Dr Ravi on the Use of Lutetium Lu 177 Vipivotide Tetraxetan in mCRPC

Praful K. Ravi, MB, BChir, MRCP, medical oncologist, Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute, instructor, medicine, Harvard Medical School, discusses the use of prostate-specific membrane antigen (PSMA)-targeted therapies in metastatic castration-resistant prostate cancer (mCRPC), highlighting the use of the targeted radioligand lutetium Lu 177 vipivotide tetraxetan (formerly 177Lu-PSMA-617; Pluvicto).

In an OncLive® State of the Science Summit™, Ravi and colleagues each gave presentations on topics spanning prostate cancer treatment. Ravi highlighted PSMA-targeted therapies in prostate cancer, specifically focusing on lutetium Lu 177 vipivotide tetraxetan, an FDA-approved targeted radioligand therapy for patients with mCRPC. Ravi shares some of the data that led to the agent’s FDA approval in March 2022, including outcomes from the phase 3 VISION trial (NCT03511664). This international, prospective, open-label, multicenter, randomized study demonstrated an overall survival benefit with the use of lutetium Lu 177 vipivotide tetraxetan compared with standard supportive care, Ravi explains. Notably, the smaller phase 2 TheraP trial (NCT03392428) compared lutetium Lu 177 vipivotide tetraxetan with cabazitaxel (Jevtana) in the same patient population, Ravi notes.

Researchers in the prostate cancer treatment landscape have known about PSMA for a long time, and the biomarker was discovered the 1990s, Ravi expands, adding that in the early 2000s, there was an initial effort to utilize PSMA-targeted agents. Over the past 10 years, investigators revived this effort, which led to the development of agents such as lutetium Lu 177 vipivotide tetraxetan, Ravi explains. Once lutetium Lu 177 vipivotide tetraxetan was developed, it showed very encouraging activity in initial trials, which is what led to the phase 3 confirmatory trial, Ravi says.

Lutetium Lu 177 vipivotide tetraxetan has been the front-runner of PSMA-targeted therapies for many years, Ravi continues. However, other agents are now entering the mix and are under investigation in clinical trials, such as other radioligands, monoclonal antibodies, and PSMA-targeted antibodies, Ravi concludes.