Highlights

So, do I use PSA? Yes, I do. Do I ever make a decision based on PSA changes alone? No. So, it’s a very accurate test, that’s why analytically it’s accurate; it’s not very reliable for telling you what’s
happening with the patient’s cancer, however, but it has a key advantage that you can do it whenever you want, whereas you can’t do a scan whenever you want. So, I would always consider symptoms as the most important measure of activity, scans next, and PSA third, but often the decision to do a scan is prompted by a rise in the PSA. So, the PSA is clearly relevant there, but it’s not a decision-making endpoint.

On the basis of VISION, that essentially places Lutetium kind of at the end of the therapeutic pathway, […] essentially it’s for patients who have had chemo, and they’ve essentially exhausted other therapeutic options. But of course a lot of these patients are quite frail at that stage, and I think therefore the prospect of inducing grade 3 toxicity means clinicians will back off. So, clinicians will select only the fitter patients who meet the product label.