Genitourinary Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Cancer Biol Ther. 2022 Dec 31;23(1):186-190. doi: 10.1080/15384047.2022.2037985.
In the last decade, many life-prolonging therapeutic options have emerged for metastatic castration-resistant prostate cancer (mCRPC). The recent VISION trial is the first to demonstrate a survival benefit of Lutetium-177[Lu]Lu-PSMA-617 in post-chemotherapy mCRPC. This journal club reviews the VISION trial in the context of the earlier TheraP trial of [Lu]Lu-PSMA-617 in mCRPC post docetaxel and androgen pathway inhibition, to provide direction for the real-world application of [Lu]Lu-PSMA-617. Treatment in the control groups differed significantly between both trials and may have influenced outcomes: TheraP mandated cabazitaxel whereas VISION's design could not allow it. In both trials, [Lu]Lu-PSMA-617 had a good safety profile, with common adverse events being fatigue, nausea, dry mouth, marrow suppression and diarrhea. Given its efficacy and favorable safety even in heavily pre-treated patients, [Lu]Lu-PSMA-617 provides hope to mCRPC patients and may be applied to earlier disease stages in future investigations.
在过去十年中，已经出现了许多延长转移性去势抵抗性前列腺癌（mCRPC）患者生存期的治疗选择。最近的 VISION 试验是第一个证明在化疗后 mCRPC 中镥-177[Lu]Lu-PSMA-617 具有生存获益的试验。本期刊俱乐部将在较早的[Lu]Lu-PSMA-617 在 mCRPC 后多西他赛和雄激素通路抑制治疗中的 TheraP 试验背景下对 VISION 试验进行回顾，为[Lu]Lu-PSMA-617 的实际应用提供指导。两项试验的对照组治疗方法存在显著差异，这可能影响了试验结果：TheraP 试验规定使用卡巴他赛，而 VISION 试验的设计不允许使用卡巴他赛。在两项试验中，[Lu]Lu-PSMA-617 的安全性良好，常见的不良反应包括疲劳、恶心、口干、骨髓抑制和腹泻。鉴于其在治疗广泛预处理患者时的疗效和良好的安全性，[Lu]Lu-PSMA-617 为 mCRPC 患者带来了希望，并可能在未来的研究中应用于更早的疾病阶段。
