Does the possibility of future Lu-177–PSMA therapy change your current threshold to offer earlier metastasis-directed RT in oligometastatic prostate cancer?
Would the extent of marrow exposure at the treatment site affect your decision-making?
This question is part of our collaboration with ASTRO to highlight impactful data from the 2026 Multidisciplinary Radiopharmaceutical Symposium. This question is inspired by the Plenary Session Presentation "Clinical Outcomes among Patients Treated with Lu-PSMA-617 and EBRT for Oligometastatic Prostate Cancer" by Dr. Mai Anh Huynh
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How does potential for future Lu-177–PSMA use impact your current threshold to offer ablative metastasis-directed RT in PSMA+ oligometastatic prostate cancer?
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2 Answers
Mednet MemberInvited Expert
Radiation Oncology · AdventHealth Cancer Institute
Answered on
There is a lot of excellent research being done on the efficacy and tolerance of combined Lu-177-PSMA therapy and EBRT. So far, the combination is well tolerated, and there is some data that sequencing the two to allow EBRT to treat the more “Pluvicto-resistant” lesions may help with efficacy.
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Mednet MemberInvited Expert
Radiation Oncology · Abramson Cancer Center, University of Pennsylvania
Answered on
In general, no. MDT can be delivered in highly conformal methods, and the majority of patients have significant EBRT exposure prior to starting PSMA therapy. We choose to use MDT as clinically appropriate, but not necessarily shy away from it due to potential receipt of PSMA therapy in the future. C...
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