Overall Survival With [177]Lu-PSMA-617 vs Cabazitaxel in Metastatic Castration-Resistant Prostate Cancer

[Magnus1964]

The Lancet Oncology

TAKE-HOME MESSAGE

TheraP was a phase II trial that compared the efficacy of radioligand therapy with 177Lu-PSMA-617 with that of cabazitaxel in patients with metastatic castration-resistant prostate cancer who had previously received docetaxel. After a median follow-up of 35.7 months, no significant differences in terms of median overall survival were noted between the cohorts (16.4 vs 19.4 months), despite higher prostate-specific antigen response rates among patients who received 177Lu-PSMA-617. Fewer grade ≥3 adverse events were observed with 177Lu-PSMA-617.

With efficacy comparable to that of cabazitaxel and an improved toxicity profile, 177Lu-PSMA-617 could be a suitable alternative for the treatment of patients with metastatic-resistant prostate cancer.

– Rodrigo Fonseca, MD

[gsun]

And what is the cost difference?

[Benkaymel]

Does the article mention efficacy of Lu-177 against liver metastases?

[GP24 in reply to Benkaymel]

Lu-177 is not very effective against liver metastases. In this case I would recommend cabazitaxel.

[Benkaymel in reply to GP24]

Thanks, that's what I've heard.

[GP24 in reply to Benkaymel]

There are therapies against liver mets, SIRT for example.

[GP24]

Usually you can get a Lu-177 therapy first and if that is no longer effective, continue with Cabazitaxel.

[Schwah]

which one got the 19.4 months vs the 16.4. That’s still almost a 19% longer medium survival.

Schwah

[TwilightZone]

I believe the brand name in the USA is PLUVICTO. My doctor has stated this will be my next stop if NUBEQA loses its effacacy.

[BigM62]

6 years in and I’ve had docetaxel (worked very well for me) and now finishing zytiga (after 2 years it’s failing). Is there any reason to go with cabazitaxel or Pluvicto at this point? I just turned 61 and I’m still in good and fit physical shape besides the large spine tumors growing…