Prostate-Specific Membrane Antigen Theranostics in Prostate Cancer - Current State and Evolving Standards

Prostate-specific membrane antigen (PSMA)-based theranostics represent a paradigm shift in the management of prostate cancer. PSMA-ligand PET/computed tomography has demonstrated superior diagnostic accuracy over conventional imaging across diverse clinical settings. Parallelly, robust phase 3 evidence has established [¹⁷⁷Lu]Lu-PSMA-617 radioligand therapy as a standard-of-care in metastatic castration-resistant prostate cancer (mCRPC), with significant improvements in survival end points and quality of life. Emerging data also support the safe and effective integration of [¹⁷⁷Lu]Lu-PSMA-617 into earlier disease settings, including chemotherapy-naïve mCRPC and metastatic hormone-sensitive prostate cancer. Collectively, PSMA theranostics exemplify the crucial role of nuclear medicine in advancing precision care for prostate cancer.