How do you approach Lu-177 use in taxane-naive patients with metastatic prostate cancer?

At this time in October 2024, Lu177-PSMA-617 is not yet approved in taxane-naive mCRPC, and decisions on its use and availability hinge both on USFDA approval in the coming months as well as NCCN guidance, which has not been updated at this time. Until then, decisions to pursue this radioligand ther...

As of 3/28/2025, the FDA has approved Pluvicto for castrate-resistant metastatic patients who are taxane naïve. So, approval in this population should cease to be an issue.

As for appropriateness, the usual considerations apply. Should be PSMA PET scan positive, ideally with average SUV levels > 10 ...