A UCLA study reveals that a novel treatment combining a radioactive drug with radiation therapy significantly extends survival for men with recurring prostate cancer, potentially delaying the need for hormone therapy.
The new treatment strategy, tested by UCLA researchers, offers new hope for men whose prostate cancer has returned after initial treatment. This approach could help delay the need for hormone therapy, which can have burdensome side effects. The study’s findings, presented at the annual American Society for Radiation Oncology (ASTRO) meeting, showed that combining a targeted radioactive drug with standard radiation therapy more than doubled the amount of time patients remained free of disease progression.
The study focused on men with a form of cancer recurrence where the disease had returned in only a few isolated spots. Traditionally, this has been treated with stereotactic body radiation therapy, a highly precise type of radiation therapy used to treat tumors in the body. The UCLA-led team wanted to determine whether adding a PSMA-targeted radioligand therapy, a radioactive drug that zeroes in on cancer cells, would be more effective, according to a press release.
The researchers enrolled 92 men with recurring prostate cancer into the trial. Half received radiation alone, while the other half received the new drug plus radiation. The men who received both treatments stayed cancer-free for a median of nearly 18 months, compared to about seven months for those who got radiation alone. Dr. Amar Kishan, executive vice chair of radiation oncology at UCLA and lead author of the study, emphasized the importance of the collaboration between radiation oncology and nuclear medicine, stating that this is the first randomized trial to show that PSMA-targeting radioligand can significantly delay progression when added to metastasis-directed radiation.
One of the biggest benefits is the potential for patients to delay starting hormone therapy. While this is a common next step, it often brings side effects like fatigue, bone loss, and mood changes. Kishan noted that delaying hormonal therapy consistently benefits quality of life. Despite the improvements, the cancer eventually came back for many of the patients, highlighting the need for further optimization of the treatment. The new drug, 177Lu-PNT2002, is not yet FDA-approved for use at this stage of disease, and Kishan recommends that men with prostate cancer spreading beyond the prostate seek a consultation with a radiation oncologist to explore options.