Clinical Trials of Prostate-Specific Membrane Antigen Radiopharmaceutical Therapy

Prostate-specific membrane antigen (PSMA) theranostics has been a momentous triumph for nuclear medicine. The recent approvals of PSMA-targeted imaging agents (⁶⁸Ga-PSMA-11, ¹⁸F-DCFPyL) and radiopharmaceutical therapy (¹⁷⁷Lu-PSMA-617) have paved the way for theranostics as a viable care strategy for men with metastatic castration-resistant prostate cancer. The imaging clinical trials OSPREY, CONDOR, and those conducted at the University of California (Los Angeles and San Francisco), as well as the randomized phase 3 therapy trial VISION, have been the fruitful beginnings for PSMA theranostics. There are currently several ongoing clinical trials to expand the reach of PSMA theranostics to the earlier phases of prostate cancer and to optimize its utility in combination therapeutic regimens. We provide a brief narrative review of the many PSMA-directed radiopharmaceutical therapy clinical trials with the β-emitter ¹⁷⁷Lu-PSMA-617 and the α-emitter ²²⁵Ac-PSMA-617 in prostate cancer.