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Friday, July 31, 2026

Novartis' Pluvicto gets US nod for hormone-sensitive prostate cancer

US regulators announced Friday that Novartis' Pluvicto (lutetium Lu 177 vipivotide tetraxetan) has been approved for patients with PSMA-positive, metastatic hormone-sensitive prostate cancer (mHSPC), significantly expanding the number of patients eligible for the radioligand therapy.

The approval extends Pluvicto's use beyond metastatic castration-resistant prostate cancer. "The treatment landscape for mHSPC is evolving, and this approval reflects a growing recognition that earlier treatment intensification matters," said Michael Morris, a principal investigator of the pivotal PSMAddition study in the US.

In the trial, Pluvicto combined with standard of care – an androgen receptor pathway inhibitor (ARPI) plus androgen deprivation therapy (ADT) – reduced the risk of disease progression or death by 28% versus standard therapy alone at the primary analysis. Updated findings showed the benefit widening to a 33% reduction, according to Novartis, with overall survival (OS) trending in Pluvicto's favour with a 0.80 hazard ratio, though data remain immature.

Safety results were consistent with those from the VISION and PSMAfore studies, which supported Pluvicto's approvals in 2022 and 2025 in castration-resistant prostate cancer. At primary analysis, grade ≥3 adverse events (AEs) were reported in 50.7% of patients who received Pluvicto plus standard care compared to 43% for standard care alone. 

Doubling eligible patient pool

The company estimates more than 186,000 men are diagnosed globally with mHSPC each year, and roughly half progress to castration-resistant disease within 20 months despite ARPI-ADT doublet therapy. 

Novartis US president Victor Bultó said the expanded label "nearly [doubles] the number of patients who may benefit from this targeted approach."

Still, despite the strength of the radiographic progression-free survival (rPFS) signal, key opinion leaders (KOLs) who spoke to FirstWord expressed caution about broad first-line adoption, citing concerns over long-term marrow toxicity, uncertainty around OS durability in a crossover-heavy trial, and high incremental cost .

The approval comes as Novartis continues to expand its radioligand manufacturing network, with five US production sites operational or under construction to support anticipated demand.

https://firstwordpharma.com/story/7801303

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