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Metastatic castration-resistant prostate cancer (mCRPC) has always been a difficulty and pain point in the treatment of prostate cancer
.
In recent years, from the first-line treatment to the back-line treatment, the diagnosis and treatment methods of mCRPC have been continuously improved, which also brings new hope for prolonging the survival time of patients
.
At the ASCO conference in 2021, the results of the VISION study were announced, letting the world see the importance of radioligand therapy (RLT) in the diagnosis and treatment of prostate cancer
.
During the "2021 Novartis Urinary Tumor Day (NUTD)-Sharing the Kidney Potential and Enjoying New Students" Conference, Yimaitong was fortunate to invite Professor Xing Jinchun from the Department of Urology at the First Affiliated Hospital of Xiamen University and Professor Shi Benkang from the Department of Urology, Qilu Hospital of Shandong University , To share the frontier progress of prostate cancer in the 2021 ASCO conference and the changes brought about by radioligand therapy for the diagnosis and treatment of prostate cancer
.
The 2021 ASCO conference continues to make new progress, and the prostate cancer research results are amazing.
At the 2021 ASCO conference, the VISION research results of 177Lu-PSMA-617 were announced in the form of LBA abstract.
Professor Xing Jinchun said that he was deeply impressed by the research
.
The results of the VISION study showed that 177Lu-PSMA-617 combined with standard treatment prolonged the median overall survival (OS) of patients by 4 months, reduced the risk of death by 38%, and the median imaging progression-free survival (rPFS) was significantly prolonged (8.
7 Months vs 3.
4 months; p<0.
001), the risk of radiological progression or death is reduced by 60%
.
Professor Xing Jinchun said that the results of the study are encouraging and also demonstrate the rapid progress in the research of radioligand therapy
.
In addition, the ASCO conference also announced another study of radioligand therapy (abstract number: 5053), a phase Ib study of 177Lu-PSMA-617 combined with pembrolizumab in the treatment of mCRPC.
The results of the study showed that the overall objective response rate was The (ORR) was 44%, and the PSA50 remission rate was 28% (the ORR of 177Lu-PSMA-617 combined with standard treatment in the VISION study was 51%, and the PSA50 remission rate was 46%)
.
Professor Shi Benkang said that in addition to the surprise results of radioligand therapy, research on combined immunotherapy for advanced prostate cancer is also "blooming
.
"
The first is the KEYNOTE-199 study of immunization combined with anti-androgen therapy.
This meeting updated the OS results of cohort 4 and cohort 5 of the study.
The median OS was 17.
6 months and 20.
8 months, respectively
.
Secondly, regarding immune combined with PARP inhibitor therapy, this year's ASCO annual meeting reported the final results of cohort A1 in the CheckMate 9KD study.
The results showed that patients with homologous recombination repair defects can benefit more from immune combined with PARP inhibitor therapy
.
Professor Shi Benkang emphasized that the application of immunization combined with PARP inhibitors needs to expand the sample size for research, and its efficacy needs to be verified in clinical practice
.
Regarding immune combined chemotherapy, the ASCO-GU meeting earlier this year reported the results of CheckMate 9KD study cohort B and KEYNOTE-365 study cohort B, showing the benefits of immune combined chemotherapy in mCRPC
.
Finally, the latest report at this year’s ASCO annual meeting was the result of a phase Ⅰb/Ⅱ study (ARC-6 study) combining immunization and chemotherapy with the targeted new drug Etrumadenant, but the study suggested that the addition of targeted drugs was not obvious Improve efficacy
.
There are various treatment options for mCRPC.
177Lu-PSMA-617 is the “escort” for the back-line treatment.
Professor Xing Jinchun introduced the current treatment options for mCRPC in China, including chemotherapy, endocrine therapy, targeted therapy, immunotherapy, and radionuclide therapy.
Treatment is the main first-line treatment plan, including traditional endocrine treatment plans and new endocrine treatment plans such as enzalutamide and abiraterone
.
Other treatments include PARP inhibitors (targeted therapy), and immunotherapy is currently only approved for Sipuleucel-T
.
In addition, radium-223 has been clinically used in patients with bone metastases
.
Overall, there are many mCRPC treatment programs in China, and they are in line with international standards
.
Professor Xing Jinchun also mentioned that the publication of the results of the VISION study means that 177Lu-PSMA-617 is a new choice for patients who are still progressing after various treatments
.
In addition to 177Lu-PSMA-617 single-drug therapy, there may be plans for combined immunotherapy or new endocrine drugs, making the research road for the treatment of mCRPC "going wider and wider" and continuously bringing benefits to patients
.
Professor Shi Benkang explained that the current definition of mCRPC is: testosterone is maintained at the castrated level (<50ng/dl or 1.
7nmol/L), and at the same time, it can be diagnosed as mCRPC if one of the serum PSA progress or the imaging progress is satisfied
.
In order to prolong the survival time and quality of life of patients, the treatment of mCRPC is progressing continuously
.
From the approval of docetaxel in 2004, to the approval of the new endocrine therapy drugs abiraterone and enzalutamide, to the approval of radium-223, the survival benefits of mCRPC patients continue to extend
.
In addition, with the implementation of the concept of tumor precision treatment, mCRPC targeted therapy has also made breakthroughs, and PARP inhibitors such as olaparib have also become second-line and above treatment options.
.
Professor Shi Benkang said that the results of the VISION study announced at this year's ASCO conference have shown us the good effect of 177Lu-PSMA-617 on patients with high expression of PSMA, and we are even more looking forward to the approval of 177Lu-PSMA-617
.
Radioligand therapy has significant benefits and advantages, bringing new changes to the diagnosis and treatment of advanced prostate cancer.
Professor Xing Jinchun said that the current treatment options for failure of mCRPC after multi-line therapy are limited, and there are serious unmet clinical needs.
177Lu-PSMA-617 is advanced prostate cancer.
Cancer patients, especially those who have failed chemotherapy, radiotherapy or endocrine therapy, provide new options.
If the therapy is launched in China, the population of prostate cancer patients in China will be large, and a large number of patients will benefit from it
.
In addition, the exploration of 177Lu-PSMA-617 monotherapy and combination therapy still needs to be clinically verified in the future
.
Professor Shi Benkang said that mCRPC, as the terminal stage of prostate cancer, poses challenges to patients’ physical conditions, economic conditions, and doctors’ treatment methods.
After a series of treatments, patients still have very low levels of androgen in their bodies.
Will progress
.
The 5-year survival rate of mCRPC patients is only about 15%, and the options for subsequent treatment are now limited, and there are still major unmet needs for treatment
.
With the continuous advancement of precision treatment research, it has been found that 80% of mCRPC patients highly express PSMA.
Therefore, the emergence of radioligand therapy allows us to accurately combat PSMA-expressing tumor cells with less impact on surrounding cells.
This is a very simple treatment method with high response rate and few adverse reactions.
I look forward to this innovative treatment as soon as possible in clinical practice
.
Message from the experts Professor Xing Jinchun expressed his gratitude to Novartis for its contribution to the research and development of oncology drugs.
The emergence of radioligand therapy has brought new "weapons" to doctors and also brought more gospel to patients
.
Professor Shi Benkang said that a number of research advances in advanced prostate cancer were announced at the ASCO conference in 2021, and mCRPC diagnosis and treatment have continued to benefit
.
The results of the VISION study made a big debut, suggesting that 177Lu-PSMA-617 can prolong the rPFS and OS of patients with mCRPC and become a new option for the posterior treatment of mCRPC
.
We expect that the precise diagnosis of PSMA-PET/CT and the precise treatment of 177Lu-PSMA-617 can bring revolutionary optimization to the diagnosis and treatment of mCRPC, and effectively improve the survival benefits of patients
.
It is more hoped that the radioligand therapy can be implemented in China as soon as possible and better serve the vast number of patients in China
.
Note: This article aims to convey new advances in medical cutting-edge research.
The new drugs involved, such as radioligand therapy (177Lu-PSMA-617), have not yet been approved for prostate cancer indications.
The interpretation of the research data is only for professional medical professionals!
.
In recent years, from the first-line treatment to the back-line treatment, the diagnosis and treatment methods of mCRPC have been continuously improved, which also brings new hope for prolonging the survival time of patients
.
At the ASCO conference in 2021, the results of the VISION study were announced, letting the world see the importance of radioligand therapy (RLT) in the diagnosis and treatment of prostate cancer
.
During the "2021 Novartis Urinary Tumor Day (NUTD)-Sharing the Kidney Potential and Enjoying New Students" Conference, Yimaitong was fortunate to invite Professor Xing Jinchun from the Department of Urology at the First Affiliated Hospital of Xiamen University and Professor Shi Benkang from the Department of Urology, Qilu Hospital of Shandong University , To share the frontier progress of prostate cancer in the 2021 ASCO conference and the changes brought about by radioligand therapy for the diagnosis and treatment of prostate cancer
.
The 2021 ASCO conference continues to make new progress, and the prostate cancer research results are amazing.
At the 2021 ASCO conference, the VISION research results of 177Lu-PSMA-617 were announced in the form of LBA abstract.
Professor Xing Jinchun said that he was deeply impressed by the research
.
The results of the VISION study showed that 177Lu-PSMA-617 combined with standard treatment prolonged the median overall survival (OS) of patients by 4 months, reduced the risk of death by 38%, and the median imaging progression-free survival (rPFS) was significantly prolonged (8.
7 Months vs 3.
4 months; p<0.
001), the risk of radiological progression or death is reduced by 60%
.
Professor Xing Jinchun said that the results of the study are encouraging and also demonstrate the rapid progress in the research of radioligand therapy
.
In addition, the ASCO conference also announced another study of radioligand therapy (abstract number: 5053), a phase Ib study of 177Lu-PSMA-617 combined with pembrolizumab in the treatment of mCRPC.
The results of the study showed that the overall objective response rate was The (ORR) was 44%, and the PSA50 remission rate was 28% (the ORR of 177Lu-PSMA-617 combined with standard treatment in the VISION study was 51%, and the PSA50 remission rate was 46%)
.
Professor Shi Benkang said that in addition to the surprise results of radioligand therapy, research on combined immunotherapy for advanced prostate cancer is also "blooming
.
"
The first is the KEYNOTE-199 study of immunization combined with anti-androgen therapy.
This meeting updated the OS results of cohort 4 and cohort 5 of the study.
The median OS was 17.
6 months and 20.
8 months, respectively
.
Secondly, regarding immune combined with PARP inhibitor therapy, this year's ASCO annual meeting reported the final results of cohort A1 in the CheckMate 9KD study.
The results showed that patients with homologous recombination repair defects can benefit more from immune combined with PARP inhibitor therapy
.
Professor Shi Benkang emphasized that the application of immunization combined with PARP inhibitors needs to expand the sample size for research, and its efficacy needs to be verified in clinical practice
.
Regarding immune combined chemotherapy, the ASCO-GU meeting earlier this year reported the results of CheckMate 9KD study cohort B and KEYNOTE-365 study cohort B, showing the benefits of immune combined chemotherapy in mCRPC
.
Finally, the latest report at this year’s ASCO annual meeting was the result of a phase Ⅰb/Ⅱ study (ARC-6 study) combining immunization and chemotherapy with the targeted new drug Etrumadenant, but the study suggested that the addition of targeted drugs was not obvious Improve efficacy
.
There are various treatment options for mCRPC.
177Lu-PSMA-617 is the “escort” for the back-line treatment.
Professor Xing Jinchun introduced the current treatment options for mCRPC in China, including chemotherapy, endocrine therapy, targeted therapy, immunotherapy, and radionuclide therapy.
Treatment is the main first-line treatment plan, including traditional endocrine treatment plans and new endocrine treatment plans such as enzalutamide and abiraterone
.
Other treatments include PARP inhibitors (targeted therapy), and immunotherapy is currently only approved for Sipuleucel-T
.
In addition, radium-223 has been clinically used in patients with bone metastases
.
Overall, there are many mCRPC treatment programs in China, and they are in line with international standards
.
Professor Xing Jinchun also mentioned that the publication of the results of the VISION study means that 177Lu-PSMA-617 is a new choice for patients who are still progressing after various treatments
.
In addition to 177Lu-PSMA-617 single-drug therapy, there may be plans for combined immunotherapy or new endocrine drugs, making the research road for the treatment of mCRPC "going wider and wider" and continuously bringing benefits to patients
.
Professor Shi Benkang explained that the current definition of mCRPC is: testosterone is maintained at the castrated level (<50ng/dl or 1.
7nmol/L), and at the same time, it can be diagnosed as mCRPC if one of the serum PSA progress or the imaging progress is satisfied
.
In order to prolong the survival time and quality of life of patients, the treatment of mCRPC is progressing continuously
.
From the approval of docetaxel in 2004, to the approval of the new endocrine therapy drugs abiraterone and enzalutamide, to the approval of radium-223, the survival benefits of mCRPC patients continue to extend
.
In addition, with the implementation of the concept of tumor precision treatment, mCRPC targeted therapy has also made breakthroughs, and PARP inhibitors such as olaparib have also become second-line and above treatment options.
.
Professor Shi Benkang said that the results of the VISION study announced at this year's ASCO conference have shown us the good effect of 177Lu-PSMA-617 on patients with high expression of PSMA, and we are even more looking forward to the approval of 177Lu-PSMA-617
.
Radioligand therapy has significant benefits and advantages, bringing new changes to the diagnosis and treatment of advanced prostate cancer.
Professor Xing Jinchun said that the current treatment options for failure of mCRPC after multi-line therapy are limited, and there are serious unmet clinical needs.
177Lu-PSMA-617 is advanced prostate cancer.
Cancer patients, especially those who have failed chemotherapy, radiotherapy or endocrine therapy, provide new options.
If the therapy is launched in China, the population of prostate cancer patients in China will be large, and a large number of patients will benefit from it
.
In addition, the exploration of 177Lu-PSMA-617 monotherapy and combination therapy still needs to be clinically verified in the future
.
Professor Shi Benkang said that mCRPC, as the terminal stage of prostate cancer, poses challenges to patients’ physical conditions, economic conditions, and doctors’ treatment methods.
After a series of treatments, patients still have very low levels of androgen in their bodies.
Will progress
.
The 5-year survival rate of mCRPC patients is only about 15%, and the options for subsequent treatment are now limited, and there are still major unmet needs for treatment
.
With the continuous advancement of precision treatment research, it has been found that 80% of mCRPC patients highly express PSMA.
Therefore, the emergence of radioligand therapy allows us to accurately combat PSMA-expressing tumor cells with less impact on surrounding cells.
This is a very simple treatment method with high response rate and few adverse reactions.
I look forward to this innovative treatment as soon as possible in clinical practice
.
Message from the experts Professor Xing Jinchun expressed his gratitude to Novartis for its contribution to the research and development of oncology drugs.
The emergence of radioligand therapy has brought new "weapons" to doctors and also brought more gospel to patients
.
Professor Shi Benkang said that a number of research advances in advanced prostate cancer were announced at the ASCO conference in 2021, and mCRPC diagnosis and treatment have continued to benefit
.
The results of the VISION study made a big debut, suggesting that 177Lu-PSMA-617 can prolong the rPFS and OS of patients with mCRPC and become a new option for the posterior treatment of mCRPC
.
We expect that the precise diagnosis of PSMA-PET/CT and the precise treatment of 177Lu-PSMA-617 can bring revolutionary optimization to the diagnosis and treatment of mCRPC, and effectively improve the survival benefits of patients
.
It is more hoped that the radioligand therapy can be implemented in China as soon as possible and better serve the vast number of patients in China
.
Note: This article aims to convey new advances in medical cutting-edge research.
The new drugs involved, such as radioligand therapy (177Lu-PSMA-617), have not yet been approved for prostate cancer indications.
The interpretation of the research data is only for professional medical professionals!
