PSMAfore: Informing Future Trials of 177Lu-PSMA-617 Versus Chemotherapy for mCRPC

Karine Tawagi, MD, of the University of Illinois College of Medicine, opines on whether the high rates of crossover in the PSMAfore control arm limit the applicability of the study results.

Additionally, she also forecasts how ongoing trials of ¹⁷⁷Lu-PSMA-617 versus chemotherapy will alter how the former will be used for patients with mCRPC.

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Dr. Tawagi: I think it would be nice to have the trials reading out ¹⁷⁷Lu-PSMA-617 versus docetaxel. One of the critiques of the PSMAfore trial is that the control arm was the ARPI switch. So yes, maybe we can start considering it pre-chemotherapy, but right now the approval really is in the post-docetaxel era.

We know that with the high crossover rate in the control arm, the OS was negative, but from the data presented today, there was improved quality of life metrics for patients that got ¹⁷⁷Lu-PSMA-617 upfront. I think that is definitely still something to consider for patients. You want to preserve their quality of life. Maybe in the next year or so, we will increasingly see ¹⁷⁷Lu-PSMA-617 given pre-chemotherapy, but it would be nice to have more clinical trial data in this space to inform that decision.

View her continued comments.