Pluvicto (lutetium Lu 177 vipivotide tetraxetan) / Novartis, Otsuka - LARVOL DELTA

Optimizing the treatment pathway in post-docetaxel mCRPC: PSMA-RLT vs cabazitaxel. (PubMed, Cancer Treat Rev) - "Available data suggest [177Lu]Lu-PSMA-617 as the preferred therapeutic option for the majority of patients with PSMA-positive mCRPC who progressed to ARPI and docetaxel. PSMA-RLT is preferred for most PSMA positive patients, with eligibility assessed individually rather than by rigid thresholds. Cabazitaxel remains a crucial treatment for patients with low PSMA expression, those ineligible for PSMA-RLT, or as an effective sequential therapy. Modern management of mCRPC demands a personalized, multidisciplinary approach to optimally balance survival gain with quality of life."

Clinical • Journal • Review • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • FOLH1

Recent Advances in the Application and Development of Coordinated Radiopharmaceuticals. (PubMed, Handb Exp Pharmacol) - "The 177Lu complexes, 177Lu-DOTATATE and 177Lu-PSMA-617, have recently been approved by the FDA to treat neuroendocrine tumors and metastatic prostate cancer, respectively. In this chapter, we systematically introduce the classification of radioactive particles and the coordination chemistry and structure-activity relationship of the type complex. In addition, we discuss the challenges encountered in the development of nuclear medicines and propose that artificial intelligence provides new ideas for the design and development of new boron drugs."

Journal • Genito-urinary Cancer • Genitourinary Neuroendocrine Tumor • Neuroendocrine Tumor • Oncology • Prostate Cancer • Solid Tumor

Multi-Tracer PET-Guided Therapy Selection and Theranostics in Radioiodine-Refractory Thyroid Cancer Patient Unsuitable for Tyrosine Kinase Inhibitor Therapy. (PubMed, World J Nucl Med) - "In this case report, multi-tracer PET imaging was employed to assess the feasibility of available theranostic options. While [ 68 Ga]Ga-DOTATATE PET/computed tomography (CT) showed low-level somatostatin receptor expression, [ 68 Ga]Ga-prostate specific membrane antigen (PSMA)-11 PET/CT revealed moderate and concordant PSMA expression across all lesions observed on [ 18 F]F-FDG PET/CT, justifying [ 177 Lu]Lu-PSMA-617 therapy in this patient."

Journal • Oncology • Solid Tumor • Thyroid Gland Carcinoma • FOLH1 • SSTR

Exploratory analysis of circulating tumor cell STEAP1/2 dynamics and outcomes in patients treated with ¹⁷⁷Lu-PSMA-617 (LuPSMA) (ESMO 2026) - No abstract available

Circulating tumor cells • Clinical • Tumor cell • Oncology • STEAP1

A Cost-Effectiveness and Health Equity Analysis of Radioligand Therapy for Metastatic Castration-Resistant Prostate Cancer (ASTRO 2026) - "At current list prices, 177Lu-PSMA-617 is not cost-effective by our designated metrics. However, this analysis identifies RLT as an equity-enhancing intervention: it delivers higher relative economic and clinical value to underserved populations by mitigating the logistical toxicities and adherence gaps associated with standard therapies. Alternative payment models are needed to ensure safety-net hospitals can sustain access to this life-prolonging therapy."

Cost effectiveness • HEOR • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Attrition After Cabazitaxel (Caba) or 177Lutetium prostate-specific membrane antigen-617 (177 Lu-PSMA) and Its Determinants in Metastatic Prostate Cancer (mPCa) (CABALUTE study) (ESMO 2026) - No abstract available

Metastases • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Favorable Survival Outcomes with 177Lu-PSMA-617 Radioligand Therapy in Metastatic Castration-Resistant Prostate Cancer Harboring SPOP Mutations (ESMO 2026) - No abstract available

Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • SPOP

Evaluation of Single-Timepoint 177 Lu-PSMA-617 Dosimetry Platforms for Tumors and Organs at Risk (ASTRO 2026) - "We evaluated STP kidney, parotid, and tumor doses following 177Lu-PSMA-617 in 4 platforms and found statistically significant differences between platforms in all VOIs, but SDs were small, suggesting limited clinical relevance. Furthermore, inter-patient variability dominated inter-platform variability in all VOIs. Tumor doses showed the greatest variability across patients, underscoring the need for personalized activity administration."

Oncology • Parotid Gland Cancer

Safety and Clinical Outcomes of Combining Radiotherapy with Lutetium-177-PSMA Therapy in Metastatic Castrate-Resistant Prostate Cancer (ASTRO 2026) - "Purpose/Objective(s): Lutetium-177 [177Lu]PSMA-617 (LuPSMA)– improves outcomes in metastatic castration-resistant prostate cancer (mCRPC)... In this single-institution cohort, RT combined with LuPSMA was well tolerated. Early survival outcomes were favorable, though time-to-event analyses were limited by small sample size and event number. These findings support the safety of integrated multimodality treatment and provide clinical reassurance for delivering RT in proximity to LuPSMA."

Clinical • Clinical data • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Impact of Prostate-Specific Membrane Antigen Scans on Treatment Decision-Making in Patients with Metastatic Prostate Cancer in Clinical Practice: A PRostatE Cancer dISease observatION (PRECISION) Database Analysis (ASTRO 2026) - "Purpose/Objective(s): Prostate-specific membrane antigen (PSMA)-targeted imaging contributes to the assessment of disease burden in patients with metastatic prostate cancer (mPC) and can help to guide treatment selection, particularly for [177Lu]Lu-PSMA-617 (177Lu-PSMA-617)... These results demonstrate rapid uptake of PSMA imaging utilization for assessment of patients with mPC, with almost half of patients receiving =1 scan in 2024, the most recent complete year of the study. In the majority of cases, PSMA scans appeared to have a meaningful effect on clinical decision-making, with substantial proportions of patients having a new documented progression and/or starting a new treatment post-scan."

Clinical • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Dosimetric Assessment of ¹77Lu-PSMA-617 and SBRT In Locally Advanced Prostate Cancer: Interim Dosimetry of the STARLiT Trial (ASTRO 2026) - P1/2 | "In the first 10 patients enrolled on STARLiT, ¹77Lu-PSMA-617 delivered substantial additional absorbed dose to the dominant intraprostatic lesion beyond SBRT alone, with strong correlation with baseline PSMA PET SUVmax. Absorbed dose to PSMA-avid lymph nodes demonstrated marked interpatient variability. Enrollment continues and patients will be followed long-term to evaluate oncologic efficacy and safety."

Metastases • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Determinants of Kidney and Tumor Dose In Single-Timepoint 177 Lu-PSMA-617 Dosimetry (ASTRO 2026) - "We examined clinical variables in relation to 177Lu-PSMA-617 dose to kidneys and tumors. Dose variability in tumors was substantial, and larger tumors received higher doses, emphasizing the importance of considering patient tumor geometry in activity administration. All but one patient had extrapolated kidney doses below conventional thresholds, posing an opportunity for dose escalation."

Oncology • Renal Cell Carcinoma

Real-World Outcomes of [177 Lu]Lu-PSMA-617 (177 Lu-PSMA-617) Treatment Extension in Patients with Metastatic Castration-Resistant Prostate Cancer (mCRPC): A PRostatE Cancer dISease observatION (PRECISION) Database Analysis (ASTRO 2026) - "These results demonstrate that some patients are receiving 177Lu-PSMA-617 treatment extension in clinical practice. Treatment extension was associated with clinical benefit in most patients deemed appropriate for it, and the observed AEs were consistent with the known safety profile of 177Lu-PSMA-617. Additional research to identify which patients may benefit from treatment extension is needed."

Clinical • Metastases • Real-world • Real-world evidence • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

The Utilization of Dosimetry with Lu-177-PSMA-617 Radiopharmaceutical Treatments: Does Dosimetry Affect Treatment Change? (ASTRO 2026) - "Dosimetry for Lu-177-PSMA-617 is feasible in routine clinical practice and associated with an increased rate of treatment changes and a higher utilization of EBRT. Future directions include prospective validation of response-based EBRT for suboptimal response to Lu-177-PSMA-617. Table 1."

Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Hematological Malignancies • Oncology • Prostate Cancer • Solid Tumor

Palliative EBRT among Patients Receiving Lu-PSMA-617 for Polymetastatic Prostate Cancer: Local Control and Survival Outcomes (ASTRO 2026) - "Among patients receiving Lu-PSMA-617 for advanced polymetastatic prostate cancer, palliative EBRT achieved durable local control using predominantly conventional fractionation, with low rates of toxicity. Even in the setting of extensive disease (>10 metastases in the majority), symptom-directed EBRT remained effective and feasible, supporting its continued integration alongside PSMA-targeted radioligand therapy."

Clinical • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Metabolic Profiling as a Predictor of Hematopoietic Adverse Events in Patients Receiving ¹77Lu-PSMA-617 Radioligand Therapy (ASTRO 2026) - "This is a novel exploration of metabolic factors in ¹77Lu-PSMA-617 therapy, demonstrating that obesity and diabetes were not significantly associated with differential toxicity, while normal-weight patients were more susceptible to greater platelet declines. These findings suggest BMI could inform risk-stratified hematologic monitoring and personalized management in ¹77Lu-PSMA-617 therapy. Larger, multicenter prospective studies evaluating metabolic states as modifiers of toxicity are warranted to validate this association and refine patient selection and toxicity mitigation strategies."

Adverse events • Clinical • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Circulating Biomarkers Predictive of Response to Lu-PSMA-617 in Metastatic Castrate Resistant Prostate Cancer Patients (ASTRO 2026) - "High-plexity proteomic profiling of patients with mCRPC receiving Lu-PSMA-617 demonstrates treatment-associated immune changes and baseline pathway differences between excellent responders and non-responders. These preliminary findings require validation in larger cohorts. The results also support investigation of combination strategies incorporating radiopharmaceutical therapy and immune checkpoint inhibition."

Biomarker • Clinical • IO biomarker • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor • ACPP • FLT3 • KLK3 • PSAP • ST14

Causes and Consequences of Lutetium-177-PSMA-617 Treatment Interruptions (ASTRO 2026) - "Treatment interruptions during Lu-PSMA-617 therapy are common, often lead to premature discontinuation, and result in significant dose waste. Cytopenias were the predominant cause of treatment interruption, and most patients who had a dose cancelled did not resume therapy. The associated financial burden of treatment interruption is substantial."

Oncology

Comprehensive plasma epigenomic profiling derived lineage states in mCRPC associate with 177Lu-PSMA-617 response and resistance (ESMO 2026) - No abstract available

Castration-Resistant Prostate Cancer • Oncology • Prostate Cancer

Baseline PSMA PET-Derived SUVmean as a Prognostic Factor for Lesion-Level Metabolic Response to [177Lu]Lu-PSMA-617 In Metastatic Castration-Resistant Prostate Cancer (ASTRO 2026) - "AI-derived lesion-level PSMA PET/CT analysis in mCRPC treated with Lu-RPT reveals a strong association between baseline SUVmean and lesion-level outcomes. Higher SUVmean was associated with increased odds of PR and SD relative to PD, whereas larger baseline lesion volume was inversely associated with CR vs PD. These findings support quantitative lesion-level PSMA PET as a potential tool for risk- or response-adaptive RPT strategies."

Biomarker • Metastases • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

A randomized phase 3 trial evaluating 177Lu-PSMA-617 in addition to standard of care in de novo metastatic hormone-sensitive prostate cancer patients with poor PSA response (ESMO 2026) - No abstract available

Clinical • Metastases • P3 data • Genito-urinary Cancer • Hormone Sensitive Prostate Cancer • Oncology • Prostate Cancer • Solid Tumor

Real-World 177Lu-PSMA-617 Exposure and Survival in mCRPC: A Time-Varying Cox Analysis (ESMO 2026) - No abstract available

Clinical • Real-world • Real-world evidence • Castration-Resistant Prostate Cancer • Oncology • Prostate Cancer

PSMA-REACH: Real-world effectiveness and safety of [177Lu]Lu-PSMA-617 in patients with mCRPC (ESMO 2026) - No abstract available

Clinical • Real-world • Real-world effectiveness • Real-world evidence • Castration-Resistant Prostate Cancer • Oncology • Prostate Cancer

Baseline and dynamic changes in circulating tumor (ct) DNA as correlates of intrinsic and acquired resistance to 177Lu-PSMA-617 (LuPSMA) in metastatic castration-resistant prostate cancer (mCRPC) (ESMO 2026) - No abstract available

Metastases • Preclinical • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor

Interim Safety Analysis of the Prospective Phase II Trial of [177Lu]Lu-PSMA-617 Retreatment in Metastatic Castration-Resistant Prostate Cancer (Re-LuPSMA; NCT06288113) (ESMO 2026) - P2 | No abstract available

Clinical • Metastases • P2 data • Castration-Resistant Prostate Cancer • Genito-urinary Cancer • Oncology • Prostate Cancer • Solid Tumor