LuPSMA shows promise as first-line treatment for prostate cancer

A Peter Mac study, part-funded by Movember, has led to a break-through in the treatment of early-stage prostate cancer.

The UpFrontPSMA study found that a targeted therapy known for treating late-stage prostate cancer can also dramatically improve outcomes for patients in earlier stages of the disease.

Lutetium-177 PSMA-617 – or LuPSMA – therapy had been shown in previous clinical trials to extend lives, and improve quality of life, in patients with advanced metastatic prostate cancer who have exhausted all other treatment options.

The UpFrontPSMA study was the first to test this treatment in patients with newly diagnosed prostate cancers that had spread. Peter Mac was the leading recruitment site for this Phase II trial, which enrolled 130 people from 11 Australian hospitals. The study compared the current standard of care – chemotherapy - to chemotherapy plus LuPSMA.

“Adding LuPSMA therapy to the standard-of-care approach was seen to dramatically improve responses compared to chemotherapy alone,” explains Associate Professor Arun Azad.

“We looked for undetectable PSA - a marker for prostate cancer - at 48 weeks after treatment and this was achieved in 41% of patients who received LuPSMA compared to just 16% for the standard-of-care.”

UpFrontPSMA was funded by the Prostate Cancer Research Alliance (PCRA) - involving Movember and the Australian Government’s Medical Research Future Fund, with support from Novartis and a US Department of Defense grant.

Movember’s Director of Prostate Cancer Research, Sam McKeown says: “Movember is proud to have supported this research through the Prostate Cancer Research Alliance. With prostate cancer cases set to double by 2040, research into preventing high-risk prostate cancer from progressing to fatal disease is critical”.

Professor Michael Hofman, who leads the Prostate Cancer Theranostics and Imaging Centre of Excellence (ProsTIC) at Peter Mac, adds: “The exciting results we have seen in the UpFrontPSMA trial validate the PCRA’s approach of supporting high risk, high reward clinical trials”.

The trial was also supported by the Australian and New Zealand Urogenital and Prostate (ANZUP) Cancer Trials Group. ANZUP CEO Associate Professor Samantha Oakes says: “ANZUP is extremely proud of this world first study, and the results are clear that adding LuPSMA to standard of care is improving lives of people with advanced metastatic prostate cancer.”

The trial’s “remarkable” results were published in the leading journal Lancet Oncology and presented by Associate Professor Arun Azad at Europe’s major cancer conference - ESMO (European Society for Medical Oncology) Congress 2024.