In a patient undergoing neoadjuvant 177Lu-PNT2002 + MDT for oligorecurrent prostate cancer as per the LUNAR trial, what are the implications for other escalated systemic therapies with ARPIs/chemotherapy, which may otherwise be used concurrent with ADT in this population?

This question is part of our collaboration with ASTRO 2025 to highlight impactful trial data from this year's meeting. This question is inspired by the Clinical Trials Session Presentation "177 Lutetium-PSMA Neoadjuvant to Ablative Radiotherapy for Oligorecurrent Prostate Cancer; Primary Endpoint Analysis of the Phase II LUNAR Randomized Trial" by Dr. Amar Kishan.

Answer from: Radiation Oncologist at Academic Institution

The LUNAR approach was designed for men who did not want to have hormone therapy. It is true that hormone therapy, either via ADT, ARPI, or both, could be added to MDT as well. The RADIOSA trial did show that PFS was improved with 6 months of ADT added to MDT. However, in RADIOSA, the eugonadal...

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In a patient undergoing neoadjuvant 177Lu-PNT2002 + MDT for oligorecurrent prostate cancer as per the LUNAR trial, what are the implications for other escalated systemic therapies with ARPIs/chemotherapy, which may otherwise be used concurrent with ADT in this population?

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