PSMA Therapy Delays Hormone Therapy by 20 Months in Early-Stage Prostate Cancer
A new study has found that PSMA therapy can postpone the need for hormone therapy by an average of 20 months in men with early-stage prostate cancer experiencing limited metastatic disease.
The research, led by Radboudumc in the Netherlands, suggests a potential new application for a therapy previously known for its efficacy in advanced prostate cancer cases.
Study Overview
The study investigated the effectiveness of PSMA therapy in earlier stages of prostate cancer, specifically in cases where patients had up to five metastases. The therapy was administered following targeted radiation or surgery, and prior to the initiation of hormone therapy.
Nuclear Medicine Physician James Nagarajah, the project leader, stated that the study aimed to explore PSMA therapy's potential to delay hormone therapy and its viability as a future alternative. He noted that many men seek to avoid hormone therapy due to its associated side effects.
Background on Prostate Cancer and PSMA Therapy
Approximately 15,000 men are diagnosed with prostate cancer annually in the Netherlands. Current treatment options include radiation, hormone therapy, and chemotherapy.
PSMA therapy involves internally irradiating tumors using lightly radioactive PSMA. In previous research, this therapy has demonstrated positive effects, including increased survival and improved quality of life, in approximately two-thirds of patients with late-stage prostate cancer who had exhausted other treatment options.
Hormone therapy is associated with side effects such as hot flashes, loss of muscle strength, and fatigue.
Methodology
Fifty-eight men participated in the study, which was led by Radboudumc with contributions from other institutions, including Amsterdam UMC and UMCG. Participants were divided into two groups:
- Immediate PSMA Therapy Group: Half of the men received PSMA therapy immediately.
- Control Group: The other half received treatment only upon disease progression, at which point they were administered PSMA therapy.
The treatment regimen consisted of four sessions. All participants were monitored for a minimum of two years.
Key Findings
The study yielded the following results:
- In the group that received immediate PSMA therapy, 52% of men experienced disease progression after 27 months.
- In the control group, 97% of men experienced disease progression within the same period.
- PSMA therapy extended the time before follow-up treatments, such as hormone therapy, were required by an average of 20 months.
- The therapy was associated with few reported side effects.
- Patient quality of life was maintained.
These findings have been published in Lancet Oncology.
Implications and Future Potential
First author Bastiaan Privé suggested that PSMA therapy could play a role in the management of limited metastatic prostate cancer by delaying the need for hormone therapy.
Privé also noted the potential for the therapy to reduce cancer sufficiently in some cases, which could make men eligible for targeted radiation again, potentially further postponing the need for hormone treatment.