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Publications

Pluvicto® approval by EMA

Pluvicto® approval by EMA

Following FDA approval in March 2022, European Medicines Agency (EMA) also approved Pluvicto® (lutetium (177Lu) vipivotide tetraxetan) of Novartis in December 2022 for targeted radioligand treatment of progressive PSMA–positive metastatic castration-resistant prostate cancer. The EMA approval is based on the results from the Phase III VISION trial, in which “radioligand therapy with 177Lu-PSMA-617 prolonged radiographic progression-free survival and overall survival when added to standard care in patients with advanced PSMA-positive metastatic castration-resistant prostate cancer”[1]. “The lutetium-177-PSMA was developed by the German Cancer Research Center (DKFZ) in cooperation with Heidelberg University Hospital and Heidelberg University.”[2]

[1] https://www.nejm.org/doi/full/10.1056/nejmoa2107322

[2] https://www.krebsinformationsdienst.de/aktuelles/2022/news059-metastasierter-prostatakrebs-zulassung-pluvicto-lutetium-177-psma-617-europa.php 

Interview with a patient

 

The patient A.G., 72 y.o., a molecular biologist himself, was diagnosed with metastatic prostate cancer in September 2018. After the conventional standard-of-care treatment (chemo- and antihormonal therapy) there were still residues of the primary tumour in the prostate, and lymph nodes and bone metastases. Up to date he has gone through 9 sessions (3 cycles) of 177Lu-PSMA therapy in the course of three years, initiating a new cycle once a routine control 68Ga-PSMA PET/CT detected PSMA expressing cancer lesions. The therapy has been extremely successful for A.G.: high response and hardly any side effects. Targeted radioligand therapy brings us much closer to the goal of making prostate cancer just another treatable chronic disease, at the same time preserving a decent quality of life, much like e.g. diabetes.

FAPi-based targeted theranostics for treating radioiodine-refractory differentiated thyroid cancer

FAPi-based targeted theranostics for treating radioiodine-refractory differentiated thyroid cancer

The study of FAPi-based lutetium-177 therapy in the All India Institute Of Medical Sciences in New Delhi was meant to investigate the therapeutic efficacy and safety of 177Lu-DOTAGA.(SA.FAPi)2 in RR-DTC patients. 15 heavily pre-treated (min 2 lines of prior treatment with lenvatinib and/or sorafenib) patients with the disease progression were selected based on FAPi PET/CT. An average of 3 sessions of 2 GBq each was administered in an 8-week interval.

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EAU updates its Prostate Cancer Guidelines

EAU updates its Prostate Cancer Guidelines

After the conclusion of the Vision trials the urological associations start gradually adjusting their Prostate Cancer guidelines, both in diagnostics and treatment. EAU now strongly recommends:

  • PSMA PET/CT (with gallium-68 or fluorine-18) as a more accurate diagnostic method than CT and bone scan for the staging of high-risk prostate cancer (PSA > 20 ng/mL, or GS > 7, or clinically palpable tumour in both lobes (cT2c)), and
  • 177Lu-PSMA as a therapy of choice for pre-treated (ADT) mCRPC patients with one or more metastatic lesions, highly expressing PSMA on the diagnostic radiolabelled PSMA PET/CT scan.

https://uroweb.org/guidelines/prostate-cancer/summary-of-changes

Both are available in our institution. Make your appointment now.

FAPI

Nuclear theranostics: what’s next?

While theranostics has immensely improved overall survival and quality of life of NET and prostate cancer patients and is increasingly becoming mainstream, the science is tirelessly working on the next big thing – pan-cancer theranostics based on fibroblast activation protein (FAP) found in the cancer-associated fibroblasts (CAF). With many widespread cancers in question, this would be truly revolutionary. First-in-human PET/CT studies of 68Ga-FAPI have demonstrated excellent results. A tracer derivative better suited for the therapeutical ends is within reach.

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Bone metastases, prostate cancer and theranostics

Bone metastases, prostate cancer and theranostics

Bone metastases are a common secondary cancer of many cancer types, such as breast (70%), prostate (85%), lung and kidney cancer (40%), due to the unique bone microenvironment. Tumors mostly metastasize to axial skeleton (i.e. bones of the trunk and pelvis) rather than to appendicular skeleton (limbs and girdles) along the distribution of the red bone marrow.

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Joint EANM procedure guideline / SNMMI procedure standard for prostate cancer imaging 2.0

Joint EANM procedure guideline / SNMMI procedure standard for prostate cancer imaging 2.0

EANM and SNMMI have updated their joint PSMA PET/CT procedure guideline for prostate cancer imaging with the most recent information. “This guideline supports physicians in recommending, acquiring, interpreting and reporting the results of PSMA-ligand PET/CT for initial diagnosis, staging and restaging of prostate cancer. … This document reports on patient selection, PET/CT acquisition, image interpretation and written summary of the clinical report. Specific advice is given for the most common PSMA radioligands available and for clinical scenarios with frequent use of PET/CT, including staging, restaging and assessment for suitability of PSMA RLT.”