Prostate cancer is a common and serious disease that primarily affects older men. While it can occur at any age, the risk increases significantly after 65. Radioligand therapy (RLT) is a new and promising treatment option for tackling this condition, which we covered in a post earlier this week.
Unlike traditional radiation therapy, RLT delivers radioactive drugs directly to cancer cells through an injection. This targeted approach minimizes damage to healthy tissues, which is a significant benefit for patients.
Dale Cousins, a patient battling prostate cancer, is a testament to the potential of RLT. After undergoing RLT in a clinical trial, his scans revealed a “dramatic reduction” in cancerous lesions. However, a hurdle remains for many prostate cancer patients: public access to this potentially life-saving treatment.
Dr. David Laidley, a Western University nuclear oncologist leading the London, Ontario site of a Canada-wide RLT clinical trial, emphasizes this benefit to the Toronto Star.
“We’re able to deliver this very specific therapy to specific cells in the body,” he explains, “[…] sparing the normal tissues.”
Clinical trials show encouraging results
Cousins’ experience reflects the promise of RLT. Diagnosed in 2010, he underwent various treatments before enrolling in the RLT trial after his cancer’s return. Following his final infusion, he has shown a remarkable response, with a significant decrease in cancerous lesions. Past clinical trials have also yielded positive results, leading to Health Canada’s approval of Pluvicto, the radioactive drug used in the prostate cancer trial, in August 2022. However, this approval only applies to patients who have exhausted other options.
Despite Health Canada‘s approval, a significant hurdle remains for prostate cancer patients outside of clinical trials. Negotiations between the pan-Canadian Pharmaceutical Alliance (pCPA) and Novartis, the manufacturer of Pluvicto, regarding its pricing have stalled since their inception in August 2023.
This delay leaves many patients in limbo, as Laidley highlights to the Star: “Oncologists are asking ‘can we refer patients […]?’ And unfortunately, we have to say that it’s not available”.
While the current roadblock limits access for prostate cancer patients, RLT holds promise for other cancers as well. Dr. Simron Singh, a medical oncologist at Sunnybrook who ran the groundbreaking NETTER-2 study on RLT, points to the success of Lutathera, another RLT drug, in treating neuroendocrine tumors.
He emphasizes the potential of RLT as a “starting treatment” beyond its established use as a last resort. Clinical trials are also exploring the use of RLT with different radioactive drugs for various other cancers.
The future of RLT
Both Singh and the Canadian Cancer Society view RLT as a potential “new pillar” in cancer treatment. The Society calls it “a remarkable breakthrough” with the potential to significantly improve patient outcomes. They are currently funding trials to explore using Pluvicto in earlier stages of prostate cancer.
The promising results of RLT are overshadowed by the current lack of public access. Patients and healthcare professionals alike eagerly await a resolution between the pCPA and Novartis that would grant broader access to this promising treatment. While Novartis acknowledges the need, reaching an agreement that reflects the innovation of Pluvicto and its value to patients remains a point of negotiation.
In the meantime, patients and healthcare professionals wait anxiously for a resolution that will bring the promise of RLT to those who need it most.
