Targeted radioactive infusion for late-stage prostate cancer shown to improve outcomes for patients in earlier stages

A targeted radioactive infusion that is a game-changer in late-stage prostate cancer can also dramatically improve outcomes for patients in earlier stages of this disease, a Peter Mac-led study has shown.

Lutetium-177 PSMA-617—or LuPSMA—therapy had been shown in previous clinical trials to extend lives, and improve quality-of-life, in patients with advanced metastatic prostate cancers who have exhausted all other treatment options.

The UpFrontPSMA study was the first to test this treatment in patients with newly diagnosed prostate cancers that had spread. The trial’s “remarkable” results were simultaneously published in The Lancet Oncology and presented at the European Society for Medical Oncology Congress (ESMO 2024), held in Barcelona, Sept. 13–17.

Peter Mac was the leading recruitment site for this Phase II trial, which enrolled 130 people from 11 Australian hospitals. All participants received androgen deprivation therapy—starving their prostate cancer of the hormone it uses as fuel—and they were then randomized to receive chemotherapy alone (the standard-of-care) or chemotherapy plus LuPSMA.

Adding LuPSMA therapy to the standard-of-care approach was seen to dramatically improve responses compared to chemotherapy alone,” explains Associate Professor Arun Azad, who presented the results at ESMO 2024.

“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.

“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.”

Benefits were also seen across a range of progression-free survival measures, while adverse events were equivalent in either treatment approach and linked mostly to chemotherapy.

The radioactive isotope Lutetium 177 that underpins this therapy is produced and supplied by Australian Nuclear Science and Technology Organisation (ANSTO) from its nuclear medicine precinct in Sydney. ANSTO produces 80% of Australia’s nuclear medicines used in the diagnosis, staging, and treatment of various medical conditions and diseases, including cancer.