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SNMMI Weighs in on Use of Radionuclide Therapy for Metastatic Prostate Cancer

By: Jenna Carter, PhD
Posted: Monday, October 2, 2023

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) recently published a statement in The Journal of Nuclear Medicine offering expert consensus on the selection and management of patients with metastatic castration-resistant prostate cancer being treated with lutetium-177–labeled prostate-specific membrane antigen (LuPSMA). This radionuclide therapy has been shown clinical benefits in this patient population, although there is limited standardized guidance on how these compounds should be used in the clinical setting. Thomas A. Hope, MD, of the University of California San Francisco, and colleagues also reported on treatment-related toxicities, when to consider cessation of treatment, and the appropriate use of imaging during treatment.

An autonomous work group of health-care providers with substantive knowledge in the use of LuPSMA therapy was selected to help formulate this consensus statement. The work group consulted and used data from the four prospective phase II and III trials that used this radionuclide therapy to formulate its report.

Based on their findings in the literature, the authors reported that PSMA PET imaging should be performed within 3 months of treatment or since disease progression on the last therapy. They also stated that if disease progression or intervening therapy is evident, PSMA PET should be repeated. Additionally, patients should be imaged with either contrast-enhanced CT or MRI to identify potential PSMA-negative disease. Authors also noted the baseline requirements for renal and bone marrow functions and suggested that treatment after chemotherapy and androgen receptor pathway inhibitors was appropriate. In closing, they suggested further testing was necessary to fully flush out the clinical use of PSMA radioligand therapy in patients with metastatic castration-resistant prostate cancer.

Disclosure: For full disclosures of the study authors, visit

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