Patients who Don't respond to lutetium 177, will they respond to Terbium 161?

So, people ask me: "Patients who don't respond to Lutetium—will they respond to Terbium?" I don't know.
We don't have any data that actually looks at patients who have not responded to Lutetium and whether they have an enhanced response to Terbium.

The theoretical benefit is there, so there is a possibility that patients who did not respond to Lutetium, or who had an inadequate response to Lutetium, or had a response and are now progressing, may have an advantage by receiving Terbium instead of Lutetium.

But we still don't have the data.
The data that we do have, which comes more from preclinical studies, suggests that recurrence rates with Terbium will probably be much lower than with Lutetium. This is due to Terbium's ability to kill single cells—those residual cells that are actually responsible for recurrence.

It may be that Terbium is used versus Lutetium as a first-line therapy, rather than using Terbium in patients who fail Lutetium. That could be the protocol in the future.

There is a large study currently happening in Australia called the VIOLET study, led by Professor Michael Hofman and his team. They are conducting a head-to-head comparison between Terbium and Lutetium.

Their initial results are very encouraging, and they show that Terbium definitely has much better efficacy compared to Lutetium.

So, who knows—maybe in the future, Terbium will replace Lutetium as a first-line therapy.

Also Read