Radioligand Therapy's Impact On Prostate Cancer Treatment
- Radioligand therapy is a prostate cancer treatment that uses a targeted dose of radiation on prostate cancer cells. This treatment approach helps minimize damage to healthy tissue which means fewer side effects.
- “One arm attaches to a protein on the cell surface, and the other carries a piece of radiation,” Dr. William Kevin Kelly, Chair of Medical Oncology at Thomas Jefferson University’s Sidney Kimmel Cancer Center, tells SurvivorNet. “The antibody goes to the tumor and delivers that radiation directly.”
- Pluvicto (lutetium Lu 177 vipivotide tetraxetan) is an approved radioligand treatment for patients with PSMA-positive metastatic castration-resistant prostate cancer. PSMA-positive means their tumors express a specific protein that can be detected through imaging. Castration-resistant means the cancer has progressed despite lowering testosterone levels.
- Eligibility requires a sensitive PSMA scan to determine if the tumor expresses the target protein. It can be a promising option for these patients when they have already been treated with either hormone therapy or a combination of hormone therapy and chemotherapy.
“One arm attaches to a protein on the cell surface, and the other carries a piece of radiation,” Dr. William Kevin Kelly, Chair of Medical Oncology at Thomas Jefferson University’s Sidney Kimmel Cancer Center, in Philadelphia, tells SurvivorNet.
Read MoreWhen Can Radioligand Therapy Be Used?
Pluvicto (lutetium Lu 177 vipivotide tetraxetan) offers a targeted treatment option for men with metastatic castration-resistant prostate cancer that is PSMA-positive. Castration-resistant means that the cancer has continued to grow despite a reduction in testosterone levels. PSMA positive means their tumors express the PSMA protein, which can be detected through imaging.Before receiving Pluvicto, prostate cancer patients must undergo a PSMA scan to confirm that their tumor expresses the target protein.
“We have to understand if your tumor takes up that protein,” Dr. Kelly notes. “If not, this drug can cause more problems than good.”
Additional eligibility criteria include a hemoglobin (a protein found in red blood cells) level above nine and healthy kidney function, as the treatment can pose risks if these conditions aren’t met.
It can be an option for these patients when they have already been treated with either hormone therapy or a combination of hormone therapy and chemotherapy.
Treatment Sequencing
Initially, Pluvicto (lutetium Lu 177 vipivotide tetraxetan) was approved for patients with metastatic castration-resistant prostate cancer who had already progressed or worsened after chemotherapy with docetaxel (a type of chemotherapy) and an androgen pathway inhibitor (APRI), which blocks male androgens such as testosterone. But newer studies are shifting the treatment timeline.
“There’s a benefit if we actually move it up front — after a patient has had hormonal therapy but before chemotherapy,” Dr. Kelly explains. This shift reflects a broader evolution in prostate cancer care.
“I think it is a great advancement for prostate cancer,” Dr. Kelly says. “I’ve been involved with these studies for almost two decades, and I’ve seen the biology and science evolve. Over the next five years, you’re going to see a lot of other radioligands come down that can be very effective.”
Side Effects
Side effects of Pluvicto may include:
- Fatigue
- Nausea
- Constipation
- Dry mouth
- Decreased blood cell counts
As the field continues to advance, radioligand therapy offers new hope for patients — combining precision, innovation, and the promise of better outcomes.
Questions To Ask Your Doctor
- Am I a candidate for radioligand therapy like Pluvicto?
- How does radioligand therapy compare to other potential treatment options?
- What does a PSMA scan involve, and what does it tell us about my cancer?
- How will I be monitored if I undergo radioligand therapy?
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