The University of New Mexico Comprehensive Cancer Center will soon be examining the potential for using cutting-edge radioisotope technology called 177 Lu-PSMA-617 to treat advanced prostate cancer.
The UNM Cancer Center will be one of a few sites in the country participating in a clinical trial to expand the application of theranostic treatment to patients with prostate cancer. This type of treatment is currently used at the cancer center for neuroendocrine tumors.
Theranostics, derived from the words therapy and diagnostic, uses a two-part molecule. One part binds to certain receptors on cancer cells, while the other part is a radioactive ion.
The treatment is a two-part process that first injects the molecule attached to a gallium-68 radioactive isotope that can be imaged to illuminate the cancer cells, which makes them easier to see under Positron Emission Tomography, or PET scans.
But the molecule also marks those cells for the second part of the treatment, a series of injections of the molecule attached to a lutetium-177 radioactive ion that will bind to the cancer cells and destroy them.
The theranostic treatment allows oncologists to target specific cancer cells with less collateral damage to healthy tissues nearby and allows physicians to treat what they see.
Depending on the clinical trial’s outcome, the treatment has the potential of giving men with metastatic prostate cancer more choices. Participants in the clinical trial will have the opportunity of getting this clinical trial treatment on top of the prostate cancer treatment that they would normally get.
Neda Hashemi, MD, leader of the Comprehensive Cancer Center’s Genitourinary Clinical Working Group, explains that the standard treatment for men who have been diagnosed with metastatic prostate cancer starts with hormonal therapy or hormonal therapy plus chemotherapy. This clinical trial, she says, compares the outcomes for men who receive the standard treatments with the outcomes for those who receive one of the standard treatments plus the theranostic treatment.
“The good thing about the clinical trial is [that] all patients are receiving standard of care,” she says.
Patients who undergo the theranostic treatment will receive six treatments with the lutetium-177 to kill the cancer.
The trial will focus on patients who have just recently been diagnosed with metastatic prostate cancer and who haven’t received any other treatments for the disease, she says. The study will include cancer centers from across the world. Roughly 1,100 men will participate.
“The other good thing about the [clinical] trial is that it allows crossover,” Hashemi said. She explains that participants whose cancer is not responding to the treatment they are receiving can elect to try the other treatment. Not every clinical trial allows participants to cross over.
The clinical trial will require a team effort across the UNM Comprehensive Cancer Center.
“It’s very multi-disciplinary,” Hashemi says. “[We] really need a big team working closely together. I could not bring this clinical trial to UNM without the help of our UNM Department of Radiology Nuclear Medicine team and our Radiology team. Everybody worked so hard to open the trial at UNM Cancer Center.”
About Neda Hashemi, MD
Neda Hashemi, MD, is an Assistant Professor in the Department of Internal Medicine, Division of Hematology/Oncology, at the UNM School of Medicine. She leads the Genitourinary Cancers Clinical Working Group and practices at the UNM Comprehensive Cancer Center. She collaborates with UNM urology and radiation oncology teams to build a well-balanced clinical trial menu.
About the Clinical Trial
The “An International Prospective Open-label, Randomized, Phase III Study Comparing 177Lu-PSMA-617 in Combination With Soc, Versus SoC Alone, in Adult Male Patients With mHSPC (PSMAddition)” closed in June at the UNM Comprehensive Cancer Center. For more information, visit https://clinicaltrials.gov/ct2/show/NCT04720157.
UNM Comprehensive Cancer Center
The University of New Mexico Comprehensive Cancer Center is the Official Cancer Center of New Mexico and the only National Cancer Institute-designated Cancer Center in a 500-mile radius.
Its more than 136 board-certified oncology specialty physicians include cancer surgeons in every specialty (abdominal, thoracic, bone and soft tissue, neurosurgery, genitourinary, gynecology, and head and neck cancers), adult and pediatric hematologists/medical oncologists, gynecologic oncologists, and radiation oncologists. They, along with more than 600 other cancer healthcare professionals (nurses, pharmacists, nutritionists, navigators, psychologists and social workers), provide treatment to 65% of New Mexico’s cancer patients from all across the state and partner with community health systems statewide to provide cancer care closer to home. They treated almost 15,000 patients in more than 100,000 ambulatory clinic visits in addition to in-patient hospitalizations at UNM Hospital.
A total of nearly 1,855 patients participated in cancer clinical trials testing new cancer treatments that include tests of novel cancer prevention strategies and cancer genome sequencing.
The more than 123 cancer research scientists affiliated with the UNMCCC were awarded $38.2 million in federal and private grants and contracts for cancer research projects. Since 2015, they have published nearly 1000 manuscripts, and promoting economic development, they filed 136 new patents and launched 10 new biotechnology start-up companies.
Finally, the physicians, scientists and staff have provided education and training experiences to more than 500 high school, undergraduate, graduate, and postdoctoral fellowship students in cancer research and cancer health care delivery.