FDA Approves Promising Therapy for Advanced PCa:

FDA Approves Promising Therapy for Advanced Prostate Cancer: Targets a Protein Called PSMA

This is an article from Memorial Sloan Kettering:

"Prostate cancer treatment took a major step forward today as the U.S. Food and Drug Administration approved a new therapy that zeros in on cancer cells to destroy them. The treatment, called 177Lu-PSMA-617, uses a molecule that selectively seeks out and attaches to a specific protein on the cancer cell surface called PSMA (prostate-specific membrane antigen). The technology delivers radiation that damages DNA and destroys the cancer cell.

“This type of precision medicine is a game changer for people whose prostate cancer has spread despite receiving multiple treatments,” says Memorial Sloan Kettering Cancer Center medical oncologist Michael Morris. He helped design, execute, and analyze a clinical trial showing the effectiveness of 177Lu-PSMA-617. “FDA approval of this therapy will enable even more people who had essentially been given death sentences to survive and live well.”

Link to the article:
https://www.mskcc.org/news/fda-approves-promising-therapy-advanced-prostate?utm_source=msknow-04-26-22&utm_medium=email&utm_content=generalcancer&utm_type=clinicalresearch

Great news! LUTATHERA (lutetium 177 dotatate) has been used for several years for neuroendocrine (carcinoid) cancer, and trials involving its use for mCRPC, though personally I don't know how the original differs from Lutetium-177 (177Lu)–PSMA-617, hopefully it's more effective than R-223(Xofigo) https://www.nejm.org/doi/full/10.1056/nejmoa2107322

Duck, I think the point is QOL more than life extension. As I understand it, Radium 223 has whole body SE's whereas Lu-177 delivers its payload directly to the tumor.

In the case of NET's, where Lu-177 has been used for four years, tumors can appear anywhere in the body, and usually involves frequent surgeries to remove a portion of or the entire affected organ.

In both cases, it is still a long slow death, but late stage treatments are less debilitating.

Duck.
Patients selected for participation in the trial had to have "Disease progression after the receipt of previous treatment both with one or more approved androgen-receptor–pathway inhibitors and with either one or two taxane regimens was required." These were patients who had exhausted most available treatments including chemo treatment with least one or two different taxane chemo drugs.

The results of the study demonstrate a statistically significant survival benefit of Lu-177 group compared to the control group who received only standard treatment. Further trials are now underway to see if patients could have greater benefit with earlier use of this treatment.

This is pretty much the way all new cancer treatments are tested. First in patients who have exhausted most other treatment options before trying it in patients who are still responsive to other treatments.

I just took a look at clinicaltrials.gov and found this. It's a currently recruiting phase 3 trial of Lu-177 in patients who haven't yet had taxane chemo for progressing PCa
https://clinicaltrials.gov/ct2/show/nct04689828