Does the possibility of future Lu-177–PSMA therapy change your current threshold to offer earlier metastasis-directed RT in oligometastatic prostate cancer?

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.

The qu...

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...