Research supports early use of LuPSMA in prostate cancer
23 November 2023
Peter Mac researchers have shown LuPSMA therapy can be safely used as a first-line treatment for men with newly diagnosed prostate cancer, potentially revolutionising treatment for aggressive forms of this cancer.
The world-first research, recently published in the journal European Urology, studied the effects of men receiving the highly-targeted radioactive treatment known as LuPSMA before their cancerous prostate was surgically removed.
LuPSMA is an infusion containing radioactive Lutetium-177 which is attracted to PSMA (Prostate Specific Membrane Antigen) on prostate cancer cells wherever they are in the body, killing these cells.
Professor Michael Hofman, head of the Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC) at Peter Mac, said LuPSMA was generally used as a last-line treatment in cases where the cancer had spread beyond the prostate.
Landmark trials have shown LuPSMA can improve quality of life and survival for these men with late-stage, aggressive prostate cancers.
“In the LuTectomy study, men with newly diagnosed, localised prostate cancer received upfront radiation treatment with LuPSMA before surgical removal of their prostate,” said Professor Hofman.
“Some types of radiotherapy can result in damage to surrounding tissue making surgery afterwards more complex, therefore treatments like LuPSMA are generally performed only after surgery has taken place.”
The study showed LuPSMA therapy did not increase the technical difficulty of later surgery or add to risk of post-operative complications, and was therefore safe to give to men ahead of prostate removal.
“While we know that early-stage localised prostate cancer can be cured with surgery or external-beam radiotherapy, around half of the men with high-risk cancer will develop disease recurrence and metastases,” Professor Hofman (Right in photo below) said.
“We hope that this new application of LuPSMA therapy, before surgery, will ultimately cure more patients.”
Professor Declan Murphy (Left in photo), Surgeon and Director of Genitourinary Oncology at Peter Mac, said the targeted nature of LuPSMA reduced the impact on healthy tissue around a tumour.
"Therapeutic radiation from LuPSMA therapy travels only 1mm resulting in highly targeted tumour killing, while sparing normal tissue,” Professor Murphy said.
“This study shows we can safely add LuPSMA therapy before surgery and, if this is also shown to improve cure rates, it will revolutionise how we manage men with high-risk prostate cancers,” he said.
Professor Hofman said collaboration with industry partners including the Australian Nuclear Science and Technology Organisation (ANSTO) was crucial to the study.
“This research underscores ANSTO's commitment to fostering a healthier future for all Australians," he said.
“ANSTO is a beacon of excellence in nuclear science and technology in Australia and their support has been instrumental in achieving these promising results.”
Dr Renu Eapen, Urologist at Peter Mac, explained: “The LuTectomy study also gives us a unique opportunity to study prostate cancer tissue samples pre and post LuPSMA therapy to understand the tumour microenvironment and how we can better select patients for individualised treatment”.
The LuTectomy clinical trial was funded by a grant from Movember and the Australian Government, together with support from Novartis, and the EJ Whitten Foundation at Epworth Healthcare.
The paper is titled "Administering [177Lu] Lu-PSMA-617 Prior to Radical Prostatectomy in Men with High-risk Localised Prostate Cancer (LuTectomy): A Single-centre, Single-arm, Phase 1/2 Study."
You can read the paper in full online or watch Professors Murphy, Hofman and Dr Eapen discuss the LuTectomy trial in detail in this Special episode of the GU Cast podcast.
The audio version of this podcast is available by searching "GU Cast" on Spotify/Apple/Google.
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For more information contact the Peter Mac Communications team on 0417 123 048.
About Peter Mac
Peter MacCallum Cancer Centre (Peter Mac) is a world leading cancer research, education and treatment centre and Australia’s only public health service dedicated to caring for people affected by cancer. Based in Melbourne, Victoria we have 3,900 employees, including more than 750 laboratory and clinical researchers, all focused on providing better treatments, better care and potential cures for cancer
About ProsTIC
The Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC) is a world leader in a new technologic platform using radioactive molecules to improve lives of men with prostate cancer. Now in its fourth year of operation, it is meeting its three aims of Accelerating Clinical Trial Research, Discovery Research and providing Education and Leadership. Led by centre Director, Prof Michael Hofman the multidisciplinary team spanning Urology, Medical Oncology, Radiation Oncology, Medical Physics, Radiochemistry, Translational Research and Nuclear Medicine is progressing ground-breaking projects focussed on the use of PSMA as a diagnostic and therapeutic agent for treating men with prostate cancer
About ANSTO
The Australian Nuclear Science and Technology Organisation (ANSTO) is one of Australia’s largest public research organisations and is widely recognised as an international player in the field of nature science and technology. ANSTO operates much of Australia’s landmark research infrastructure and its Sydney campus is home to a nuclear medicine precinct, including the multipurpose research reactor, OPAL. ANSTO currently supplies around 75 – 80 per cent of the nuclear medicine used in Australia. Lutetium-177, which is a key component in LuPSMA, is produced locally by ANSTO in Sydney.
About Movember
Movember is the leading charity changing the face of men’s health on a global scale. Since 2003, the men's health movement has funded vital men’s health projects, challenged the status quo, shaken up men’s health research and transformed the way health services reach and support men. Taking on prostate cancer, testicular cancer, and mental health and suicide prevention with unwavering determination. Supporting men to live healthier, longer lives. Movember is working with community and expert partners year-round to improve the health of men and boys, their families, mates, and communities.