177Lu-PSMA Radiotherapy for Oligorecurrent Prostate Cancer – LUNAR Trial Results
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ASTRO 2025: Key Updates in Radiation Oncology
Table of Contents
Coverage of presentations from the American Society for Radiation Oncology (ASTRO) annual meeting, as of September 29, 2025.
LUNAR Trial: Neoadjuvant PSMA Radiotherapy Shows Promise
Preliminary results from the Phase II LUNAR randomized trial, presented at ASTRO 2025, indicate potential benefits of neoadjuvant 177Lu-PSMA radiotherapy combined with ablative radiotherapy for oligorecurrent prostate cancer. The study’s primary endpoint analysis suggests this approach is a viable treatment option. Oncodaily reports that the trial is evaluating the efficacy of this combined modality.
Oligorecurrent prostate cancer refers to cases where the cancer has returned in a limited number of sites after initial treatment. Neoadjuvant therapy, given *before* definitive treatment like surgery or radiation, aims to shrink the tumor and improve outcomes. PSMA (prostate-specific membrane antigen) is a protein found on prostate cancer cells, making it a target for both imaging and therapy. 177Lu-PSMA is a radioactive isotope that binds to PSMA, delivering radiation directly to cancer cells.
Advances in Radiation Therapy Techniques
ASTRO 2025 also featured presentations on new advancements in radiation therapy techniques,including targeted radioactive therapy and stereotactic body radiotherapy (SBRT). Oncodaily highlighted the use of 5DCT-guided imaging to improve the precision of SBRT.
SBRT is a highly focused form of radiation therapy that delivers high doses of radiation to a small area, minimizing damage to surrounding healthy tissues. 5DCT (five-dimensional computed tomography) imaging provides detailed information about the tumor’s size, shape, and location, as well as its movement during breathing, allowing for even more precise targeting.
Looking Ahead: implications for Prostate Cancer Treatment
The findings presented at ASTRO 2025 suggest a growing trend towards personalized and targeted radiation therapy for prostate cancer. The LUNAR trial’s results, if confirmed in larger studies, could lead to a new standard of care for patients with oligorecurrent disease. Continued advancements in imaging and radiation delivery techniques promise to further improve the precision and effectiveness of radiation therapy, ultimately leading to better outcomes for patients.