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?

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 PFS ...