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PEER-TO-PEER CLINICAL CONVERSATIONS |
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Discussion on Patient Selection for Radioligand Therapy in Prostate Cancer
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Daniel Petrylak, MD, and A. Oliver Sartor, MD
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| Neeraj Agarwal speaks with Oliver Sartor and Daniel Petrylak about patient selection strategies for radioligand therapy. With multiple treatment options now available for metastatic castration-resistant prostate cancer, the experts emphasize that patient selection has become both an art and science.
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Integrating PSMA PET Imaging: From Interpretation to Systemic Therapy Selection in Castration-Resistant Prostate Cancer
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A. Oliver Sartor, MD
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| Phillip Koo speaks with Oliver Sartor about integrating PSMA PET imaging in hormone-resistant pre-chemotherapy settings. Dr. Sartor advocates for obtaining PSMA PET scans relatively early when PSA rises after androgen deprivation therapy to identify oligometastatic disease.
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Phase II LUNAR Trial Results: Adding Lutetium PSMA to SBRT for Oligorecurrent Prostate Cancer
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Amar Kishan, MD
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| Amar Kishan presents results from the Phase II LUNAR trial, which investigates combining radioligand therapy with stereotactic radiation for oligorecurrent prostate cancer.
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| Associations Between Quantitative Baseline 68Ga-PSMA-11 PET Parameters and 177Lu-PSMA-617 Efficacy in the PSMAfore Study
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| Ken Herrmann, MD
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| Baseline quantitative PSMA PET metrics in PSMAfore reinforce that how “PSMA‑avid” and how bulky a patient’s disease is matters for outcomes with 177Lu‑PSMA‑617. Higher whole‑body SUVmean was associated with better rPFS and OS, whereas greater PSMA‑positive tumor volume was consistently linked to worse prognosis regardless of treatment, supporting SUVmean as a predictive marker and tumor volume as a prognostic marker in PSMA‑targeted radioligand therapy.
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| Imaging Meets Genomics in Treatment-Naïve Prostate Cancer: SUVmax on PSMA PET as a Biomarker of Genomic Classifier Risk
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| Sophia Coraci
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| SUVmax on PSMA PET shows a modest but meaningful association with genomic risk in treatment‑naïve prostate cancer. In this retrospective cohort (n=104), higher intraprostatic SUVmax correlated with higher Decipher genomic classifier scores, and an SUVmax ≥15 best identified men with high Decipher risk, suggesting SUVmax may serve as a complementary, non‑invasive imaging biomarker to support integrated risk stratification alongside genomic testing.
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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
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| PSMA-targeted therapies, led by 177Lu‑PSMA‑617, are rapidly expanding beyond single-agent use toward more strategic sequencing and rational combinations aimed at deepening and prolonging responses in prostate cancer. Emerging data highlight the importance of timing, pairing PSMA agents with therapies that modulate PSMA expression or DNA repair and immune pathways, and extending these strategies into earlier disease states, all while balancing toxicity, cost, and the need for robust biomarkers and standardized PSMA-PET–guided selection.
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| Long-Term Adverse Events in PSMA Targeted Radionuclide Therapy for Castration-Resistant Prostate Cancer
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| Aaron Holmes, MD
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| Long-term follow-up across 11 prospective trials suggests PSMA-targeted radionuclide therapy remains generally well tolerated, with only 6% of patients experiencing grade 3–4 adverse events deemed treatment-related and subsequent primary malignancies uncommon. Most late hematologic, renal, liver, or marrow toxicities appeared multifactorial rather than directly attributable to PSMA-TRT, underscoring the need for ongoing surveillance but supporting PSMA-TRT as a durable, safe option in CRPC.
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