Success and Limitations of PSMA RLT : The Nuclear Medicine View
- Author(s)
- Hofman, MS;
- Journal Title
- European Urology Focus
- Publication Type
- Online publication before print
- Abstract
- Lutetium-177 PSMA radioligand therapy (RLT) represents a paradigm shift in advanced prostate cancer care, establishing a precision oncology standard through its inherent theranostic capability. From a nuclear medicine perspective, its defining success lies in the ability to precisely select patients and offer targeted cytotoxic delivery of radiation, resulting in high objective response rates and quality-of-life improvements, particularly rapid pain palliation. A collaborative view with medical oncology highlights critical limitations. Despite frequent favourable initial responses, disease recurrence is almost universally inevitable, demonstrating a modest survival benefit in randomised trials and possibly limited control over micrometastatic or heterogeneous disease. The future requires bridging this gap through interdisciplinary research: leveraging molecular imaging for adaptive treatment strategies, evaluating earlier-line use, and developing synergistic combinations and next-generation isotopes, including Auger/conversion electron and alpha emitters, to maximise clinical benefit and achieve durable responses.
- Department(s)
- Cancer Imaging
- Publisher's Version
- https://doi.org/10.1016/j.euf.2026.05.016
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-06-04 11:59:36
Last Modified: 2026-06-04 12:00:13