Evidence map›Paper›PMID 42529062›Full record

ReviewOncology reviews2026

PSMA-targeted radioligand therapy in advanced prostate cancer: a narrative review of ^177Lu-PSMA, emerging ^225Ac-PSMA strategies, and therapeutic sequencing.

Natalia Gierulska, Nina Jankowska, Adrianna Kwiatkowska, Piotr Kuchno, Kinga Łysak, Katarzyna Szklener, Kamil Kośmider, Magdalena Skórzewska

Abstract readReview
In one paragraph

Review in Oncology reviews, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Natalia GierulskaDepartment of Clinical Oncology and Chemotherapy, Student Scientific Society, Medical University of Lublin, Lublin, Poland.
Nina JankowskaDepartment of Clinical Oncology and Chemotherapy, Student Scientific Society, Medical University of Lublin, Lublin, Poland.
Adrianna KwiatkowskaDepartment of Clinical Oncology and Chemotherapy, Student Scientific Society, Medical University of Lublin, Lublin, Poland.
Piotr KuchnoDepartment of Clinical Oncology and Chemotherapy, Student Scientific Society, Medical University of Lublin, Lublin, Poland.
Kinga ŁysakCopernicus Hospital, Gdańsk, Poland.
Katarzyna SzklenerDepartment of Clinical Oncology and Chemotherapy, Medical University of Lublin, Lublin, Poland.
Kamil KośmiderDepartment of Clinical Oncology and Chemotherapy, Medical University of Lublin, Lublin, Poland.
Magdalena SkórzewskaDepartment of Clinical Oncology and Chemotherapy, Medical University of Lublin, Lublin, Poland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Prostate cancer remains a leading cause of cancer-related morbidity and mortality among men, and metastatic castration-resistant prostate cancer continues to present substantial therapeutic challenges despite advances in androgen receptor pathway inhibitors, taxane chemotherapy, PARP inhibitors, and immunotherapy for selected molecular subgroups. Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy has emerged as a clinically important theranostic strategy that combines molecular imaging-based patient selection with targeted delivery of cytotoxic radiation to PSMA-expressing tumor sites. This narrative review summarizes the biological rationale, clinical evidence, safety profile, and evolving treatment-sequencing considerations for PSMA-targeted radioligand therapy in advanced prostate cancer. Particular emphasis is placed on ^177Lu-PSMA-617, which has demonstrated improved radiographic progression-free survival and overall survival in pivotal randomized trials, including VISION, TheraP, and PSMAfore. The review also examines investigational alpha-emitting PSMA-targeted therapies, particularly ^225Ac-PSMA compounds, which offer high-linear-energy-transfer cytotoxicity and may have activity in selected patients after progression on beta-emitting radioligand therapy, although definitive phase III evidence remains lacking. The established bone-targeted alpha-emitter ^223Ra is discussed separately as contextual therapy for selected patients with symptomatic bone-predominant mCRPC without visceral metastases. As clinical use of radioligand therapy expands, optimization of PSMA PET-based patient selection, management of salivary, hematologic, and renal toxicities, sequencing with other systemic therapies, and integration into multidisciplinary care pathways will be essential. Future research should prioritize randomized clinical trials, individualized dosimetry, predictive biomarkers, toxicity mitigation, and patient-centered implementation strategies.

Indexed as

actinium-225bone metastasescancerlutetium-177nuclear medicineprostate cancerradioisotopesradionuclides

Identifiers

PMID42529062
PMCPMC13416105

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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.