Novel radionuclide therapy combinations in prostate cancer

Andrisha-Jade Inderjeeth; Amir Iravani; Shalini Subramaniam; Ciara Conduit; Shahneen Sandhu

doi:10.1177/17588359231187202

Novel radionuclide therapy combinations in prostate cancer

Ther Adv Med Oncol. 2023 Aug 2:15:17588359231187202. doi: 10.1177/17588359231187202. eCollection 2023.

Authors

Andrisha-Jade Inderjeeth^{1

2}, Amir Iravani³, Shalini Subramaniam^{4

5}, Ciara Conduit^{1

2

6}, Shahneen Sandhu^{7

6}

Affiliations

¹ Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia.
² Walter and Eliza Hall Institute of Medical Research, Melbourne, VIC, Australia.
³ Department of Radiology, University of Washington, Seattle, WA, USA.
⁴ NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia.
⁵ Department of Medical Oncology, Bankstown-Lidcombe Hospital, Bankstown, NSW, Australia.
⁶ Sir Peter MacCallum Cancer Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
⁷ Department of Medical Oncology, Peter MacCallum Cancer Centre, 302 Gratton Street, Melbourne, VIC 3000, Australia.

Abstract

Prostate cancer remains the commonest cancer diagnosed in males and a leading cause of cancer-related death. Men with metastatic castration-resistant prostate cancer (mCRPC) who have progressed on chemotherapy and androgen receptor pathway inhibitors (ARPI) have limited treatment options, significant morbidity, and poor outcomes. Prostate-specific membrane antigen (PSMA)-directed radionuclide therapy (RNT) is emerging as an efficacious and well-tolerated therapy; however, disease progression is universal. Several ongoing RNT trials focus on combination strategies to improve efficacy and durability of treatment response, including combinations with ARPIs, chemotherapy, immunotherapy, and targeted therapies. Further, efforts are underway to expand the role of PSMA-directed RNT to earlier stages of disease including hormone-sensitive and localized prostate cancer. In this review, we discuss the rationale and ongoing RNT combination therapeutic trials in prostate cancer and summarize the efficacy and toxicity associated with RNT.

Keywords: prostate cancer; radiation; radioligand therapy; radionuclide therapy; theranostics.

Publication types

Review