Swimming lessons save lives: What parents should know
Strong legs help power summer activities: Hiking, biking, swimming, and more
What is a successful mindset for weight loss maintenance?
French fries versus almonds: Calorie for calorie, which comes out on top?
Summer camp 2022: Having fun and staying safe
Finding balance: 3 simple exercises to steady your steps
An action plan to fight unhealthy inflammation
How to recognize and tame your cognitive distortions
LATE: A common cause of dementia you’ve never heard of
How to break a bad habit
Radiation therapy is getting more precise, enabled by technologies that make it easier to kill tumors while sparing their surrounding tissues. Some newer therapies are even given intravenously instead of by machines, and they deliver radiation particles directly to the cancer cell itself. One of these new therapies — a sort of smart bomb targeted at malignant cells — is now generating promising data for men with the most aggressive prostate cancer.
In early June, investigators reported results from a phase 3 clinical trial showing that among men who received the experimental treatment, there was nearly a 40% reduction in deaths over the course of the study, compared to men who did not.
The treatment is called lutetium-177-PSMA-617, or LuPSMA, and it has two components: a compound that targets a cancer cell protein called prostate-specific membrane antigen, or PSMA, and a radioactive particle that destroys the cells. Healthy prostate cells don’t contain PSMA, or do at very low levels. And some men with prostate cancer have more of the protein than others. Doctors can detect the protein using a specialized imaging scan.
To qualify for enrollment in the study, called the VISION trial, men had to be PSMA-positive. In all, 831 men were split into two groups: one group got the experimental treatment plus standard of care, while men in the control group got standard of care only. All the men had metastatic castration-resistant prostate cancer, meaning that the disease was spreading in the body and no longer responding to drugs that suppress testosterone (which fuels growing tumors).
Results after 21 months showed that cancer progression was delayed for longer among the LuPSMA-treated men: 8.7 months on average versus 3.4 months among the controls. The treatment was also associated with better overall survival: 15.3 months versus 11.3 months.
The VISION study comes on the heels of on an earlier phase 2 study (known as TheraP) that compared LuPSMA to chemotherapy in a population of 200 men. During that study, investigators monitored how the treatment affected prostate-specific antigen (PSA) levels, which usually increase if the cancer starts growing. In two-thirds of the LuPSMA-treated men, PSA levels fell by 50% or more. And as in the VISION trial, the experimental treatment was better at delaying cancer progression, which was confirmed with traditional imaging tests.
Dr. Thomas Hope, a radiologist and associate professor at the University of California, San Francisco, has been closely following this research. He says that TheraP is arguably the better study, since investigators in that case compared LuPSMA to chemotherapy, whereas standard of care in the VISION study excluded chemotherapy, immunotherapy, and other agents that doctors would otherwise try. In other words, Hope says, the VISION study compared LuPSMA to “nothing,” which would ordinarily never happen. “So, the VISION trial doesn’t really help you as much in terms of deciding which treatment to choose,” he says.
LuPSMA was generally well-tolerated, but it also had side effects including fatigue, nausea, kidney problems, and bone marrow suppression. Dr. Hope says more research is needed to determine how and when to use the drug, “since if you have an eight-to-10-year expected lifespan, these side effects can be problematic.”
If it’s approved by the FDA, LuPSMA will be the first PSMA-targeted drug for prostate cancer to reach the market.
As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date of last review or update on all articles.
No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.
Commenting has been closed for this post.
You might also be interested in…
Most men eventually develop some type of prostate problem, and when they do there are usually no easy solutions. More than a primer on prostate conditions, this Special Health Report, the Annual Report on Prostate Diseases, includes roundtable discussions with experts at the forefront of prostate research, interviews with men about their treatment decisions, and the latest thinking on complementary therapies. This report will provide you with the information you need to understand the current controversies, avoid common pitfalls, and work with your doctor to make informed choices about your prostate health.
Get the latest in health news delivered to your inbox!
© 2022 by The President and Fellows of Harvard College
Thanks for visiting. Don’t miss your FREE gift.
The Best Diets for Cognitive Fitness, is yours absolutely FREE when you sign up to receive Health Alerts from Harvard Medical School
Sign up to get tips for living a healthy lifestyle, with ways to fight inflammation and improve cognitive health, plus the latest advances in preventative medicine, diet and exercise, pain relief, blood pressure and cholesterol management, and more.
Health Alerts from Harvard Medical School
Get helpful tips and guidance for everything from fighting inflammation to finding the best diets for weight loss…from exercises to build a stronger core to advice on treating cataracts. PLUS, the latest news on medical advances and breakthroughs from Harvard Medical School experts.
BONUS! Sign up now and
get a FREE copy of the
Best Diets for Cognitive Fitness
Stay on top of latest health news from Harvard Medical School.
Plus, get a FREE copy of the Best Diets for Cognitive Fitness.
Swimming lessons save lives: What parents should know