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@thmssllvn

Call me a frustrated researcher. The 'HIGH'-er metastatic risk Gleason scores and NCCN recommendations have not anticipated the newer technology's effects. I believe the G9 five year period free of micro mets is about 75-80%; In the remainder or about 20% who have 1-5 yrs micromets rate about 60% involve one lymph node, another 22% two lymph nodes. both are amenable to spot SBRT that resets the 'clock' as it were. It is my understanding that the base reference G7, 8, and 9 prognostications were derived post radical prostatectomy. In that context wouldn't PLUVICTO or the other emerging systemic radiotherapeutic ligands make a nice control versus 'preventive' lymph node irradiation for newbies in the 'HIGH'-er metastatic risk categories?

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Replies to "Call me a frustrated researcher. The 'HIGH'-er metastatic risk Gleason scores and NCCN recommendations have not..."

Darned good question! I initially thought it was only for bone metastasis, but that’s not the case.
They use it for soft tissue areas as well. However, it will only target cells which express PSMA and many PCa’s do not.
But it would be revolutionary to have a ligand therapy that homes in on a ‘universal’ cancer marker and attacks ONLY the cancer and not every cell from your navel to your pelvis.
Phil