Terence Wong, MD, PhD, and Stacy Wood, a Duke Health nuclear medicine technologist, provides treatment to a patient.
Men with advanced metastatic prostate cancer that has not responded to other treatments may now benefit from a new radiopharmaceutical treatment called PLUVICTOTM (lutetium Lu 177 vipivotide tetraxetan). Duke is one of the first cancer centers in the Southeastern region to offer PLUVICTOTM following its FDA approval in March 2022. Studies show it can extend the lives of people with this aggressive form of prostate cancer, even in the late stages, said Terence Wong MD, PhD, a nuclear radiologist at Duke Health.
Targeting Prostate Cancer
Men with metastatic prostate cancer -- prostate cancer that had spread to other parts of the body -- have several choices for fighting the disease, including hormone therapy, chemotherapy, radiation therapy, and surgery. In the past, if these treatments failed to halt the progression of the cancer, there were few other options.
PLUVICTOTM is a unique drug that targets PSMA -- a protein found on the surface of most prostate cancer cells. Treatments such as chemotherapy cannot identify PSMA specifically and can come with many unpleasant side effects. In contrast, PLUVICTOTM seeks out and delivers a high dose of radiation directly to the areas of disease throughout the body but bypasses healthy cells. This can mean fewer side effects like nausea, vomiting, and hair loss. The drug is typically given intravenously every six weeks for up to six treatments.
Just One Weapon Against Cancer
Before treatment with PLUVICTOTM is recommended, patients undergo a PSMA-PET/CT scan to determine if their tumor contains the PSMA target. If it does not, PLUVICTOTM would not be appropriate, explained Dr. Wong. “At Duke we treat you as an individual. Each case is discussed among a multidisciplinary team of surgeons, radiation oncologists, medical oncologists, radiologists, and nuclear medicine specialists.” He emphasized that PLUVICTOTM is not for everyone and is just one weapon in the arsenal for fighting cancer. “Our team will determine how and if this new option fits in with all the others we offer.”
Duke can provide PLUVICTOTM and other novel treatments because it is a Comprehensive Cancer Center with the latest advances in diagnosing and treating prostate cancer. Duke is also recognized as a Comprehensive Radiopharmaceutical Therapy Center of Excellence, which requires strict adherence to safety and treatment criteria that ensures the best care for patients.
Hope for the Future
Dr. Wong is optimistic about treating patients with PLUVICTOTM in the future. Ultimately, he hopes to use it earlier in the course of the disease and to have the capability to fine tune dosing based on tumor size. For now, he is encouraged by the response in patients who were at the end of the road in terms of treatment options. “A treatment that prolongs survival in that scenario is pretty impressive and can be a game-changer in the management of prostate cancer."