Neeraj Agarwal: Today, we are going to discuss the upcoming approval of PSMA-based radiopharmaceuticals and how this is going to impact the management of our patients with advanced and, probably, down the line, localized prostate cancer. So, let me start with the first question to our esteemed colleague, Dr. Calais. Jeremy, please tell us about the upcoming approval or upcoming PSMA-based radiopharmaceuticals. What drugs are coming up?
Jeremie Calais: Yes, a very good question. I will try to stay synthetic. Radiopharmaceutical therapy equals molecular radiotherapy equals radio nuclear therapy. You have many different names to say that you are administering on an IV setting in the blood, a molecule that is radioactive, seeking for specific target in the body to deliver locally some radiation. That’s what we’re doing with these drugs or treatment. These are radioactive drugs with a specific target. Here, we’re talking about the target PSMA. A target that is highly overexpressed by prostate cancer. We see very nicely, visually, this overexpression on PSMA-targeted PET imaging. And now, you can use the same overexpression converting contrasted imaging into high therapeutic index ratio. The aim here is to be able to treat, still in a targeted manner and almost focal manner, lesions that cannot be treated by [inaudible 00:02:00] treatment such as surgery, radiation therapy, or other types of technique like that.
Jeremie Calais: It’s kind of a hybrid approach between a systemic drug and some focal treatment, more of targeted. Now, the one that is most down the road and close to approval in clinical use is mutation 177 PSMA-617. Let’s call it mutation PSMA. There is a cold compound called PSMA-617 on which is attached the mutation, the radioactive agent. The PSMA-617 will go into the blood, go where the PSMA protein is overexpressed in all the prostate cancer lesion of a patient, and will deliver locally the mutation that will emit some radiation and kill some cells where it has been emitted. That’s the overall concept. Of course, it may benefit, for sure, patient with multiple sites of a disease that cannot be ablated by focal therapy. The first trial that will be used for registration and approval is called a VISION trial.
Jeremie Calais: Our colleague, Dr. [inaudible 00:03:14], will talk about it. Here, it was tested in an advanced setting in patient with mCRPC, Metastatic Castration-Resistant Prostate Cancer, who already failed one or two line of chemotherapy. So, pretty advanced. And I’m sure that with more and more earlier stage of disease, because there are multiple trials down the road, will show even greater efficacy in a disease that is more sensitive to treatment, less resistant, less heterogenous, and maybe we’ll reach even the point of the oligometastatic stage for colleagues in radiation therapy, Dr. [inaudible 00:03:54] can comment about that, where we could even combine stereotatic body radiation therapy with the PSMA-targeted molecular radiotherapy in the early stages of that.
Neeraj Agarwal: Sure. Yeah, those are great points. Thank you for such a great overview of how PSMA-based radiopharmaceuticals are emerging. They’re going to be approved soon and how they’re going to impact the lives of our patients.