# PSMA PET → PSMA radioligand therapy

Source: https://onco.cc/pairings/psma-pet-to-rlt/  
OnCo record `psma-pet-to-rlt` (Pairing). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The scan shows whether the target is there; the treatment uses the same address. Only patients whose tumours light up are treated.

## Summary

This diagnostic-therapeutic pairing links PSMA PET to Radioligand therapy (beta emitters) against PSMA in Prostate cancer: the scan shows whether the target is there, the treatment uses the same address, and only patients whose tumours light up are treated. Identical ligand chemistry means imaging biodistribution predicts therapeutic biodistribution and enables dosimetry. VISION and PSMAfore required PSMA PET positivity, so the pairing is embedded in phase 3 design and drug labels, and the standardised uptake value predicts response. The linked agents are Piflufolastat F-18 / Pylarify TruVu and Lutetium-177 vipivotide tetraxetan, and the pairing is the archetype of Theranostics now being copied for FAP, TROP2, HER2 and CAIX.

## Fields

- Kind: Pairing
- Last checked: 2026-09-04
- Pairs: PSMA PET + Radioligand therapy (beta emitters)
- Type: diagnostic-therapeutic
- Rationale: Identical ligand chemistry means imaging biodistribution predicts therapeutic biodistribution; also enables dosimetry.
- Evidence: Embedded in phase 3 design and labels.

## Sources

- VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer (New England Journal of Medicine 2021): https://doi.org/10.1056/NEJMoa2107322
- ClinicalTrials.gov NCT03392428: TheraP (ANZUP 1603): https://clinicaltrials.gov/study/NCT03392428

## Connected records

- cancers: [Prostate cancer](https://onco.cc/cancers/prostate/)
- targets: [PSMA](https://onco.cc/targets/psma/)
- drugs: [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [Piflufolastat F-18 / Pylarify TruVu](https://onco.cc/drugs/pylarify/)
- terms: [Theranostics](https://onco.cc/terms/theranostics/)
- technologies: [PSMA PET](https://onco.cc/technologies/psma-pet/), [Radioligand therapy (beta emitters)](https://onco.cc/technologies/radioligand-therapy/)
- ideas: [Qualify PSMA PET tumour volume as a validated imaging biomarker](https://onco.cc/ideas/idea-tr2-psma-volume-qualification/), [TROP2 PET to choose and sequence TROP2 ADCs](https://onco.cc/ideas/idea-trop2-pet-selection/)
- key papers: [VISION: lutetium-177 PSMA-617 radioligand therapy extends survival in advanced prostate cancer](https://onco.cc/key-papers/paper-vision-nejm-2021/)

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JSON: https://onco.cc/api/v1/entities/psma-pet-to-rlt.json