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首页> 外文期刊>Journal of the advanced practitioner in oncology >Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: VISION Trial: Novel PSMA-Targeted Radiotherapy Improves Outcomes in Metastatic Prostate Cancer, By Alice Goodman
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Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: VISION Trial: Novel PSMA-Targeted Radiotherapy Improves Outcomes in Metastatic Prostate Cancer, By Alice Goodman

机译：Prostate Cancer: 2021 ASCO Annual Meeting Highlights for the Advanced Practitioner: The Advanced Practitioner Perspective: VISION Trial: Novel PSMA-Targeted Radiotherapy Improves Outcomes in Metastatic Prostate Cancer, By Alice Goodman

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Lutetium-177–PSMA-617 (LuPSMA)—an investigational radiolabeled small molecule—significantly improved radio-graphic progression-free survival and overall survival when added to the standard of care compared with the standard of care alone for men with metastatic castration-resistant prostate cancer who had experienced disease progression on other lines of treatment. These findings were from the phase III VISION trial presented during the 2021 ASCO Annual Meeting.1 LuPSMA plus the standard of care achieved a median of 8.7 months of radiographic progression-free survival vs 3.4 months with the standard of care alone—more than doubled in this pretreated population with advanced disease. Overall survival was also extended to 15.3 months with LuPSMA plus the standard of care vs 11.3 months with the standard of care alone. The Advanced Practitioner Perspective: A novel target for treatment is the prostate-specific membrane antigen (PSMA), which is unique to prostate cancer cells. The agent used in this study is one of the agents being evaluated for use against this target. Lutetium-177– PSMA-617 (LuPSMA) was previously evaluated in the phase II TheraP trial that compared LuPSMA to cabazitaxel in patients who had progressed on docetaxel. This study showed a significant difference in favor of LuPSMA in regard to the PSA decline. The VISION trial was a phase III study evaluating LuPSMA plus standard of care compared to standard of care alone in patients with metastatic castration-resistant prostate cancer who had progressed on other lines of treatment. Of note, the prior therapies included were androgen receptor pathway inhibitors and one to two prior taxane therapies. The standard of care could not include chemotherapy, immunotherapy, radium-223, or investigational drugs. With a median follow-up of 20.9 months, the primary endpoints of overall survival (OS) and radiographic-progression free survival (PFS) showed a significant difference in favor of LuPSMA for both. Overall, side effects of all grades and higher grades were more common in the LuPSMA arm. The most common side effects in the LuPSMA arm were fatigue, bone marrow suppression, dry mouth, and nausea/vomiting. High-grade adverse drug events included bone marrow suppression, anemia, decreased platelet count, and renal side effects. These are consistent with prior studies with LuPSMA. In evaluating the current study and applying it to patients, the choice for standard of care will be of interest. It is also important to consider the importance of coordination of care where needed between nuclear medicine and medical oncology when considering the use of LuPSMA.

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