ReviewAnnals of nuclear medicine2026
PSMA-targeted radioligand therapy in prostate cancer: evidence hierarchy, platform maturity of ¹⁷⁷Lu-PSMA-617, and the clinical differentiation challenge for emerging radionuclides.
Review in Annals of nuclear medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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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.
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Authors and funding
1 author.
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Abstract
Among prostate-specific membrane antigen (PSMA)-directed radioligand therapies (RLT), ¹⁷⁷Lu-PSMA-617 is supported by two peer-reviewed phase III randomised controlled trials in metastatic castration-resistant prostate cancer (VISION and PSMAfore) and one in metastatic hormone-sensitive prostate cancer (PSMAddition). This structured narrative review uses eight predefined PubMed evidence sets, yielding 931 unique records after deduplication, to describe the study-design distribution and evidence-maturity profile of established and emerging PSMA-RLT strategies, including ¹⁷⁷Lu-PSMA-617, other Lu-177 PSMA agents, ²²⁵Ac, ¹⁶¹Tb, ²¹²Pb, ²¹¹At, and ⁹⁰Y. The review addresses five evidence questions: the differential patient-selection criteria between TheraP and VISION; rPFS-to-OS interpretation in PSMAfore; the sequencing implications of earlier hormone-sensitive RLT use; xerostomia and daughter-nuclide redistribution as unresolved development barriers for ²²⁵Ac-PSMA; and whether the microdosimetric rationale for ¹⁶¹Tb-PSMA is supported by clinical comparative data. The current evidence base identifies ¹⁷⁷Lu-PSMA-617 as the most mature PSMA-RLT platform, while emerging radionuclides remain dependent on prospective clinical differentiation.
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Registered trials
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.