and their PS[M]A therapy in a package. I'm very eager to look at POINT [Biopharma]. They [and Convergent Therapeutics] are going to move the lutetium earlier into the hormone-sensitive phase where there is probably going to be a little less tumor heterogeneity, and that hormone-sensitive phase should be able to show more effectiveness of lutetium in the hormone-sensitive phase….[W]e're looking forward to having that trial open here as well. So all in all, a very rich field and potentially one that will eliminate tumor cells earlier before they develop resistance to castration.
And linking…radioactive drugs to target cancer cells—not only in prostate cancer but other cancers—will be a wave of the future. And we already have many examples of that in leukemia, lymphoma, and now in bladder cancer, and lutetium will be a good example in prostate cancer.
EP. 6B: Phenotypic Theranostics in the Future of Precision Medicine
December 22nd 2021In the sixth and final interview of the series, VISION trial co-principal investigator Oliver Sartor, MD, discusses how the VISION trial fits into new PSMA research; examines combination therapies, PET imaging, and novel biomarkers for prostate cancer; and explores the future of phenotypic theranostics in precision medicine.
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EP. 6A: After VISION: Phenotypic Theranostics in the Future of Precision Medicine
December 20th 2021In the final interview of the series, Oliver Sartor, MD, medical director at Tulane Cancer Center in New Orleans, Louisiana, discusses the aftermath of the VISION trial, new research examining 177Lu-PSMA-617 in less heavily pretreated patients and in combination therapies, forthcoming advances in PSMA imaging, novel biomarkers, the horizon for prostate cancer therapy and research, and the future role of theranostics in precision medicine.
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EP. 5B: PSMA and the Future of Targeted Therapy
December 15th 2021In the fifth interview of this series, Nicholas J. Vogelzang, MD, FASCO, FACP, medical oncologist at Comprehensive Cancer Centers in Las Vegas, Nevada, discusses how the VISION trial informs the future of both PSMA biomarking and theranostic precision medicine.
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EP. 4B: How the VISION Trial May Change Prostate Cancer Therapy
December 2nd 2021In the fourth interview of the series, Jorge Garcia, MD, FACP, discusses the VISION trial, how LuPSMA fits within the current mCRPC treatment landscape, and implications of VISION’s results for prostate cancer therapy.
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EP. 3B: Expert Perspective on the Changing Treatment Spectrum for Advanced Prostate Cancer
October 25th 2021In this companion article, Alicia K. Morgans, MD, MPH, explains the role of androgen deprivation therapy, second-line options in the treatment of advanced prostate cancer, and methods of selecting appropriate treatment.
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EP. 2B: New Horizons in Nuclear Medicine for Prostate Cancer
September 30th 2021In an interview with Targeted Oncology™, Phillip J. Koo, MD, discusses both the role of novel PSMA tracers in prostate cancer imaging and the promise that theranostics, including LuPSMA, hold for prostate cancer therapy.
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