Andrei Gafita, MD, discusses available therapies for men with advanced castration-resistant prostate cancer.
Andrei Gafita, MD, of the Department of Nuclear Medicine at Klinikum Rechts der Isar at the Technical University Munich, discusses available therapies for men with advanced castration-resistant prostate cancer (CRPC).
Multiple retrospective, large series studies, as well as phase 2 data have led to the ongoing, phase 3 VISION trial, which is now aiming to result in the FDA approval of 177Lutetium-prostate-specific membrane antigen (LuPSMA), says Gafita. Men with prostate cancer are initially treated with an androgen deprivation therapy and hormone treatment, although most of them eventually progress. They then enter into a lethal phenotype of disease for metastatic CRPC.
For those with this advanced, late-stage prostate cancer, several treatments have been approved. Chemotherapy agents, such as docetaxel and cabazitaxel, are available, as well as the new generation of antiandrogen treatments, such as abiraterone acetate (Zytiga) or enzalutamide (Xtandi). Radiopharmaceuticals, such as radium-223 dichloride (Xofigo), which is a nuclear medicine treatment, is also available, as well as PARP inhibitors.
Unfortunately, in this state of disease, most patients progress on treatment and all standard treatments are exhausted. This is where LuPSMA comes into play; it can serve as an option for patients who have progressed on all other conventional treatment modalities, concludes Gafita.