Scott Tagawa, MD, highlights phase 3 trial of 177Lu-TLX591 in mCRPC

In this video, Scott T. Tagawa, MD, MS, FACP, FASCO, highlights the phase 3 ProstACT GLOBAL trial (NCT06520345), which is assessing the safety and efficacy of 177Lu-TLX591 plus standard of care (SOC) vs SOC alone in patients with metastatic castration-resistant prostate cancer. Tagawa isa professor of medicine and urology at Weill Cornell Medicine, and an attending physician at NewYork-Presbyterian – Weill Cornell Medical Center in New York, New York.

Video Transcript:

ProstACT GLOBAL is a study investigating a PSMA-targeted radionuclide with lutetium 177. Going back historically, the way that we first started targeting PSMA was with antibodies, and this study uses the first antibody that was able to target viable cells. So, the first antibody was capromab, but that binds to the internal domain of PSMA, so therefore can only bind to necrotic cells vs other antibodies, more specifically GFM1, could bind to the external domain, upon binding it gets internalized and retained. That has been really labeled with lutetium 177 which is a beta emitter, and completed a number of early phase clinical trials, really in New York, other than 1 multi-center trial. Patients with pre-treated metastatic CRPC receiving that and showed, in non-randomized trials, some efficacy at the expense of toxicity with myelosuppression. So, the antibodies tradeoff vs small molecules is it's too big to get into areas such as the salivary glands or kidneys or intestines, so we don't see as much dry mouth or nausea, but what we do see is the potential for myeloppression. In the quote pivotal study—it was only 17 patients—at the maximum tolerated dose, it showed an overall survival of 40 plus months. There was 59% grade 4 thrombocytopenia, but that seems to be less in this particular target population for ProstACT, which is an earlier line of therapy study.

This transcript was AI generated and edited by human editors for clarity.