Suffering from very advanced prostate cancer, Andy Taylor, the guitarist of the group Duran Duran, claims that his radioactive treatment with lutetium-177 should save him 5 years of life expectancy. A miracle cure? We put the question to Dr. Ivan Pourmir, oncologist.
Duran Duran guitarist Andy Taylor was diagnosed with stage 4 prostate cancer in 2018, a very advanced stage which means the cancer has invaded the lymph nodes and/or spread throughout the body. then forming metastases. Today in palliative care, he says he benefited from a “state-of-the-art” radioactive treatment capable of targeting cancer cells: Lutetium-177, a type of radioactive treatment targeting cancer cells, and would be asymptomatic to date. Louder still, he states that should have extended the man’s life by five years.
A radioactive treatment that better targets cancer cells?
In articles mentioning his story, experts are full of praise: “Lutetium-177 can both identify the location of cancer and treat cancer,” explains Dr. Mona S. Jhaveri, who holds a doctorate in biochemistry, in Healtline, “which allows for more precise internal radiation therapy, compared to external radiation therapy which uses beams of radiation to target tumors.” For Stewart Parnacott, a certified nurse anesthetist, also interviewed, this therapy has had “notable” success, particularly in cases where traditional treatments have failed. “According to the VISION trial, lutetium-177 increased survival by 38%, which is huge considering that advanced-stage prostate cancer is not curable with current standard treatments.”.
As for the side effect, if the term radioactive can be scary, here again, the trials mention effects that are mostly milder than other standard treatments. In addition, patients would experience less pain and deterioration in their quality of life. Is lutetium 177 the perfect treatment for prostate cancer?
But a solution that is not suitable for all patients
Contacted on the subject, Dr. Ivan Pourmir, researcher and medical oncologist, explains the mechanism of lutetium-177, a treatment whose marketing was recently approved in England and Europe. This treatment is currently reserved for metastatic prostate cancer.
“The principle is that the radioactive molecule injected by infusion will cling to a protein found on the surface of prostate cancer cells, even when they are disseminated in the body. The radioactivity will then damage these cancer cells specifically and cause their death, while the exposure of the rest of the body will be more limited”.
But this intervention is not easy to carry out: “The radioactive element must first have been produced, which requires a lot of preparation, transport and precaution so that other people are not exposed” explains our expert. This interesting but restrictive solution is in fact not envisaged in the first line, “but only when the chemotherapy doesn’t work or the patient doesn’t want it” explains the expert.
More relative efficiency than mentioned
Contrary to echoes read in the foreign press, Dr. Pourmir also tells us that the effectiveness generated by this lutetium-177 is not perfect either: the Phase 3 Vision trial in which it was tested remains to this day. controversial for several reasons.
- Normally in a controlled trial, the treatment is compared with another standard treatment, here chemotherapy. “In this trial, there was the fear that the combination of the two would be too toxic, so the control treatment used did not include any chemotherapy… Result: how to know if the radioactive treatment is better than the chemotherapy, if the latter is not not represented in the essay?”;
- The researcher also notes an attrition bias, i.e. the exclusion from the analysis population of subjects initially included in the study – even though this exclusion influences the results and therefore the evaluation of efficiency. “The number of people who withdrew from the trial after being randomized is very important in this trial. This exclusion has various reasons, in particular because the participants in the control arm realized that they would receive neither the test treatment nor the chemotherapy. Again, how can two groups be compared if we remove the people who survive the best from the control group?
This solution seems to work for Andy Taylor. “So much the better, but let’s not exaggerate the expectations of this new treatment” concludes Dr. Pourmir. Radioactive treatment or not, the management of a cancer patient must be done on a case-by-case basis. It is the subject of a multidisciplinary consultation: the choice of the most suitable treatments is not carried out by a single doctor, but by a team of several health professionals.