Please select the option that best describes you:
Topics:
Radiation Oncology • Genitourinary Cancers • Prostate Cancer • Medical Oncology • Nuclear Medicine • ASTRO 2026
For patients starting Pluvicto, do you have patients stop their ARPI?
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 "Safety and Efficacy of Lu-177 PSMA-617 Versus Established Therapies in mCRPC: Pooled Evidence from Randomized Phase II/III Trials" by Dr. Mohammad Arfat Ganiyani
Answer from: Radiation Oncologist at Academic Institution
From the PSMAfore trial, ARPI was not allowed concurrently with Pluvicto. Notably, these were patients with prior exposure to at least one ARPI (inclusion was "eligible for a change in ARPI")Permitted and prohibited concomitant treatments:Androgen deprivation therapy was continued, and concomitant s...
Answer from: Radiation Oncologist at Academic Institution
In patients who start Pluvicto after multifocal progression on an ARPI, I favor discontinuing the ARPI. Concomitant ARPIs can add significant toxicity and, in these situations, may not offer additional clinical benefit. Retrospective data from Mayo showed that after adjusting for baseline clinical d...
Is it possible that continuing an ARPI could inter...
I agree with you, but one could ask the same quest...
@Stephen C. King, ARPI can upregulate PSMA express...