PSMA Radioligand Before SBRT Doubles Progression-Free Survival in Oligometastatic Prostate Cancer

Overview

• Adding 177Lu-PNT2002 before SBRT extended median progression-free survival to 17.6 months from 7.4 months, cutting the combined risk of progression, ADT start, or death by 63%.
• The combination postponed initiation of androgen deprivation therapy to a median of 24.3 months versus 14.1 months with SBRT alone.
• Researchers randomized 92 hormone-sensitive men with one to five PSMA-PET–visible lesions to SBRT alone or two cycles of 177Lu-PNT2002 followed by SBRT, with roughly 22 months of follow-up and results presented at ASTRO 2025.
• Severe toxicities did not increase with the radioligand; the only grade 3 events were low white blood cell counts in a small number of patients.
• Most progression events (98%) were new metastases outside treated sites, and investigators said the drug remains experimental in this setting, with the study funded by Lantheus.