PSMAddition: Lutetium-177 PSMA Therapy – A New Hope in Prostate Cancer
Prostate cancer is one of the most common cancers in men. Although significant advances have been made in treatment in recent years, there is still a need for new therapeutic approaches, particularly in the metastatic (advanced) stage of the disease.
One of the most notable developments in this field was the PSMAddition study, presented at the 2025 ESMO (European Society for Medical Oncology) Congress.
The study demonstrated that the novel therapy Lutetium-177 PSMA, when combined with standard hormone therapy, significantly reduces the risk of cancer progression.
Evolving Approaches in Prostate Cancer Treatment
In the early 2000s, the main treatment approach for prostate cancer was androgen deprivation therapy (ADT). However, over time, some patients developed resistance to this treatment, and the cancer began to grow again.
In the 2010s, a new generation of medications known as androgen receptor pathway inhibitors (ARPIs) was introduced. These drugs more effectively blocked the action of hormones, leading to prolonged survival in many patients.
Nevertheless, some cancer cells—often too small to be detected even under a microscope—were able to survive treatment and eventually cause the disease to progress again.
At this stage, a new therapeutic target emerged: PSMA (Prostate-Specific Membrane Antigen), a unique protein found on the surface of prostate cancer cells.
How Does Lutetium Therapy Work?
Lutetium-177 PSMA therapy is an advanced treatment that functions like a "smart" drug, capable of locating cancer cells with precision—almost like finding an address. In this method, a radioactive substance called Lutetium is linked to a molecule that specifically targets PSMA (Prostate-Specific Membrane Antigen). This allows the radioactive agent to travel directly to prostate cancer cells and destroy them.
As a result, cancer cells are selectively treated while healthy tissues are largely spared from damage. This targeted approach was first validated in the VISION trial in 2021, which showed that Lutetium-177 PSMA therapy could prolong survival in patients with advanced-stage prostate cancer, leading to its approval in the United States.
Another study, TheraP, further confirmed that this treatment is both effective and safe. Additionally, a 2024 study published in the journal Radiology suggested that the intensity of PSMA uptake on PET imaging (measured by SUV values) may be associated with the patient’s response to the therapy.
The PSMAddition Study: The Beginning of a New Era
The PSMAddition study is the first large-scale research to demonstrate that Lutetium therapy may be effective not only in advanced stages but also in hormone-sensitive prostate cancer. In this study, when Lutetium-177 PSMA therapy was combined with standard hormone therapy, disease progression was significantly reduced.
Researchers described these findings as “promising, though still preliminary,” noting that longer follow-up is needed to fully understand the therapy’s impact on overall survival.
Nevertheless, the results provide a strong indication that Lutetium therapy may potentially be used in earlier stages of prostate cancer in the future. The goal is to eliminate microscopic cancer residues at an early phase, thereby keeping the disease under long-term control.
