"We'll have to obviously amend this document quickly as these drugs move earlier in the stage of disease," says Thomas A. Hope, MD.
In this interview, Thomas A. Hope, MD, broadly discusses what is covered in the publication, “SNMMI consensus statement on patient selection and appropriate use of 177Lu-PSMA-617 radionuclide therapy,” for which he served as the lead author. Hope is a nuclear medicine physician and radiologist, a professor of radiology, and the director of the radioligand therapy program at the University of California, San Francisco.
The document recommends using PSMA radioligand therapy in patients after they've received chemotherapy and androgen receptor targeted therapy, which is the label for Pluvicto or 177Lu-PSMA-617 radioligand therapy. That's not too exciting of news. That's where you're legislated by the approval of drugs. I think that will get changed very soon, with the outcomes of PSMAfore, ECLIPSE, and SPLASH. We'll have to obviously amend this document quickly as these drugs move earlier in the stage of disease.
I think the more interesting aspect of it is how do you approach patients who may not be candidates for the trials. How do you approach a patient who might have a GFR of 30? How do you approach a patient whose platelets might be 60,000? In that setting, how do you use these drugs? And I think that's where it gets to be a lot more complicated when you think about managing these patients, particularly for nuclear medicine physicians, because we're not so used to patients who are so heavily pretreated. We're used to neuroendocrine tumor patients who are generally healthier, less marrow injury, etc. This patient population can be a lot more sick than we're used to dealing with.
This transcription has been edited for clarity.