Prostate cancer: vectorized internal radiotherapy is a game-changer

Prostate cancer: vectorized internal radiotherapy is a game-changer

Faced with advanced prostate cancer, a new treatment combines the benefits of targeted therapy and radiotherapy. Internal vectored radiotherapy (IVR) destroys tumor cells from the inside and offers real hope to patients who no longer have options.

In Europe, around one in seven men will develop prostate cancer during their lifetime. This disease has recently benefited from a new treatment with impressive results: vectorized internal radiotherapy. An update on this method reserved for advanced forms.

Treatment of prostate cancer

Prostate cancer develops from a normal cell, which transforms and multiplies in an anarchic manner, forming a tumor. Initially limited in size, it can grow and extend beyond the prostate and to other organs. This development is most often very slow. Its management is mainly based on surgery, radiotherapy, active surveillance (which allows the initiation of treatment to be postponed, particularly in elderly patients) and hormonal therapy.

Prostate cancer is hormone sensitive, which means that the growth of cancer cells is stimulated by a male hormone: testosterone. Hormone therapy consists of preventing this stimulating action of testosterone, and thus preventing the development of the tumor and its possible metastases (spread to other organs).

For advanced forms of prostate cancer, the use of second-generation hormonal therapies and chemotherapy is possible. And for two years, for patients who no longer respond to hormonal therapy or chemotherapy, the use of vectorized internal radiotherapy has offered new hope.

A real homing missile

If vectorized internal radiotherapy (IVR) is getting so much attention, it is because it is a step forward.both historic and thriving“details the University Hospital of Lyon. Concretely, this treatment administered orally or intravenously uses “the physical properties of atoms to fight cancer cells from inside the body“, adds the institute.

The treatment can be compared to a two-stage guided missile: a “seeker” capable of detecting tumor cells, and a “bomb” which delivers radiation to eliminate them. In other words: the radioactive isotope is delivered to the tumor cell which is destroyed by irradiation. By bringing radiotherapy as close as possible to the tumor cell, we obtain better effectiveness and spare adjacent tissues.

Treatment is based on an injection every six weeks. The drug will seek out a receptor present specifically on the surface of tumor cells, PSMA (in the prostate but also throughout the body).

What place for this new treatment?

For Dr. Ivan Pourmir, if he “is indeed an additional weapon (…) with a fairly original mode of action compared to existing treatments”, its place nevertheless remains “difficult to find due to the particularities of the clinical trials which evaluated it“.

According to our oncologist, short and medium term tolerance is acceptable and the benefit-risk balance seems favorable. “in the case of metastatic prostate cancer for which other options have been exhausted“.

On the other hand, it may differ if we consider applying vectorized lutetium to other situations, for example a complementary treatment of cancer after operation, as it would be a question of using it in certain patients who may already be cured. and with a prolonged life expectancy“, he adds.

For the moment, only the most severe cases can access treatment. But new studies are underway to evaluate its effectiveness on less advanced forms of cancer. The results will allow us to know whether these indications could be “expanded”.

Expensive treatments that require significant investments

However, the government will need to invest heavily in research to make this drug accessible to as many people as possible: investments to have centers capable of producing the drug, doctors trained in this treatment, etc.

So many financial constraints, which Dr Ivan Pourmir highlights:

The treatment involves a significant cost and quite complicated logistics to produce and administer the radioactive products. But there are prospects of being able to use it appropriately with additional data: if scanners that use the tracer targeting PSMA become more accessible, this could be a promising way to early assess effectiveness and modulate the duration of treatmentt”, says our expert.

Dr. Pourmir also believes that expanding the indications for this type of therapy could promote an economy of scale.

In the future, if we develop this type of therapy for other molecular targets and in other cancers, we can hope to make economies of scale in infrastructure and organization, but this is not yet possible. short term” concludes our expert.