Radiopharmaceutical Therapy Extends Survival in Patients with Metastatic Prostate Cancer

Clinical trial findings suggest that patients with limited metastases from recurrent prostate cancer can experience a significantly longer interval before disease progression when treated with a radiopharmaceutical drug before targeted radiation therapy, compared to radiation alone. The phase II LUNAR trial, presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting, demonstrated that the addition of radioligand therapy can improve progression-free survival and delay hormone therapy.

Key Takeaways:

• The LUNAR trial found that patients with oligometastatic prostate cancer who received a radiopharmaceutical drug before targeted radiation therapy experienced a median survival of 18 months, compared to 7 months with radiation alone.
• The addition of radioligand therapy significantly improved progression-free survival, with 98% of instances of disease progression being new metastases rather than regrowth at previously treated sites.
• Both groups tolerated treatment well, with no increase in severe side effects with the addition of the radiopharmaceutical.
• The results of the LUNAR trial reinforce the growing role of definitive radiation therapy for oligometastatic disease and point to a potential new strategy to extend its benefits.
• Hormone therapy remains effective but is associated with side effects such as fatigue, metabolic changes, bone loss, and cardiovascular risks.
• The LUNAR trial is the first randomized study to show that a treatment established for later-stage prostate cancer can delay progression and defer hormone therapy when added to high-precision radiation therapy for patients with early metastatic disease.

Statistics:

• 92 patients with hormone-sensitive, oligometastatic prostate cancer participated in the LUNAR trial.
• The trial involved 47 patients who received SBRT alone and 45 patients who received 177Lu-PNT2002 followed by SBRT.
• The median survival of patients who received the radiopharmaceutical before SBRT was 18 months compared to 7 months with SBRT alone.
• Patients who received the radiopharmaceutical before SBRT were able to delay hormone therapy by 24 months compared to 14 months without SBRT alone.
• SBRT resulted in very high local control for both groups, with 98% in the SBRT arm and 100% in the combination arm.

Sources:

• American Society for Radiation Oncology (ASTRO) Annual Meeting
• University of California, Los Angeles
• NewsReporter-Staff News Editor at VerticalNews Health (October 19, 2025)