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Updated: Jun 25, 2026

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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How will PLUDO, PSMAfore, SPLASH, and ECLIPSE Impact Prostate Cancer Management?

Jean-Mathieu Beauregard1, Michael Ong2, Frédéric Pouliot3

  • 1Department of Radiology and Nuclear Medicine, Université Laval, Quebec City, Canada; Division of Nuclear Medicine, Department of Medical Imaging, CHU de Québec - Université Laval, Quebec City, Canada.

European Urology Focus
|June 23, 2026
PubMed
Summary

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This summary is machine-generated.

Prostate-specific membrane antigen radioligand therapy (PSMA-RLT) prolongs survival in metastatic castration-resistant prostate cancer (mCRPC). New trials show PSMA-RLT delays progression in patients before or after chemotherapy.

Area of Science:

  • Oncology
  • Nuclear Medicine
  • Radiopharmaceutical Therapy

Background:

  • Prostate-specific membrane antigen radioligand therapy (PSMA-RLT) is approved for metastatic castration-resistant prostate cancer (mCRPC).
  • The VISION trial established 177Lu-PSMA-617 as a standard of care post-androgen receptor pathway inhibitor (ARPI) and taxane chemotherapy.
  • Recent trials investigate PSMA-RLT in earlier mCRPC settings.

Purpose of the Study:

  • To review recent phase 3 trial results (PSMAfore, SPLASH, ECLIPSE) on PSMA-RLT in mCRPC.
  • To discuss the impact of these findings on mCRPC treatment sequencing.
  • To evaluate PSMA-RLT as an option for chemotherapy-naive patients.

Main Methods:

  • Review of published and presented results from three phase 3 trials (PSMAfore, SPLASH, ECLIPSE).
Keywords:
Metastatic castration-resistant prostate cancerProstate-specific membrane antigen radioligand therapyRadiopharmaceutical therapyTheranostics

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  • Inclusion of data from select randomized phase 2 trials.
  • Analysis of progression-free survival (PFS) and overall survival (OS) data.

    • Main Results:

    • PSMA-RLT demonstrated delayed PFS compared to ARPI in post-ARPI, chemotherapy-naive mCRPC patients.
    • 177Lu-PSMA-617 showed prolonged OS and PFS in previously treated mCRPC patients (VISION trial).
    • Emerging data supports PSMA-RLT's efficacy in earlier lines of mCRPC treatment.

    Conclusions:

    • PSMA-RLT is an effective treatment for mCRPC, both post-chemotherapy and in earlier settings.
    • Optimal sequencing of PSMA-RLT within mCRPC management requires further investigation.
    • PSMA-RLT offers a new therapeutic avenue for patients ineligible for chemotherapy.