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PEER-TO-PEER CLINICAL CONVERSATIONS
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Real-World Data Explores Post-177Lu-PSMA-617 Therapies in Advanced Prostate Cancer
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Xiao Wei, MD, MAS
Xiao Wei discusses real-world evidence from the Precision database evaluating treatment patterns and outcomes following lutetium-177 PSMA therapy in approximately 2,000 patients with advanced prostate cancer treated between March 2022 and June 2025.
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Lutetium-177 PSMA-617 Therapy Across the Prostate Cancer Spectrum: Mechanism and Clinical Considerations
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Phillip Koo, MD
Phillip Koo explains the mechanistic components of radioligand therapy, describing how the isotope, chelator, and targeting agent each independently influence biodistribution and efficacy.
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Adaptive Dosing of Lutetium PSMA Based on Imaging and PSA Response
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Louise Emmett, MD, MBChB, FRACP, FAANMS
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| Louise Emmett discusses how imaging and PSA response may inform ongoing research into lutetium-177 PSMA therapy optimization, including data from ENZA-p evaluating PSMA expression changes after enzalutamide and the potential role of adaptive treatment strategies.
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| Predicting Early PSA Response to 177Lu-PSMA Therapy Using Baseline PET Imaging Biomarkers and Cycle 1 Dosimetry
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| Molly Roseland, MD
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| Molly Roseland’s SNMMI 2026 presentation found that higher baseline PSMA PET SUVmean and greater cycle 1 whole-body tumor absorbed dose were associated with better early PSA responses to 177Lu-PSMA therapy. The study suggests that baseline PET imaging and early dosimetry may help inform future predictive models, although larger datasets are still needed to refine these approaches.
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| Emerging Evidence for Sequencing and Combining PSMA-Based Therapies in Prostate Cancer - Beyond the Abstract
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| Sola Adeleke, PhD, MBBS, MRCP(UK)
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| PSMA-based therapies are being studied beyond single-agent use, with growing interest in sequencing and combination strategies across advanced prostate cancer. This Beyond the Abstract article highlights the need for stronger biomarkers, standardized PSMA-PET measures, and multidisciplinary trial design to better understand which patients may benefit from radioligand therapy and how these approaches may be integrated in future care.
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| Baseline PSMA PET Tumor Volume Predicts Overall Survival with 177Lu-PSMA-I&T in Individual mCRPC patients: A Single-Center Real-World Study
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| Kwan Kit Wu, MBChB (CUHK), FHKCR, FHKAM
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| Kwan Kit Wu’s single-center real-world study found that baseline PSMA PET tumor volume was an independent predictor of overall survival in mCRPC patients treated with 177Lu-PSMA-I&T. Patients with lower tumor volume had better 2- and 3-year survival, supporting the potential role of PSMA PET-derived tumor burden measures in future patient-selection and treatment-planning strategies.
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| Subgroup Analyses by Disease Volume and De Novo/recurrent mHSPC in the PSMAddition Study of 177Lu-PSMA-617
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| Fred Saad, CQ, MD, FRCS, FCAHS
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| Fred Saad reported subgroup findings from the PSMAddition study evaluating [¹⁷⁷Lu]Lu-PSMA-617 plus ADT + ARPI in PSMA-positive mHSPC. Results showed radiographic progression-free survival benefit across disease-volume and metastatic-presentation subgroups, with patient-reported outcomes and safety generally consistent across subgroups. These findings contribute to the evolving evidence base for PSMA-targeted therapy in earlier prostate cancer settings.
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| How to Better Personalize Treatment with 177Lu-PSMA-617
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| Louise Emmett, MD, MBChB, FRACP, FAANMS
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| Louise Emmett discussed approaches to personalizing 177Lu-PSMA-617 therapy, including ctDNA, PSMA tumor volume, and early imaging response. She also reviewed emerging data on radioligand therapy combinations, adaptive dosing, and repeat imaging as potential tools to help optimize benefit and avoid ineffective treatment.
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