In addition to all questions answered at the end of this webinar, here are a few remaining ones, which Prof Hofman kindly answered:
• What´s your opinion about the cost-effectiveness of 177-Lu-PSMA compared with others options?
There is regional variation. Interestingly, in low- and lower-middle-income countries, Lu-PSMA is also widely adopted and made available to patients. In these countries where there is a fee-for-service infrastructure, Lu-PSMA is preferred by many as a cheaper option to expensive pharmaceuticals. This generally uses Lu-177-PSMA-I&T made in hospital radiopharmacies.
For the USA / Europe, it is a more complex question. Lu-PSMA-PSMA-617 is approved for purchase from Novartis in a single country - Switzerland, and the cost upwards of 20,000 swiss francs per dose. We do not have yet pricing elsewhere. This will needs FDA and EMA approval first.
So it is a complex landscape, but when you take into account the efficacy and toxicity of Lu-PSMA compared to other treatments, I am confident it will be a cost effective treatment.
• What about non prostate related PSMA uptake in other benign or neoplastic process?
There is a range of non-prostate uptake. We have written a nice Radiographic review article on this.
• Can patients fail to respond to first dose of Lu-PSMA, then respond after the second one?
It can take several cycles of treatment until a response is seen.