Evidence map›Paper›PMID 41872814›Full record

SynthesisBMC cancer2026

Beyond [

Ahmed Saad Abdlkadir, Dhuha Al-Adhami, Serin Moghrabi, Mike Machaba Sathekge, Michael Kreissl, Enrique Estrada-Lobato, Hongcheng Shi, Akram Al-Ibraheem

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Efficacy and safety of [Frontiers in medicine · 2026
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ahmed Saad AbdlkadirDepartment of Nuclear Medicine, Baghdad Radiotherapy and Nuclear Medicine Hospital, Bab Al-Muadham, Baghdad, 10047, Iraq. ahmedshukri92@hotmail.com.
Dhuha Al-AdhamiDepartment of Nuclear Medicine, Baghdad Radiotherapy and Nuclear Medicine Hospital, Bab Al-Muadham, Baghdad, 10047, Iraq.
Serin MoghrabiDepartment of Nuclear Medicine, King Hussein Cancer Center (KHCC), Queen Rania Street, Al Jubeiha, Amman, 11941, Jordan.
Mike Machaba SathekgeDepartment of Nuclear Medicine, University of Pretoria and Steve Biko Academic Hospital, Pretoria, 0001, South Africa.
Michael KreisslDepartment of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, 39120, Germany.
Enrique Estrada-LobatoDepartment of Nuclear Sciences and Applications, Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, International Atomic Energy Agency, Vienna, Austria.
Hongcheng ShiDepartment of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
Akram Al-IbraheemDepartment of Nuclear Medicine, King Hussein Cancer Center (KHCC), Queen Rania Street, Al Jubeiha, Amman, 11941, Jordan. akramalibrahim@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThis systematic review and meta-analysis evaluates the safety and efficacy of emerging prostate-specific membrane antigen (PSMA) radioligand therapy (RLT) agents used beyond [¹⁷⁷Lu]Lu-PSMA in metastatic castration-resistant prostate cancer (mCRPC).

methodsSystematic searches of PubMed, Web of Science, and Scopus were performed from inception until November 3, 2025. Studies reporting objective response rate (ORR), disease control rate (DCR), and/or toxicity outcomes were included. Meta-analytic pooling, assessment of publication bias, heterogeneity analyses, and subgroup evaluations were conducted using Stata software.

resultsA total of 33 studies published between 2017 and 2025 met inclusion criteria, encompassing 3625 therapy cycles administered to 1525 patients. The pooled DCR was 86% (95% CI: 82–90%), and the pooled ORR was 57% (95% CI: 50–63%). [²²⁵Ac]Ac-PSMA monotherapy, evaluated in 17 studies, achieved pooled DCR and ORR values of 88% and 62%. Eight studies assessing [¹⁷⁷Lu]Lu/[²²⁵Ac]Ac-PSMA tandem therapy reported pooled DCR and ORR values of 84% and 51%. Five studies on [¹⁶¹Tb]Tb-PSMA demonstrated pooled DCR and ORR values of 81% and 46%. [¹³¹I]PSMA therapy, reported in three studies, resulted in a pooled DCR of 75% and pooled ORR of 48%. Adverse events were documented in 32 studies, with a pooled incidence of 26%. Most events were low-grade and reversible. Xerostomia and anemia were the most frequently reported toxicities, with xerostomia particularly associated with [²²⁵Ac]Ac-PSMA–containing regimens.

conclusionThese findings underscore the promising therapeutic potential of emerging PSMA RLT agents beyond [¹⁷⁷Lu]Lu-PSMA, with favorable biochemical responses and manageable safety profiles. Future large-scale prospective studies are essential to define optimal therapeutic roles and expand treatment opportunities for patients with mCRPC.

Indexed as

Antigens, SurfaceGlutamate Carboxypeptidase IILutetiumProstatic Neoplasms, Castration-ResistantRadioisotopesRadiopharmaceuticalsHumansMaleTreatment OutcomeAntigens, SurfaceFOLH1 protein, humanGlutamate Carboxypeptidase IILutetiumLutetium-177RadioisotopesRadiopharmaceuticals[¹³¹I]PSMA[¹⁶¹Tb]Tb-PSMA[²²⁵Ac]Ac-PSMAProstate cancerPSMA RLTTandem therapy

Identifiers

PMID41872814
PMCPMC13134245

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.