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In mCRPC patients who had an initial response to Pluvicto but progress within 12 months, where do you position PSMA radioligand retreatment relative to other next-line systemic options in your sequencing strategy?

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 "Radiopharmaceutical Retreatment" by Dr. Andrew L. Salner
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In fit mCRPC patients who had an initial deep response to Pluvicto but progress at 12 months, how do you approach next line treatment?

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2 Answers
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Mednet Member
Radiation Oncology · Johns Hopkins University School of Medicine
Answered on

After Lu-PSMA therapy, we may consider taxane chemotherapy, Ra-223, ARPI, or clinical trials in addition to Lu-PSMA retreatment. Retreatment may be more heavily considered in patients with prior deep response to Lu-PSMA, high avidity on a repeat PSMA PET, and/or limited candidacy for other treatment...

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Mednet Member
Mednet Member
Radiation Oncology · BAMF Health
Answered on

For such a clinical situation, consideration of retreatment with PSMA radioligand therapy is evolving. There are currently phase II trials at UCLA Health (RE-LuPSMA) and in France (ReaLuP) for patients with a previous favorable response to Lu-PSMA that will assist in building the experience with suc...

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