{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T02:31:20Z","timestamp":1793845880584,"version":"4.6.1"},"reference-count":28,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"36","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["J Clin Oncol"],"published-print":{"date-parts":[[2025,12,20]]},"abstract":"\n PURPOSE<\/jats:title>\n Progression after metastasis-directed therapy via stereotactic body radiotherapy (SBRT) for oligorecurrent hormone-sensitive prostate cancer (orHSPC) is common. We aimed to assess whether the addition of neoadjuvant prostate-specific membrane antigen (PSMA)\u2013targeting radioligand therapy to SBRT would improve outcomes.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n The LUNAR trial was a single-center, randomized, open-label, controlled phase II trial conducted at the University of California, Los Angeles. Eligible participants had orHSPC as determined by the presence of one to five lesions identified on PSMA positron emission tomography\/computed tomography (PET\/CT). After stratifying by stage (N1\/M1a\n v<\/jats:italic>\n M1b) and lesion count (1\n v<\/jats:italic>\n 2-3\n v<\/jats:italic>\n 4-5), we randomly assigned patients 1:1 to receive SBRT to all lesions or two cycles of\n 177<\/jats:sup>\n Lu-PNT2002 (6.8 GBq\/cycle, 2 weeks apart) followed by SBRT to all lesions. The primary end point was progression-free survival (PFS), defined by PSMA PET\/CT, salvage hormonal therapy, or death. PSMA PET\/CT was acquired systematically at prostate-specific antigen progression and\/or 12 months after SBRT. All analyses were done in the intention-to-treat population. The study is registered with ClinicalTrials.gov (identifier:\n NCT05496959<\/jats:ext-link>\n ).\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n From September 2, 2022, to November 9, 2023, 92 patients were randomly assigned (SBRT n = 47 and\n 177<\/jats:sup>\n Lu + SBRT n = 45), with 87 evaluable patients (SBRT n = 42 and\n 177<\/jats:sup>\n Lu + SBRT n = 45). At a median follow-up of 22 months, the addition of\n 177<\/jats:sup>\n Lu to SBRT significantly improved PFS (17.6 months [95% CI 15 months to not reached]\n v<\/jats:italic>\n 7.4 months [95% CI, 6.0 to 13.5 months]; hazard ratio, 0.37 [95% CI, 0.22 to 0.61],\n P<\/jats:italic>\n < .0001). The only grade 3 adverse events were lymphopenia (two patients [4.8%] in the SBRT group and three patients [6.7%] in the\n 177<\/jats:sup>\n Lu + SBRT group). Prognostic biomarkers for PFS were identified.\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSION<\/jats:title>\n \n Compared with SBRT alone, the addition of\n 177<\/jats:sup>\n Lu-PNT2002 to SBRT significantly improved PFS in patients with orHSPC without an attendant increase in toxicity.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1200\/jco-25-01553","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T21:00:09Z","timestamp":1762981209000},"page":"3812-3821","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":39,"title":["177<\/sup>\n Lu-Prostate-Specific Membrane Antigen Neoadjuvant to Stereotactic Ablative Radiotherapy for Oligorecurrent Prostate Cancer (LUNAR): An Open-Label, Randomized, Controlled, Phase II Study"],"prefix":"10.1200","volume":"43","clinical-trial-number":[{"clinical-trial-number":"nct05496959","registry":"10.18810\/clinical-trials-gov"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7437-6591","authenticated-orcid":true,"given":"Amar U.","family":"Kishan","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5781-4174","authenticated-orcid":true,"given":"Luca F.","family":"Valle","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Greater Los Angeles VA Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8434-6548","authenticated-orcid":true,"given":"Holly","family":"Wilhalme","sequence":"additional","affiliation":[{"name":"Department of Medicine Statistical Core, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Felix","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rejah","family":"Nabong","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9604-992X","authenticated-orcid":true,"given":"Jesus E.","family":"Juarez-Casillas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0053-7874","authenticated-orcid":true,"given":"T. Martin","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of Washington, Seattle, WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vinicius","family":"Ludwig","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Department of Radiological Sciences, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5985-6052","authenticated-orcid":true,"given":"Zachary","family":"Ells","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magnus","family":"Dahlbom","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1194-0148","authenticated-orcid":true,"given":"Michael","family":"Lauria","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4542-2608","authenticated-orcid":true,"given":"Catherine","family":"Meyer","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minsong","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of San Francisco, San Francisco, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5096-3281","authenticated-orcid":true,"given":"Joanne B.","family":"Weidhaas","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatello","family":"Telesca","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3767-5971","authenticated-orcid":true,"given":"Kristen","family":"McGreevy","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas G.","family":"Nickols","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Greater Los Angeles VA Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Karasik","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4054-9546","authenticated-orcid":true,"given":"Sophia","family":"Parmisano","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. Vincent","family":"Basehart","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-5262","authenticated-orcid":true,"given":"Wayne","family":"Brisbane","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard","family":"Marks","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Rettig","sequence":"additional","affiliation":[{"name":"Greater Los Angeles VA Medical Center, Los Angeles, CA"},{"name":"Department of Medicine, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2654-1628","authenticated-orcid":true,"given":"Robert E.","family":"Reiter","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0553-7520","authenticated-orcid":true,"given":"Paul C.","family":"Boutros","sequence":"additional","affiliation":[{"name":"Department of Urology, University of California, Los Angeles, Los Angeles, CA"},{"name":"Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Allen-Auerbach","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Czernin","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4292-5824","authenticated-orcid":true,"given":"Michael L.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8839-4379","authenticated-orcid":true,"given":"Jeremie","family":"Calais","sequence":"additional","affiliation":[{"name":"Ahmanson Translational Theranostics Division, Department of Molecular and Medical Pharmacology, University of California, Los Angeles, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"233","reference":[{"key":"e_1_3_11_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.4853"},{"key":"e_1_3_11_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2020.0147"},{"key":"e_1_3_11_4_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.22.00644"},{"key":"e_1_3_11_5_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2023.0161"},{"key":"e_1_3_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2020.08.030"},{"key":"e_1_3_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(24)00730-7"},{"key":"e_1_3_11_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00016-6"},{"key":"e_1_3_11_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2014.07.010"},{"key":"e_1_3_11_10_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.semnuclmed.2019.02.008"},{"key":"e_1_3_11_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.05.006"},{"key":"e_1_3_11_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2018.08.066"},{"key":"e_1_3_11_13_2","first-page":"46","article-title":"Lutetium-177-prostate-specific membrane antigen therapy for prostate cancer: Current status and future prospects","volume":"35","author":"Wong CH-M","year":"2025","unstructured":"Wong CH-M, Nicoletti R, Mazzone E, et al: Lutetium-177-prostate-specific membrane antigen therapy for prostate cancer: Current status and future prospects. Curr Opin Urol 35:46-52, 2025","journal-title":"Curr Opin Urol"},{"key":"e_1_3_11_14_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2107322"},{"key":"e_1_3_11_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01653-2"},{"key":"e_1_3_11_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00529-6"},{"key":"e_1_3_11_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(25)00009-9"},{"key":"e_1_3_11_18_2","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.121.262713"},{"key":"e_1_3_11_19_2","doi-asserted-by":"publisher","DOI":"10.2967\/jnumed.124.267452"},{"key":"e_1_3_11_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.15988"},{"key":"e_1_3_11_21_2","doi-asserted-by":"publisher","DOI":"10.1158\/2159-8290.CD-17-0256"},{"key":"e_1_3_11_22_2","unstructured":"Reference Deleted"},{"key":"e_1_3_11_23_2","unstructured":"Reference Deleted"},{"key":"e_1_3_11_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.05.025"},{"key":"e_1_3_11_25_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO-25-00131"},{"key":"e_1_3_11_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(24)00326-7"},{"key":"e_1_3_11_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2025.04.017"},{"key":"e_1_3_11_28_2","unstructured":"Reference Deleted"},{"key":"e_1_3_11_29_2","first-page":"266772","article-title":"The potential contribution of radiopharmaceutical therapies in managing oligometastatic disease","volume":"123","author":"Kishan AU","year":"2024","unstructured":"Kishan AU, Siva S, Hofman MS, et al: The potential contribution of radiopharmaceutical therapies in managing oligometastatic disease. J Nucl Med 123:266772, 2024","journal-title":"J Nucl Med"}],"container-title":["Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ascopubs.org\/doi\/pdfdirect\/10.1200\/JCO-25-01553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T22:59:22Z","timestamp":1766012362000},"score":1,"resource":{"primary":{"URL":"https:\/\/ascopubs.org\/doi\/10.1200\/JCO-25-01553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,20]]},"references-count":28,"journal-issue":{"issue":"36","published-print":{"date-parts":[[2025,12,20]]}},"alternative-id":["10.1200\/JCO-25-01553"],"URL":"https:\/\/doi.org\/10.1200\/jco-25-01553","relation":{},"ISSN":["0732-183X","1527-7755"],"issn-type":[{"value":"0732-183X","type":"print"},{"value":"1527-7755","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,20]]},"assertion":[{"value":"2025-06-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-30","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}