Dr. Morris on Logistical Challenges of Using 177Lu-PSMA-617 in Prostate Cancer

Michael J. Morris, MD, medical oncologist, section head, Prostate Cancer, GU Oncology, Memorial Sloan Kettering Cancer Center, discusses logistical challenges of utilizing Lutetium 177 (¹⁷⁷Lu) PSMA-617 in prostate cancer.

On September 30, 2021, the FDA granted a priority review designation to a new drug application for ¹⁷⁷Lu-PSMA-617 for use in the treatment of patients with metastatic castration-resistant prostate cancer (mCRPC) following androgen receptor pathway inhibition and taxane-based chemotherapy. The regulatory designation was based on findings from the phase 3 VISION trial (NCT03511664), in which ¹⁷⁷Lu-PSMA-617 improved radiologic progression-free survival and overall survival vs standard-of-care treatment in patients with PSMA-positive mCRPC.

Although the anticipated approval of this agent is encouraging, logistical challenges in utilizing the therapy will likely be faced in the community setting for patients with prostate cancer, Morris says. Multidisciplinary collaboration between medical oncologists, radiation oncologists, and nuclear medicine physicians will be needed to ensure eligible patients can receive the treatment.

Moreover, physical resources to build out nuclear medicine sections of radiation departments will be needed to ensure patients with prostate cancer have the necessary access to treatment, Morris explains. Additionally, the field will have to overcome standard systemic barriers that patients face globally. Although patient access to high-quality care is limited overall, this burden may be more significant with ¹⁷⁷Lu-PSMA-617 vs other therapies as it is a radioligand therapy that requires PSMA scans, Morris concludes.