NEJM Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer

204 33 184KB

English Pages [13]

Report DMCA / Copyright

DOWNLOAD PDF FILE

Recommend Papers

Prostate Cancer for Dummies 2003101850, 9780764519741

Hearing that you have prostate cancer, or even that you may have it, is very scary. But this disease, in many cases, is

152 40 5MB Read more

Salvage Therapy for Prostate Cancer [1 ed.] 9783030571801, 9783030571818

This book comprehensively covers application of salvage therapy in reccurrent prostate cancer. Chapters focus on specifi

355 22 5MB Read more

Le Cancer de la prostate 9782759803415

On en apprend chaque jour un peu plus sur le cancer de la prostate, mais il reste encore trop peu connu de la population

128 2 2MB Read more

Prostate Specific Antigen and Prostate Cancer [1 ed.] 9781621005865, 9781612098364

Prostate cancer (PCa) is a disease with high incidence and prevalence. Early detection of PCa has been an area for resea

137 90 2MB Read more

Prostate Cancer--Testing, Diagnosis, Surgery, Recovery (What to Expect) 9781386792628

Thinking About Getting A Prostate PSA Test? Been Told You Should Have A Prostate Biopsy? Get The Guide That Will Tell Y

146 75 805KB Read more

Prostate Cancer: Expert Advice for Helping Your Loved One 1421446006, 9781421446004

An illuminating guide for those newly diagnosed with prostate cancer as well as their partners and caregivers―one filled

112 34 1MB Read more

A History of Prostate Cancer: Cancer, Men and Medicine [1 ed.] 9781137565952, 2016948766

This book offers a comprehensive and inclusive insight into the history of prostate cancer and its sufferers. Until rece

310 105 890KB Read more

Therapeutic Management of Metastatic Breast Cancer [First named authors: K. W. Brunner Reprint 2019] 9783110888942, 9783110121827

121 14 5MB Read more

Prostate Cancer Methods and Protocols (Methods in Molecular Medicine) [1 ed.] 9780896039780, 9781592593729, 0896039781

A collection of basic and advanced molecular methods that reveal those markers essential for more accurate diagnoses of

401 85 4MB Read more

Prostate Cancer Methods and Protocols (Methods in Molecular Medicine, 81) 0896039781, 9780896039780

Prostate cancer is the second leading cancer in men in Western society. A major concern, and an area of intensive resear

119 42 5MB Read more

NEJM
Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer

Similar Topics
Medicine

0 0 0
Like this paper and download? You can publish your own PDF file online for free in a few minutes! Sign Up

File loading please wait...

Citation preview

The

n e w e ng l a n d j o u r na l

of

m e dic i n e

Original Article

Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer O. Sartor, J. de Bono, K.N. Chi, K. Fizazi, K. Herrmann, K. Rahbar, S.T. Tagawa, L.T. Nordquist, N. Vaishampayan, G. El‑Haddad, C.H. Park, T.M. Beer, A. Armour, W.J. Pérez‑Contreras, M. DeSilvio, E. Kpamegan, G. Gericke, R.A. Messmann, M.J. Morris, and B.J. Krause, for the VISION Investigators*

A BS T R AC T BACKGROUND

Metastatic castration-resistant prostate cancer remains fatal despite recent advances. Prostate-specific membrane antigen (PSMA) is highly expressed in metastatic castration-resistant prostate cancer. Lutetium-177 (177Lu)–PSMA-617 is a radioligand therapy that delivers beta-particle radiation to PSMA-expressing cells and the surrounding microenvironment.

The authors’ full names, academic de‑ grees, and affiliations are listed in the Ap‑ pendix. Address reprint requests to Dr. Sartor at Tulane Cancer Center, School of Medicine, Tulane University, New Orleans, LA 70112, or at [email protected].

METHODS

*The list of the VISION investigators is provided in the Supplementary Appen‑ dix, available at NEJM.org.

We conducted an international, open-label, phase 3 trial evaluating Lu-PSMA-617 in patients who had metastatic castration-resistant prostate cancer previously treated with at least one androgen-receptor–pathway inhibitor and one or two taxane regimens and who had PSMA-positive gallium-68 (68Ga)–labeled PSMA-11 positronemission tomographic–computed tomographic scans. Patients were randomly assigned in a 2:1 ratio to receive either 177Lu-PSMA-617 (7.4 GBq every 6 weeks for four to six cycles) plus protocol-permitted standard care or standard care alone. Protocol-permitted standard care excluded chemotherapy, immunotherapy, radium-223 (223Ra), and investigational drugs. The alternate primary end points were imagingbased progression-free survival and overall survival, which were powered for hazard ratios of 0.67 and 0.73, respectively. Key secondary end points were objective response, disease control, and time to symptomatic skeletal events. Adverse events during treatment were those occurring no more than 30 days after the last dose and before subsequent anticancer treatment. 177

RESULTS

From June 2018 to mid-October 2019, a total of 831 of 1179 screened patients underwent randomization. The baseline characteristics of the patients were balanced between the groups. The median follow-up was 20.9 months. 177Lu-PSMA-617 plus standard care significantly prolonged, as compared with standard care, both imaging-based progression-free survival (median, 8.7 vs. 3.4 months; hazard ratio for progression or death, 0.40; 99.2% confidence interval [CI], 0.29 to 0.57; P