Study tests combined targeted radiopharmaceuticals and precision radiation for recurrent prostate cancer

Study tests combined targeted radiopharmaceuticals and precision radiation for recurrent prostate cancer

Researchers at the UCLA Health Jonsson Comprehensive Cancer Center have opened a Clinical trial investigating whether precision radiation can be combined with a targeted radioactive therapy drug may help patients with recurrent prostate cancer delay progression while delaying or avoiding the side effects of long-term hormone therapy.

The Phase 2 trial, called ANDROMEDA, is the first study to directly compare two types of PSMA-targeting radiopharmaceuticals - lutetium-177–PSMA-617 (Lutetium Lu 177 vipivotide tetraxetan) and actinium-225–PSMA-617 - when used together with stereotactic body radiotherapy (SBRT), a focused form of radiation that is all detectable Tumors treated.

PSMA, or prostate-specific membrane antigen, is a protein found on the surface of most prostate cancer cells. This makes it an ideal target for radiopharmaceutical therapy, in which radiation is delivered directly to cancer cells while sparing surrounding healthy tissue. Lutetium-177 emits beta particles that travel further but are less energetic, while actinium-225 emits alpha particles that are more potent and can deliver a highly localized dose of radiation.

The study is led by Amar Kishan, MD, professor and vice chair of radiation oncology and co-director of the Cancer Molecular Imaging, Nanotechnology and Theranostics Program at the UCLA Health Jonsson Comprehensive Cancer Center, and Jeremie Calais, MD, PhD, director of the clinical research program in the Division of Nuclear Medicine and Theranostics and associate professor at the David Geffen School of Medicine at UCLA.

While we have previously shown that adding lutetium-177-based therapy to SBRT can extend progression-free survival in recurrent prostate cancer, we believe that actinium-225 may be even more effective in targeting microscopic disease. By comparing the two treatments directly, we hope to determine which approach provides the most durable cancer control.”

Amar Kishan, MD, professor and vice chair of radiation oncology and co-director of the Cancer Molecular Imaging, Nanotechnology and Theranostics Program at the UCLA Health Jonsson Comprehensive Cancer Center

The study involves men with oligorecurrent prostate cancer, meaning the cancer has recurred in 1 to 5 sites, as detected by a PSMA-PET scan.Patients in the study will receive radiation to all detectable tumors and either two cycles of lutetium-177-based therapy or a single cycle of actinium-225-based therapy before SBRT. Your progress will be tracked using follow-up imaging and blood tests, as well as patient-reported quality of life measures.

Researchers hope the combination may delay or possibly even prevent the need for hormone therapy, which is often accompanied by fatigue, hot flashes, bone loss and other long-term side effects.

“By combining targeted whole-body radiopharmaceutical therapy with precise local radiotherapy, we hope to eliminate both visible tumors and microscopic disease,” Calais said. “The ultimate goal is to improve long-term cancer control while maintaining quality of life.”

The ANDROMEDA trial builds on previous research, including the LUNAR trial, which showed encouraging early results combining targeted lutetium-177-based therapy and SBRT. This study represents the next step in studying how these treatments can work together to more effectively treat oligorecurrent prostate cancer.

Those interested in participating can find more information at Clinicaltrials.gov or contact Sophia Parmisano at [email protected] or 310-825-9775.

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