Alpha-emitting PSMA therapy at first metastatic diagnosis
If Pluvicto helps at first diagnosis, an alpha version might do more against microscopic disease, when tumour burden is smallest.
Overview
This speculative idea would give alpha-emitting PSMA therapy with actinium-225 at the first metastatic diagnosis of hormone-sensitive prostate cancer, alongside hormone therapy. Short-range alpha emission suits small-volume disease and is oxygen-independent, and early treatment avoids the PSMA heterogeneity of castration resistance; PSMAddition established beta-emitter therapy here. The hypothesis is deeper PSA nadirs and longer radiographic progression-free survival than lutetium-177 PSMA-617 at equal or lower salivary dose; salivary toxicity and actinium-225 supply are limiting. The test is a randomised phase 2 with PSMA PET-based dosimetry, salivary gland protection and the undetectable-PSA rate at one year as primary endpoint.
Similar pages
not linked directly; found by shared links- PairingBeta radioligand → alpha radioligand
Shares Alpha vs beta emitters, Actinium-225 PSMA agents, Lutetium-177 vipivotide tetraxetan, Targeted alpha therapy.
- TrialAlphaBreak (FPI-2265) & AcTION (225Ac-PSMA-617)
Shares Actinium-225 PSMA agents, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha, Targeted alpha therapy.
- TermRelative biological effectiveness (RBE)
Shares Alpha vs beta emitters, Targeted alpha therapy, Actinium-225, Radioligand therapy (beta emitters).
- PersonClemens Kratochwil
Shares Actinium-225 PSMA agents, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha, Targeted alpha therapy.
- Pairing177Lu-PSMA-617 then 225Ac-PSMA rescue therapy
Shares Actinium-225 PSMA agents, Lutetium-177 vipivotide tetraxetan, Targeted alpha therapy, Actinium-225.
- TechnologyAlpha-emitter nanogenerators and daughter trapping
Shares Alpha vs beta emitters, Dosimetry, Targeted alpha therapy, Actinium-225.
- CompanyFusion Pharmaceuticals (AstraZeneca)
Shares Actinium-225 PSMA agents, Alpha-emitter roadmap: radium-223 → 225Ac-PSMA-617 → a phase 3 pipeline, Targeted alpha therapy, Actinium-225.
- IdeaRegional cyclotron hubs for actinium-225 with an agreed actinium-227 impurity limit
Shares Alpha vs beta emitters, Dosimetry, Targeted alpha therapy, Actinium-225.