Pluvicto for Advanced Prostate Cancer

Pluvicto, also called Lutetium Lu 177 vipivotide tetraxetan, is a treatment option for men battling advanced prostate cancer. This article delves into the mechanics, benefits, and considerations of Pluvicto.

What is Pluvicto and How Does It Work?

Pluvicto is a type of targeted radiation therapy, specifically formulated to attack prostate cancer cells expressing PSMA (prostate-specific membrane antigen). The drug consists of a PSMA-binding molecule linked to lutetium-177, a radioactive atom. 

When administered, Pluvicto targets PSMA-positive cancer cells, delivering potent radiation directly to the tumor sites while minimizing impact on healthy cells. This selective approach damages the DNA of cancer cells, leading to their destruction.

The Dual Role of Pluvicto: Theranostic Applications

One of the unique aspects of Pluvicto is its theranostic capability, serving both diagnostic and therapeutic purposes. Prior to treatment, patients undergo a PSMA PET scan with a gallium-68-tagged molecule, allowing physicians to visualize the spread of the cancer and assess its responsiveness to Pluvicto.

Who Benefits from Pluvicto?

Pluvicto is FDA-approved for adults with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have previously undergone androgen receptor (AR) pathway inhibition and taxane-based chemotherapy. This treatment is particularly beneficial for patients with advanced prostate cancer that has spread and is resistant to conventional therapies.

Clinical Evidence: The VISION Trial

The efficacy of Pluvicto was highlighted in the VISION trial, involving 831 men with mCRPC. The study demonstrated that Pluvicto, combined with standard care, significantly reduced the risk of death by 38% and disease progression by 60% compared to standard care alone. This led to a noticeable improvement in both overall and progression-free survival rates.

Managing Side Effects of Pluvicto

While Pluvicto is generally well-tolerated, it can cause side effects like fatigue, dry mouth, nausea, anemia, decreased appetite, and constipation. These are primarily due to its radioactivity and its effects on normal cells expressing PSMA. Patients are advised to take precautions, such as staying hydrated and limiting close contact with vulnerable individuals post-treatment.

Conclusion

Pluvicto is a new theranostic medicine for advanced metastatic prostate cancer that targets PSMA on the surface of prostate cancer cells and delivers a high dose of radiation to them. It can extend the survival and improve the quality of life of patients who have exhausted other treatment options. 

It is administered as an injection every six weeks for up to six doses, along with best standard of care. It requires a PSMA PET scan before treatment to confirm PSMA expression in tumors. It has some side effects due to its radioactivity and its effect on normal cells that also express PSMA.

Disclaimer: The blog post titled 'Pluvicto for the Treatment of Advanced Prostate Cancer' is intended solely for informational purposes, based on the references cited. It is not meant to serve as medical advice. For professional medical guidance, please consult your doctor.

References

  1. FDA approves Pluvicto for metastatic castration-resistant prostate cancer [Internet]. U.S. Food & Drug Administration; 2022 [cited 2023 Nov 29]. Available from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-pluvicto-metastatic-castration-resistant-prostate-cancer
  2. Lutetium-177 PSMA Therapy for Prostate Cancer (Pluvicto) [Internet]. UChicago Medicine; 2022 [cited 2023 Nov 29]. Available from: https://www.uchicagomedicine.org/cancer/types-treatments/prostate-cancer/treatment/lutetium-177-psma-therapy-for-prostate-cancer
  3. Pluvicto™ Prostate Cancer Treatment [Internet]. UVA Health; 2022 [cited 2023 Nov 29]. Available from: https://uvahealth.com/services/imaging/nuclear-imaging/pluvicto
  4. Pluvicto: Men with advanced prostate cancer going without life-extending treatment [Internet]. CNN; 2023 [cited 2023 Nov 29]. Available from: https://www.cnn.com/2023/03/21/health/pluvicto-prostate-cancer/index.html

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