Dr Saad on Long-Term Safety of 177Lu-PSMA-617 in mHSPC

In an on-site interview at the 2026 ASCO Annual Meeting, Fred Saad, MD, of Montreal Cancer Institute discusses key considerations for clinicians caring for patients with metastatic hormone-sensitive prostate cancer (mHSPC) who have previously received radioligand therapy. Drawing on emerging data and clinical experience, Saad emphasizes that ¹⁷⁷Lu-PSMA-617 (Pluvicto) has thus far demonstrated a favorable safety profile, with most patients tolerating treatment well.

He notes that concerns regarding bone marrow toxicity have been less pronounced in the hormone-sensitive setting than in later-stage disease, likely because patients have stronger marrow reserves earlier in their treatment journey. Saad also highlights the importance of monitoring for potential cumulative renal toxicity over time, although current findings remain reassuring.

Looking ahead, investigators will continue to evaluate whether treatment with radioligand therapy may influence the long-term risk of myelodysplastic syndromes or acute myeloid leukemia. While no significant safety signals have emerged to date, Saad stresses that continued follow-up will be critical as more patients receive ¹⁷⁷Lu-PSMA-617 earlier in the disease course and are observed for longer periods.