New concept drug chasing late stage prostate cancer

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A new class of drugs successfully targets treatment-resistant prostate cancers and extends the life of patients. The treatment delivers beta radiation directly to tumor cells, is well tolerated by patients and keeps them alive longer than standard treatment, according to a phase 3 study presented today at the European Association of Urology Congress, EAU21 .

Despite the advances in medicine in recent years, metastatic castration-resistant prostate cancer remains untreatable and fatal. The new treatment, known as Lu-PSMA-617, takes a new approach and targets a molecule called PSMA, which is known to multiply on the surfaces of tumor cells, destroying them and their surrounding microenvironment.

Professor Johann de Bono, Professor of Experimental Cancer Medicine at the Institute of Cancer Research, London, and Consultative Medical Oncologist at the Royal Marsden NHS Foundation Trust, and Professor Ken Herrmann, Director of the Clinic for Nuclear Medicine at Essen University Hospital, Germany, and an international team of researchers investigated whether Lu-PSMA-617 was more effective than standard of care and enrolled 831 patients with metastatic castration-resistant prostate cancer between June 2018 and October 2019. Patients were randomly assigned to treatment plus standard care or standard care alone.

They report that the treatment significantly improved patient survival by an average of four months compared to standard treatment. The median survival time was 15.3 months for the treatment group and 11.3 months for those receiving standard care. Progression-free survival, or the time it took for a patient’s tumor to get worse, was also longer with treatment: a median of 8.7 months compared to 3.4 months for standard care patients.

The study also compared side effects and found that it did not adversely affect health-related quality of life, and the team concludes that it is an effective and safe drug that can improve the standard of care for patients with this advanced prostate cancer.

Professor Ken Herrmann says: “This is a completely new therapy concept, a precision medicine that irradiates a highly incidence tumor directly. The treatment was well tolerated by the patients and they had an average of four months longer survival with a good quality of life. ” Lu-PSMA-617 may improve the lives of many men with advanced prostate cancer and their families. “

Professor Johann de Bono says: “Our results show that this highly effective radioactive drug can irradiate and destroy cancer cells in a targeted manner, thereby extending the life of patients. I hope that men whose tumors have high PSMA levels can soon benefit from this highly innovative treatment. The treatment is currently being assessed by the National Institute for Health and Care Excellence (NICE) for use in the NHS in England and Wales. “

“The direct use of the PSMA molecule to directly address prostate cancer cells is the beginning of a new era in precision medicine in urological diagnostics and therapy,” says Professor Peter Albers, head of the Urological Clinic at the University of Düsseldorf and chairman of the EAU’s scientific office. “LU-PSMA-617 was tested in what is known as end-stage disease and still showed superiority, paving the way for studies to treat patients in earlier stages. We have seen similar success in the diagnostic field, using this molecule to improve the way we stage tumors. This focused approach will revolutionize the way we treat men with prostate cancer in the future. ”

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