A University of British Columbia student was recognized at the largest cancer conference in North America for her recent work identifying potential side effects of a promising cancer drug.
Patients in 小蓝视频 and to Pluvicto, a treatment that delivers targeted radiation to prostate cancer cells. The treatment costs around $27,000 per dose, and can require around six doses.
In 小蓝视频, the drug will be available through 小蓝视频 Cancer’s Compassionate Access Program. Only Ontario, Nova Scotia and Alberta have publicly funded the drug. In Canada Pluvicto is approved for treatment of late-stage prostate cancer.
Between 250 and 300 patients will be eligible for treatment with Pluvicto each year, according to 小蓝视频 Cancer. Around 4,165 people are diagnosed with prostate cancer in 小蓝视频 annually, which kills around 30 people per year.
Scientists need to understand what risks there are for any cancer treatment so they can know how to mitigate them, said Asli Munzur, one of the winners of the .
Munzur took the prize home after presenting an in June.
She’s a PhD candidate working at the Vancouver Prostate Centre and a student at U小蓝视频.
Cancer care is moving towards what’s known as precision medicine, where each patient’s unique genes and the genetic and molecular profile of their cancer are used to choose the best treatment for a patient, 小蓝视频 Cancer said in an emailed statement.
“Personalizing treatment in this way may lessen harmful side effects, reduce damage to healthy cells and make it more likely that a treatment will work,” 小蓝视频 Cancer told The Tyee. “Precision medicine can also be used to predict cancer risk, diagnose cancer earlier and help people make treatment decisions that are right for them.”
To personalize cancer care, 小蓝视频 Cancer says it’s expanding precision radiotherapy, where patients receive targeted radiation at higher doses with less damage to neighbouring healthy tissues. The agency is also increasing access to new chemotherapy drugs, immunotherapy, hormone therapy and targeted therapy tailored to specific cancer types.
Pluvicto, which is the brand name for lutetium vipivotide tetraxetan, is injected intravenously and carries lutetium, the radioactive molecule, through the body until it attaches specifically to the outside of a prostate cancer cell.
This lets doctors “deliver targeted radiation to those cells only, which will minimize damage to other tissues,” Munzur said.
Treatment for prostate cancer usually starts with hormone therapy that suppresses a body’s testosterone production, which is known as “chemical castration.” When the cancer starts to advance again, becoming “castration resistant,” it’s time to move on to chemotherapy or Pluvicto.
If the cancer spreads elsewhere in the body it’s called metastatic cancer, or late-stage cancer, which can be incurable.
Treatment at this stage can help give patients a couple of extra months to live, but cannot cure the cancer, Munzur said.
“The way drug approval works is they’re first tested at the very late stages of cancer, when the patient has exhausted all other options,” Munzur said. “If the drug demonstrates clinical benefits at that stage, it slowly moves to clinical trials in earlier stages.”
In March 2025, Pluvicto was for use before a patient tried chemotherapy.
Shortly after the FDA’s approval, 小蓝视频 Cancer announced it had and would treat patients at the INITIO Medical Group facility in Burnaby and at Royal Jubilee Hospital in Victoria starting in June, and at other facilities across the province later in the year.
Pluvicto seems to have fewer side effects than chemotherapy and is widely considered to be a “transformative drug,” for cancer care, Munzur said.
But because it’s relatively new more work is needed to understand its potential side effects, which can help doctors understand how to limit them.
Possible side effects of Pluvicto
One possible risk is a condition known as secondary leukemia.
This does not mean that Pluvicto causes secondary leukemia. Instead it increases the number of mutated blood cells a patient might have, which is a “known and established risk factor” for future blood cancers, Munzur said.
Secondary leukemia can develop when an original cancer treatment affects the body’s blood stem cells and causes the cells to transform into a very lethal, treatment-resistant form of leukemia. This can happen after a patient receives chemotherapy, radiation, or a drug like Pluvicto, she said.
This is where Munzur’s research comes in.
She used targeted DNA sequencing, which looks at specific regions of a DNA strand to check for mutations, to evaluate blood samples from a where 180 patients were given either Pluvicto or chemotherapy.
She said her research goals were to compare how these treatments impacted a patient’s risk of future cancer, which can be measured by checking their levels of clonal hematopoiesis, the word for cellular mutations in blood.
Before patients started treatment, blood mutations were “prevalent” in their blood, she said, which was expected because prostate cancer and blood mutations tend to happen in older patients, she said.
Munzer said she found that cancer patients who’d been given Pluvicto had a higher risk of blood cell mutations, which puts them at higher risk of future blood cancers.
Patients who received Pluvicto had 3.2 times the risk of developing mutations compared to patients that received the chemotherapy drug. Munzer also found the amount of mutated blood cells increased as well, with Pluvicto causing 87 per cent expansion in mutations and chemotherapy drugs causing 33 per cent expansion.
“This is high-risk. If the mutations are expanding within the time frame of months, then that’s a concern for a future blood malignancy,” she said.
That’s good to know if the drug continues to be approved to treat earlier and earlier stages of prostate cancer, she said, because this means patients will have to live with side effects for longer.
It’s also helpful to know that doctors can test a patient’s blood to check for these DNA “signatures” that signal which patients might be at higher risk of later developing secondary leukemia, she said, adding it’s too early to say how doctors might want to use this information clinically.
Novartis is a multinational pharmaceutical company based in Switzerland and considered one of the largest pharmaceutical companies in the world. It is the manufacturer of Pluvicto and has been choosing recipients of the Novartis Oncology Young Canadian Investigator Awards for 22 years.
Munzur said it’s “meaningful” the company who made the drug recognized her work because it shows company dedication to better understanding what the drug does, “not just to the cancer but to the patient’s entire body.”
