{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T21:12:36Z","timestamp":1786914756235,"version":"build-2736575974"},"reference-count":31,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Klinikum der Universit\u00e4t M\u00fcnchen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This study aimed to evaluate the efficacy and safety of Lutetium-177\/Actinium-225 prostate-specific membrane antigen tandem radioligand therapy ([\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu\/[\n                      <jats:sup>225<\/jats:sup>\n                      Ac]Ac-PSMA tandem RLT) and to explore clinical and imaging-based predictors of treatment response to support individualized patient selection.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective, single-center study included 23 patients with mCRPC who underwent Fluor-18 ([\n                      <jats:sup>18<\/jats:sup>\n                      F]F)-PSMA-1007 positron emission tomography\/computed tomography (PET\/CT) and subsequent tandem RLT. Whole-body tumor segmentation on PET\/CT and standard laboratory values were acquired before treatment initiation. Primary endpoint was partial response (PR), defined as either a decline in prostate specific antigen of \u2265\u200950% (according to prostate cancer clinical trial working group) or PET-based response according to Response Evaluation Criteria on PSMA PET\/CT. Safety assessment included renal and hematological side effects following common terminology criteria of adverse events version 5.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Following two cycles of tandem RLT, 11 patients (48%) achieved a PR. The treatment was generally tolerated well. Grade 3 events included renal impairment in two (9%) and grade 3 anemia in five (22%) patients, while no Grade 4\/5 events occurred. Patients with increased PSMA expression on pretherapeutic PET (defined by the average mean standardized uptake value of all tumor lesions [SUV\n                      <jats:sub>mean<\/jats:sub>\n                      ]) had a higher response rate (86%; 6 out of 7) compared to those with decreased SUV\n                      <jats:sub>mean<\/jats:sub>\n                      (31%; 5 out of 16). In Cox regression analysis, SUV\n                      <jats:sub>mean<\/jats:sub>\n                      was significantly associated with PR with a hazard ratio of 1.34 (95% CI, 1.01\u20131.77;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.042). PSMA-tumor volume (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.036) and total lesion-PSMA (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.041) were also significant predictors, whereas none of the clinical parameters showed predictive value. Kaplan-Meier analysis further confirmed SUV\n                      <jats:sub>mean<\/jats:sub>\n                      as the strongest PR (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu\/[\n                      <jats:sup>225<\/jats:sup>\n                      Ac]Ac-PSMA tandem RLT may offer a safe, effective treatment option. Assessment of PSMA expression on pretherapeutic PET predicts response, supporting its use in guiding personalized treatment.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-025-07632-1","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:11:13Z","timestamp":1761955873000},"page":"2271-2281","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Refining the clinical utility of [177Lu]Lu\/[225Ac]Ac-PSMA tandem RLT in patients with metastatic castration resistant prostate cancer"],"prefix":"10.1007","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0243-9338","authenticated-orcid":false,"given":"Liam","family":"Widjaja","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Hornfeck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie C.","family":"Siegmund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz J.","family":"Gildehaus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina-Sophie","family":"Schmidt-Hegemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Wenter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel T.","family":"Sheikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konrad","family":"Klimek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jozefina","family":"Casuscelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian G.","family":"Stief","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathias J.","family":"Zacherl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,1]]},"reference":[{"key":"7632_CR1","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1038\/s41391-023-00725-8","volume":"27","author":"SJ Freedland","year":"2024","unstructured":"Freedland SJ, Davis M, Epstein AJ, Arondekar B, Ivanova JI. 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The study was approved by the ethical committee of Ludwig-Maximilians University (#25\u20130130).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"All participants consented to imaging and subsequent therapy, as well as to potential scientific analysis.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"RAW has received speaker honoraria from Novartis\/AAA and PentixaPharm, reports advisory board work for Novartis\/AAA and Bayer.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}