{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:54:24Z","timestamp":1781636064431,"version":"3.54.5"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T00:00:00Z","timestamp":1770940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100005788","name":"Medical University of Vienna","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100005788","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Nucl Med Mol Imaging"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Lutetium-177-labelled radioligand therapy targeting prostate-specific membrane antigen ([\u00b9\u2077\u2077Lu]Lu-PSMA-RLT) is an established third-line treatment for metastatic castration-resistant prostate cancer (mCRPC). We evaluated the therapeutic effectiveness of [\u00b9\u2077\u2077Lu]Lu-PSMA-RLT in systemic therapy-na\u00efve patients with metastatic hormone-sensitive prostate cancer (mHSPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>This retrospective analysis included mHSPC patients without prior systemic hormone therapy or chemotherapy who received [\u00b9\u2077\u2077Lu]Lu-PSMA-RLT between September 2015 and February 2025. The primary outcomes were prostate-specific antigen (PSA) response one month after the final cycle and PSA progression-free survival (PFS). Hematological and biochemical laboratory parameters were monitored to assess toxicity. Baseline PSMA PET imaging parameters (maximum standardized uptake value (SUVmax), mean SUV, peak SUV, and total tumor volume (TTV)) were collected. Uni- and multivariable analyses, together with Kaplan-Meier survival analysis, were performed to identify predictors of PSA-PFS, androgen deprivation therapy (ADT)-free survival, and any-therapy-free survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Twenty-four patients were identified. Median PSA declined significantly from 6.4 ng\/mL (range 0.49\u20133149) at baseline to 2.3 ng\/mL (range 0.00-1731) one month after last [\u00b9\u2077\u2077Lu]Lu-PSMA-RLT cycle (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). All patients received\u2009\u2265\u20093 cycles of [\n                      <jats:sup>177<\/jats:sup>\n                      Lu]Lu-PSMA-RLT. Overall, 15 of 24 patients (62.5%) achieved a PSA decline\u2009\u2265\u200950%, including 10 patients (41.7%) with a decline\u2009\u2265\u200980%. Median PSA-PFS was 24.6 months in patients with a PSA decline\u2009\u2265\u200950%, versus 5.2 months in those with a decline\u2009&lt;\u200950% (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). In the Kaplan-Meier analysis, baseline TTV, the presence of bone metastases, and age\u2009&lt;\u200966.3 years were significant predictors of shorter ADT-free and any-therapy-free survival (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In contrast, baseline SUV-values of metastatic lesions showed no predictive value in distinguishing responders from non-responders. No severe treatment-related adverse events occured. One patient (4.2%) died 10.3 months after initiation of [\u00b9\u2077\u2077Lu]Lu-PSMA-RLT.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study evaluated [\u00b9\u2077\u2077Lu]Lu-PSMA-RLT in early-stage PCa, demonstrating strong PSA decline, prolonged PCa progression-free period, and good tolerability. Baseline TTV and metastatic extent were independent predictors of ADT-free and any-therapy-free survival. The absence of differences in PSMA PET-derived SUV-parameters between responders and non-responders suggests a more homogeneous tumor biology in treatment-na\u00efve mHSPC patients. Prospective studies are needed to define the clinical benefit and predictors of response to [\u00b9\u2077\u2077Lu]Lu-PSMA-RLT in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00259-026-07802-9","type":"journal-article","created":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T01:18:47Z","timestamp":1770945527000},"page":"4395-4404","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["[177Lu]Lu-PSMA radioligand therapy in systemic therapy-na\u00efve metastatic hormone-sensitive prostate cancer patients: a retrospective study"],"prefix":"10.1007","volume":"53","author":[{"given":"Ilva K.","family":"Langrate","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidemarie","family":"Ofner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Kretschmer-Chott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Einspieler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oana C.","family":"Kulterer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Schmitl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas","family":"Nics","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahrokh F.","family":"Shariat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Hacker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2898-3232","authenticated-orcid":false,"given":"Sazan","family":"Rasul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gero","family":"Kramer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,13]]},"reference":[{"key":"7802_CR1","unstructured":"European Commission, Joint Research Centre. 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J Nucl Med. 2022;63(8):1199\u2013207. https:\/\/doi.org\/10.2967\/jnumed.121.262713.","journal-title":"J Nucl Med"}],"container-title":["European Journal of Nuclear Medicine and Molecular Imaging"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-07802-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00259-026-07802-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00259-026-07802-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:11:52Z","timestamp":1781633512000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00259-026-07802-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,13]]},"references-count":38,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["7802"],"URL":"https:\/\/doi.org\/10.1007\/s00259-026-07802-9","relation":{},"ISSN":["1619-7070","1619-7089"],"issn-type":[{"value":"1619-7070","type":"print"},{"value":"1619-7089","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,13]]},"assertion":[{"value":"14 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 January 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 February 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 February 2026","order":5,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Update","order":6,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The article was modified to insert the missing article note: Sazan Rasul and Gero Kramer share last authorship.","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This was a retrospective study. The study was authorized by the Ethics Committee of the Medical University of Vienna (EK: 1143\/2019). All procedures described in this study followed the ethical standards of the institutional and\/or national research committee and the principles of the 1964 Declaration of Helsinki and its subsequent amendments or comparable ethical standards. This work does not contain any animal experiments performed by the authors.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval\u00a0& institutional review board statement"}},{"value":"Informed consent was obtained from all individual participants included in this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}},{"value":"I.K.L. received financial support from DSD Pharma GmbH as part of her doctoral studies. DSD Pharma GmbH was neither involved in the study nor in reporting the results. M.H. is a member of the Editorial Board of the European Journal of Nuclear Medicine and Molecular Imaging. Remaining authors have no relevant financial or non-financial interests to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}