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Radioligand Tx for mCRPC

CE / CME

Advances in Metastatic Castration-Resistant Prostate Cancer: Focus on Radioligand Therapies

ABIM MOC: maximum of 0.75 Medical Knowledge MOC point

Physicians: Maximum of 0.75 AMA PRA Category 1 Credit

Released: September 16, 2025

Expiration: March 15, 2026

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Course Completed

References

  1. Seifert R, Emmett L, Rowe RP, et al. Second version of the Prostate Cancer Molecular Imaging Standardized Evaluation Framework Including Response Evaluation for Clinical Trials (PROMISE V2). Eur Urol. 2023;83:405-412.
  2. Sartor O, de Bono J, Chi KN, et al, Lutetium-177-PSMA-617 for metastatic castration-resistant prostate cancer. N Engl J Med. 2021;385:1091-1103.
  3. Lutetium-177-PSMA-617 [prescribing information]. Millburn, NJ: Advanced Accelerator Applications USA, Inc; 2025.
  4. American Cancer Society. Survival rates for prostate cancer. cancer.org/cancer/types/prostate-cancer/detection-diagnosis-staging/survival-rates.html. Accessed September 10, 2025.
  5. Saad F, Bögemann M, and Suzuki K, et al. Treatment of nonmetastatic castration-resistant prostate cancer: focus on second-generation androgen receptor inhibitors. Prostate Cancer Prostatic Dis. 2021;24:323-334.
  6. Devlies W, Eckstein M, Cimadamore A, et al. Clinical actionability of the genomic landscape of metastatic castration resistant prostate cancer. Cells. 2020;9:2494.
  7. National Comprehensive Cancer Network. Clinical practice guidelines in oncology: prostate cancer. v.1.2026. nccn.org. Accessed September 10, 2025.
  8. Pembrolizumab [prescribing information]. Rahway, NJ: Merck & Co., Inc.:2025.
  9. Marshall CH. Acting on actionable mutations in metastatic prostate cancer. J Clin Oncol. 2023;41:3295-3299.
  10. Mosillo C, Calandrella ML, Caserta C, et al. Targeted approaches in metastatic castration-resistant prostate cancer: Which data? Cancers (Basel). 2022;14:4189.
  11. Sipuleucel-T [prescribing information]. Seal Beach, CA: Dendreon Pharmaceuticals LLC; 2017.
  12. Kantoff PW, Higano CS, Shore ND, et al. Sipuleucel-T immunotherapy for castration-resistant prostate cancer. N Engl J Med. 2010;363:411-22.
  13. Radium-223 [prescribing information]. Whippany, NJ: Bayer Healthcare Pharmaceuticals. Inc; 2019.
  14. Halabi S, Kevin WK, Ma H, et al. Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration resistant prostate cancer. J Clin Oncol. 2016;34:1652.
  15. Boixareu C, Taha T, Venkadakrisnan VB, et al. Targeting the tumor cell surface in advanced prostate cancer. Nat Rev Urol. 2025; 22:569-589.
  16. Theranostictrials.org. theranostictrials.org/. Accessed September 10, 2025.
  17. Gupta N, Devgan A, Bansal I, et al. Usefulness of radium-223 in patients with bone metastases. Proc (Bayl Univ Med Cent). 2017;30:424-426
  18. Morris MJ, de Bone JS, Chi KM, et al. Phase III study of Lutetium-177-PSMA-617 in patients with metastatic castration-resistant prostate cancer (VISION). Presented at: 2021 American Society of Clinical Oncology Annual Meeting; June 4-8, 2021. Abstr LBA4.
  19. Gallium Ga 68 gozetotide [prescribing information]. East Hanover, NJ; Novartis; 2025.
  20. Freedland SJ, Humphreys EB, Mangold LA, et al. Risk of prostate cancer-specific mortality following biochemical recurrence after radical prostatectomy. JAMA. 2005;294:433-439.
  21. Kupelian PA, Buchsbaum JC, Elshaikh M, et al. Factors affecting recurrence rates after prostatectomy or radiotherapy in localized prostate carcinoma patients with biopsy Gleason score 8 or above. Cancer. 2002;95:2302-2307.
  22. Kuo PH, Benson T, Messmann R, Groaning M. Why we did what we did: PSMA PET/CT selection criteria for the VISION trial. J Nucl Med. 2022;63:816-818.
  23. Hoskin P, Sartor O, O’Sullivan JM, et al. Efficacy and safety of radium-223 dichloride in patients with castration-resistant prostate cancer and asymptomatic bone metastases, with or without previous docetaxel use: a prespecified subgroup analysis from the randomised, double-blind, phase 3 ALSYMPCA trial. Lancet Oncol. 2014; 15:1397-1406.
  24. Gillessen S, Choudhury A, Saad F, et al. Randomized multicenter open label phase III trial comparing enzalutamide vs a combination of radium-223 (Ra223) and enzalutamide in asymptomatic or mildly asymptomatic patients with bone metastatic castration-resistant prostate.  cancer (mCRPC): first results of EORTC-GUCG 1333/PEACE-3.  Presented at: European Society of Medical Oncology; September 13-17, 2024. Abstr LBA1.
  25. Tombal B, Choudhury A, Saad F, et al. Enzalutamide plus radium-223 in metastatic castration-resistant prostate cancer: results of the EORTC 1333/PEACE-3 trial. Ann Oncol. 2025;36:1058-1067.
  26. Higano CS, George DJ, Shore N, et al. Clinical outcomes and treatment patterns in REASSURE: planned interim analysis of a real-world observational study of radium-223 in metastatic castration-resistant prostate cancer. EClinicalMedicine. 2023;60:101993.
  27. McKay R, Xie W, Ajmer A, et al. A multicenter randomized, phase 2, investigator-initiated ETCTN trial of olaparib + radium-223 vs. radium-223 in men with castration resistant prostate cancer (CRPC) with bone metastases (BM) (COMRADE): initial efficacy and biomarker analysis. Presented at: 2025 American Society of Clinical Oncology Annual Meeting; May 30-June 3, 2025. Abstr 5007.
  28. Morris MJ,  Castellano D, Herrman K, et al. 177Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor therapy for taxane-naive patients with progressive metastatic castration-resistant prostate cancer (PSMAfore): a phase 3, randomised, controlled trial. Lancet. 2024;404:1227-1239.
  29. Sartor O, Jiang DM, Smoragiewicz M, et al. Efficacy of 177Lu-PNT2002 in PSAM-positive mCRPC following progression on an androgen-receptor pathway inhibitor (ARPI) (SPLASH). Presented at: European Society of Medical Oncology; September 13-17, 2024. Abstr LBA65.
  30. Kuo PH, Morris MJ, Hesterman J, et al. Quantitative 68GA-PSMA-11 PET and clinical outcomes in metastatic castration-resistant prostate cancer following 177Lu-PSMA-617 (VISION trial). Radiology. 2024;312:e233460.
  31. Kuo PH, Calais J, and Crosby M. PSMA PET imaging in the management of patients with metastatic castration resistant prostate cancer treated with radioligand therapy. Target Oncol. 2025;20:597-613.
  32. Beltran H, Calais J, Emmett L, Kuo PH, Logothetis CJ. Biomarkers to optimize PSMA-targeted radioligand therapy for metastatic castration-resistant prostate cancer. Front Oncol. 2025;15:1583168.