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Commercial supply of piflufolastat (18F) begins in Italy

News
Article

The therapy is currently being manufactured in Italy at Curium facilities in Milan.

The first commercial doses of piflufolastat (18F) (Pylclari, (18F)-DCFPyL) have been sold in Italy for the detection of prostate-specific membrane antigen (PSMA)-positive lesions with PET in patients with prostate cancer, announced Curium, the European distributor of the diagnostic, in a news release.1

The imaging agent received US FDA approval in May 2021.

The imaging agent received US FDA approval in May 2021.

“We are thrilled that we have successfully started the commercial supply of PYLCLARI in Italy – supporting even more nuclear medicine physicians and their patients across Europe. As we continue to redefine the experience of cancer through our trusted legacy in nuclear medicine, today’s announcement underscores our priority on improving the choice of diagnostic modalities available to our customers – ultimately for the benefit of patients with prostate cancer,” said Benoit Woessmer, PET Europe CEO at Curium, in the news release.1

Piflufolastat (18F) is an 18F-PSMA PET tracer indicated for use in the primary staging of patients with high-risk prostate cancer prior to initial curative therapy, and to localize recurrence of prostate cancer in patients with suspected recurrence based on increasing PSA level after primary treatment with curative intent.

The therapy is currently being manufactured in Italy at Curium facilities in Milan. The company plans to expand production to Rome and Pisa in the future.

In July 2023, the European Commission granted a marketing authorization to piflufolastat (18F) in the European Union. The imaging agent also received US FDA approval in May 2021.2

Data on piflufolastat (18F)

Piflufolastat (18F) was approved in the United States in May 2021 based on data from the phase 3 OSPREY (NCT02981368) and CONDOR (NCT03739684) trials, which demonstrated the safety and efficacy of the agent in different clinical settings.

Both clinical trials enrolled patients with prostate cancer who were given a single dose of piflufolastat (18F) for the study.

In total, the OSPREY trial3 enrolled 385 patients who were divided into 2 cohorts: cohort A, consisting of 252 evaluable patients with high-risk prostate cancer undergoing radical prostatectomy with lymphadenectomy, and cohort B, consisting of 93 evaluable patients with suspected recurrent/metastatic prostate cancer on conventional imaging.

Data showed high specificity and positive predictive value (PPV) with piflufolastat (18F) prior to initial therapy. In cohort A, median specificity with piflufolastat (18F) was 97.9% among 3 readers, and the median sensitivity was 40.3%. The median PPV and the median negative predicative value with the diagnostic was 86.7% and 83.2%, respectively.

In cohort B of the study, the median sensitivity of the agent was 95.8%, and the PPV for extraprostatic lesions was 81.9%.

Further, the CONDOR study4 enrolled 208 men with prostate cancer with non-informative baseline imaging and a median baseline PSA of 0.8 ng/mL. The primary end point was correct localization rate (CLR), defined as PPV with anatomic lesion colocalization between piflufolastat (18F) and a composite standard of truth.

Findings showed high rates of CLR and detection with piflufolastat (18F) in patients with biochemical recurrent prostate cancer, including in those with low PSA values. Overall, the CLR was found to be 84.8% to 87.0%. The disease detection rate, defined as 1 lesion detected per patient by piflufolastat (18F) by central readers, was 59% to 66%. Among all patients, 63.9% had a change in intended management following piflufolastat (18F).

Adverse events from both trials were observed among 2% or less of patients, which included headache, dysgeusia, and fatigue. One patient with a history of allergic reactions also reported experiencing a delayed hypersensitivity reaction to the treatment.

References

1. Curium announces first commercial doses in Italy of PYLCLARI – An innovative 18F-PSMA PET tracer indicated in patients with prostate cancer. News release. Curium. March 7, 2024. Accessed March 8, 2024. https://www.curiumpharma.com/2024/03/07/pylclari-italy-commercial-dose-psma-tracer/

2. Lantheus received US FDA approval of PYLARIFY (piflufolastat F 18) injection, the first and only commercially available PSMA PET imaging agent for prostate cancer. News release. Lantheus Holdings, Inc. May 27, 2021. Accessed July 31, 2023. https://investor.lantheus.com/news-releases/news-release-details/lantheus-receives-us-fda-approval-pylarifyr-piflufolastat-f-18

3. Pienta KJ, Gorin MA, Rowe SP, et al. A phase 2/3 prospective multicenter study of the diagnostic accuracy of prostate specific membrane antigen PET/CT with 18F-DCFPyL in prostate cancer patients (OSPREY). J Urol. 2021;206(1):52-61. doi:10.1097/JU.0000000000001698

4. Morris MJ, Rowe SP, Gorin MA, et al. Diagnostic performance of 18F-DCFPyL-PET/CT in men with biochemically recurrent prostate cancer: Results from the CONDOR phase III, multicenter study. Clin Cancer Res. 2021;27(13):3674-3682. doi:10.1158/1078-0432.CCR-20-4573

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