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During a discussion at 2021 ASCO, Neal D. Shore, MD, said he was most excited to see data from the phase 3 VISION trial of lutetium-177-PSMA-617 in metastatic castration-resistant prostate cancer.
CancerNetwork® sat down with Neal D. Shore, MD, of Duke University School of Medicine, the 2021 American Society of Clinical Oncology (ASCO) Annual Meeting to talk about the results of the phase 3 VISION trial (NCT03511664) of the prostate-specific membrane antigen (PSMA) antibody-drug conjugate lutetium-177-PSMA-617 (LuPSMA 177) as therapy for patients with metastatic castration-resistant prostate cancer (mCRPC). The radioligand therapy, he says, was able to induce positive effects on radiographic progression-free survival (rPFS) and overall survival (OS) and additional clinical trials are ongoing.
In prostate cancer, you know, the, the most important presentation was the results of the VISION trial. And you know, This phase 3 trial [was] the first completion of a prospective, blinded, randomized trial looking at a PSMA antibody-[radionucleotide] conjugate, with [LuPSMA 177] demonstrating both a statistically significant rPFS as well as an OS benefit. This is wonderful for expanding the therapeutic armamentarium for all of us to take care of advanced prostate cancer.
The inclusion criteria for these [patients with mCRPC], like many of our prior phase 3 trials that led to an initial drug approval, is in the post-chemotherapy, post-taxane [setting]; this is fine, and that’s a nice way to begin. You get to the radiographic progression-free survival and the overall survival end points sooner, which is good in terms of biostatistical analysis, [but] not so good for patients. But now, this is opening up the clinical trial landscape which is ongoing right now.
There are close to 3 dozen different theranostic platform trials that are being evaluated in post-chemotherapy mCRPC, but importantly in pre-chemotherapy mCRPC and even looking at patients with [metastatic castration-sensitive prostate cancer]. This is great for advancing the field; bringing in evidence-based, well-conducted trials that will broaden our ability to add to the discussion with patients who would benefit. What’s also exciting is the myriad number of combination studies with already approved therapeutic agents in addition to antibody isotope conjugates.
Morris MJ, DeBono JS, Chi KN, et al. Phase III study of lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer (VISION). J Clin Oncol. 2021;39(suppl 15):LBA4. Doi:10.1200/JCO.2021.39.15_suppl.LBA4