A study by Peter MacCallum Cancer Centre (Peter Mac) has shown that targeted radioactive infusion for late-stage prostate cancer, can improve outcomes for patients in earlier stages.
Peter Mac led the UpFrontPSMA study, the first trial to evaluate the effectiveness of Lutetium-177 PSMA-617 (LuPSMA) therapy in patients with newly diagnosed prostate cancers that had metastasised.
Previously, LuPSMA therapy had shown success in extending life and improving quality of life in patients with advanced prostate cancer who had exhausted other treatment options. This Phase II trial aimed to explore its potential in early-stage cases where the cancer had already spread.
A remarkable result
The study enrolled 130 participants from 11 Australian hospitals, all of whom initially received androgen deprivation therapy. They were then randomised to receive either the standard treatment of chemotherapy alone or chemotherapy combined with LuPSMA therapy. The results were considered "remarkable," showing a significant improvement in response rates when LuPSMA was added to the standard chemotherapy regimen.
Findings were published in The Lancet Oncology and presented at the European Society for Medical Oncology (ESMO) Congress 2024 in Barcelona, held from September 13-17. Associate Professor Arun Azad, who presented the results, highlighted the potential of LuPSMA to substantially enhance treatment responses.
"We looked for undetectable PSA—a marker for prostate cancer—at 48 weeks after treatment and this was achieved in 41% of patients who received LuPSMA compared to just 16% for the standard-of-care,” Azad said.
"This is a remarkable result; however, before we can say this should change clinical practice, we need to see this replicated in a larger Phase III clinical trial and, thankfully, a trial like this is already underway globally."
Positive signs
Progression-free survival benefits were observed across multiple measures, with adverse events being comparable between both treatment approaches, primarily associated with chemotherapy.
The therapy relies on the radioactive isotope Lutetium-177, which is produced and supplied by the Australian Nuclear Science and Technology Organisation (ANSTO) at its nuclear medicine precinct in Sydney.
ANSTO supplies 80% of Australia’s nuclear medicines, which are used for diagnosing, staging, and treating a wide range of medical conditions, including cancer.