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ReviewUrologic oncology · 2026

Lutetium-177-PSMA radioligand therapy in metastatic hormone-sensitive prostate cancer: A systematic review of efficacy, safety, and combination strategies.

Joseph McGrath, Robert Willis, Sudharshanan Balaji … K C Balaji

UrologyReview

Combination ¹⁷⁷Lu-PSMA-RLT regimens show a median progression-free survival of 31 months.

Lutetium-177-PSMA radioligand therapy in metastatic hormone-sensitive prostate cancer: A systematic review of efficacy, safety, and combination strategies.

Joseph McGrath et al. · Urologic oncology · 2026

Background

Lutetium-177-labeled prostate-specific membrane antigen radioligand therapy (¹⁷⁷Lu-PSMA-RLT) emerged as a novel treatment for metastatic castration-resistant prostate cancer (mCRPC) following FDA approval in 2022.

Methods

This systematic review synthesizes evidence on the efficacy, safety, and combinatorial strategies involving ¹⁷⁷Lu-PSMA-RLT in mHSPC.

31.0

Results

months

Combination therapy meant a longer time before the cancer got worse

More results

Its role in metastatic hormone-sensitive prostate cancer (mHSPC) is under active investigation.

PubMed, Embase, ClinicalTrials.gov, and WHO ICTRP were searched for studies (2010-2025) evaluating ¹⁷⁷Lu-PSMA in mHSPC.

PSA50 rates ranged from 44% to 100%, with the highest responses in treatment-naïve de novo populations.

More results

Randomized trials (LUNAR, UpFrontPSMA, CONSOLIDATE, and interim PSMAddition) demonstrated improved PSA/PFS responses compared with their respective control arms.

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Conclusion

Current studies face limitations of small sample sizes, heterogeneous protocols, and short follow-up durations.

Post

Lutetium-177-PSMA radioligand therapy in metastatic hormone-sensitive prostate cancer: A systematic review of efficacy, safety, and combination strategies.

Combination ¹⁷⁷Lu-PSMA-RLT regimens show a median progression-free survival of 31 months.

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