Highlights

The comparator arm [in the Phase III VISION trial] was best supportive care, so I would say one major deficiency in the clinical trial was that there wasn’t an open-label control of best supportive care. I mean, that’s unappealing. I have a feeling that if the toxicity was controlled for the duration of the exposure, so how long they were on Lutetium, and how long they were followed on the control arm, that would probably go a long way into explaining some of the different toxicities. For instance, patients did better with the Lutetium-PSMA, they lived longer, these patients were excited to get those therapies. If patients were assigned to the best supportive care arm, I think they probably frequently would have just sort of drifted away and looked for something else. It wasn’t placebo-controlled.

For [Lutetium 177Lu-PSMA-617 in] first-line mCRPC, I think there will be a significant amount of enthusiasm. A couple of reasons for that; number one, many patients in their first-line castration-resistant setting, they’ve already gone through something like one of the novel hormonal drugs which I just spoke about, because you can give them already for mHSPC, because of cross-resistance. Sometimes we’re already starting to think about something like chemotherapy. Patients don’t like the idea of chemotherapy, so if we have a non-chemotherapeutic option available for patients beyond the novel hormonal therapy in castration-resistant disease, patients will be excited about it.