Radionuclide Combination Strategies in Prostate Cancer: Insights from the AlphaBet Trial
- Author(s)
- Kostos, L; Buteau, JP; Azad, AA; Hofman, MS;
- Journal Title
- European Urology Focus
- Publication Type
- Online publication before print
- Abstract
- The integration of [(177)Lu]Lu-prostate-specific membrane antigen (PSMA) therapy into the treatment paradigm for advanced prostate cancer has improved survival and quality of life; however, resistance and disease progression remain inevitable. Radionuclide combination strategies, particularly α-/β-emitter pairings, aim to overcome biological and dosimetric limitations of [(177)Lu]Lu-PSMA monotherapy. The AlphaBet trial demonstrated the feasibility and safety of combining the bone-seeking α-emitter radium-223 with [(177)Lu]Lu-PSMA in metastatic castration-resistant prostate cancer, underpinned by complementary spatial targeting and radiophysical properties. Ongoing studies are evaluating other novel combinations to overcome resistance, earlier integration to define optimal sequencing, and biomarker-driven approaches to refine patient selection. For patients, these strategies may enable more effective and durable treatments by combining different types of targeted radiation or systemic therapies; however, further studies are needed to confirm long-term benefits and safety.
- Keywords
- Lutetium-177; Metastatic castration-resistant prostate cancer; Psma; Radioligand therapy; Radionuclide combinations
- Department(s)
- Medical Oncology; Cancer Imaging
- Publisher's Version
- https://doi.org/10.1016/j.euf.2026.05.017
- Terms of Use/Rights Notice
- Refer to copyright notice on published article.
Creation Date: 2026-06-04 11:59:37
Last Modified: 2026-06-04 12:00:13