Prostate cancer, Europe approves “nuclear therapy”
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In European countries, the treatment of advanced prostate cancer becomes precision and “nuclear”. The European Commission has in fact given the green light to the use of the radiopharmaceutical Lutetium 177 (177Lu) vipivotide tetraxetan, in association with anti-androgen therapy (ADT). The new therapy is indicated for patients with metastatic castration-resistant prostate cancer (mCRPC) who shows progression after previous medications and who test positive for prostate-specific membrane antigen (PSMA). This represents, in fact, the “target” of the therapy, present in the vast majority of patients.
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What are radiopharmaceuticals
Radiopharmaceuticals (or radioligands) are radioactive atoms – or, better, isotopes – bound to molecules capable of recognizing tumor cells. Once administered, these isotopes reveal metastases and deliver their small, lethal dose of radiation there – ultra-targeted and with manageable side effects. “Treatment with radioligands opens up new perspectives in terms of treatment for one of the most widespread tumors in the world, the prostate,” he says. Sergio BracardaPresident of SIUrO – Italian Society of Uro-oncology: “It is important to underline that this is a completely new mechanism of action, which combines a radioisotope with a molecule capable of recognizing and binding to a receptor expressed on tumor cells and able to overcome both innate and induced resistances from previous treatments, while demonstrating a significant advantage in terms of survival”.
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In particular, the new drug combines a molecule that binds to a specific receptor (ligand) with a therapeutic radioisotope (a radioactive particle, in this case lutetium-177). After intravenous administration, it binds to target cells, including PSMA-expressing prostate cancer cells. Once bound, the radioisotope’s energy emissions damage target cells and neighboring cells, impairing their ability to replicate and/or inducing their death. “More than 80% of patients with metastatic prostate cancer express the prostate-specific membrane antigen, a therapeutic target for Lutetium (177Lu) vipivotide tetraxetan therapy,” he explains. Marcello TucciDirector of the Oncology structure of Asl Asti”.
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The study that led to approval and the process in Italy
The European approval of lutetium (177Lu) vipivotide tetraxetan is based on results from the pivotal Phase III Vision study. Treatment-experienced participants received the radiopharmaceutical plus best standard of care and had a 38% reduction in the risk of death and a statistically significant (60%) reduction in the risk of radiographic disease progression or death compared with radiographic alone. traditional therapy. Approximately one third (30%) of patients demonstrated an objective response, compared with 2% in the other arm. “Soon concludes Tucci – following the completion of the Price and Reimbursement process, these patients will also be able to benefit in Italy from this valid treatment option. Other studies are currently underway to test therapy with lutetium (177Lu) vipivotide tetraxetan also in early stage prostate cancer.
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