Prostate Cancer Theranostics With ¹⁷⁷Lu-PSMA

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Therapy

Background:

• Prostate cancer management has evolved with targeted therapies.
• Metastatic castration-resistant prostate cancer (mCRPC) presents significant treatment challenges.
• Prostate-specific membrane antigen (PSMA)-targeted therapies have emerged as a promising approach.

Purpose of the Study:

• To review the current role of PSMA-targeted diagnostics and therapy, particularly 177Lu-PSMA-617, in prostate cancer.
• To analyze the indications, patient selection, and treatment execution for radioligand therapy (RLT).
• To evaluate the comparative effectiveness and safety of Lu-PSMA against other mCRPC treatments.

Main Methods:

• Review of existing literature and clinical trial data, including the VISION trial.
• Critical examination of comparative effectiveness studies (Lu-PSMA vs. cabazitaxel, Ra-223).
• Discussion of ongoing research in chemotherapy-naïve and hormone-sensitive prostate cancer settings.

Main Results:

• 177Lu-PSMA-617 is approved for post-chemotherapy and ARPI mCRPC patients.
• Evidence supports Lu-PSMA's efficacy, with ongoing studies exploring broader applications.
• Nephrotoxicity is a key safety concern requiring further investigation.

Conclusions:

• PSMA-targeted therapy represents a major advancement in prostate cancer treatment.
• Integration into multimodal, patient-centric strategies is recommended.
• Further comparative studies and real-world data are crucial for optimizing treatment protocols and outcomes.