Dr. Koo on Novel Technological and Therapeutic Advancements in Prostate Cancer

Phillip J. Koo, MD, division chief of Diagnostic Imaging, Northwest Region Oncology physician executive, the Banner MD Anderson Cancer Center in Phoenix, Arizona, discusses ongoing areas of technological and therapeutic advancements within the prostate cancer landscape.

Current data on the use of PSMA-PET scans show support for its use as a highly effective and predictive tool in prostate cancer, Koo begins. Ongoing and developing trials in prostate cancer continue to incorporate PSMA-PET into their study protocols, he says. Accordingly, PSMA-PETscans may become the new standard technique for localizing prostate cancer recurrence, Koo explains.

Moreover, the role of radiopharmaceuticals is an additional area of interest in prostate cancer research, Koo continues. The phase 3 PSMAfore (NCT04689828) trial of Lutetium 177 (177Lu) PSMA-617 (177Lu-PSMA-617) evaluated the role of this targeted radioligand in earlier stages of metastatic castration-resistant prostate cancer (mCRPC). Evaluable will be treated with 177Lu-PSMA-617 vs changing AR-directed therapy.

Evaluable patients will have mCRPC or metastatic hormone-sensitive prostate cancer (mHSPC), had prior exposure to an alternate AR inhibitor, and were not exposed to a taxane-containing regimen. The trial was reported as positive in a recent press release, and initial data are forthcoming, Koo notes. Results from this trial may support the continued inclusion of radioligand therapies into standard treatment strategies, Koo says.

Several other trials are being designed to investigate the utility of radiopharmaceuticals across disease states, Koo adds. This includes the phase 3 PSMAddition trial (NCT04720157) 177Lu-PSMA-617 in combination with SOC androgen deprivation therapy (ADT) plus an AR inhibitor in patients with mHSPC.

Although PSMA-PET imaging and radioligand therapies continue to improve the treatment landscape in prostate cancer, future investigations are still needed to identify patient subsets who would most benefit from these approaches, Koo concludes.