The Potential of Combination Therapy With Radiopharmaceuticals in Prostate Cancer

In an interview with Targeted Oncology^TM, Jeffrey Wong, MD, radiation oncologist and co-director of the Center for Theranostic Studies at City of Hope, discusses the evolving field of combination therapy with radiopharmaceuticals for prostate cancer treatment.

Combining radiopharmaceuticals with immune checkpoint inhibitors is a significant area of interest. The radiation delivered by the radiopharmaceutical can potentially make cancer cells more immunogenic, and the immunotherapy can then enhance the immune response against the tumor. Early trials have shown promising results.

Research shows that combining radiopharmaceuticals with PARP inhibitors could be synergistic, especially in tumors with DNA repair deficiencies. Additionally, using a combination of alpha- and beta-emitting radiopharmaceuticals sequentially or concurrently (e.g., Actinium-225 and Lutetium-177 labeled to the same targeting molecule) is being investigated to potentially improve efficacy and overcome resistance.

Alpha particles have a higher energy and shorter range than beta particles, potentially leading to more potent and localized tumor cell killing with less damage to surrounding healthy tissue. While already approved for metastatic castration-resistant prostate cancer with bone metastases, alpha emitter Radium-223 is being investigated in combination with other therapies like docetaxel and immune checkpoint inhibitors to enhance its efficacy.