Pluvicto (lutetium Lu 177 vipivotide tetraxetan)

P3, N=940, Recruiting, Novartis Pharmaceuticals | Trial primary completion date: Feb 2028 --> Sep 2028

177Lu-PSMA-617 strongly promotes CH, supporting integration of longitudinal monitoring for long-term hematologic sequelae as radioligand therapy is implemented earlier in prostate cancer care.

P2, N=46, Active, not recruiting, Novartis Pharmaceuticals | Recruiting --> Active, not recruiting | N=80 --> 46

P1, N=28, Active, not recruiting, Novartis Pharmaceuticals | Recruiting --> Active, not recruiting

P=N/A, N=20, Not yet recruiting, Shanghai General Hospital; Shanghai General Hospital

P=N/A, N=30, Recruiting, West Southwest Medical University Affiliated Hospital; West Southwest Medical University Affiliated Hospital

P4, N=30, Recruiting, Brigham and Women's Hospital | Trial completion date: Dec 2025 --> Dec 2026 | Trial primary completion date: Dec 2025 --> Dec 2026

P1, N=30, Recruiting, City of Hope Medical Center | Not yet recruiting --> Recruiting | Trial completion date: Jun 2027 --> Jul 2028 | Initiation date: Dec 2025 --> Mar 2026 | Trial primary completion date: Jun 2027 --> Jul 2028

P2, N=15, Recruiting, Fred Hutchinson Cancer Center | Trial primary completion date: Jul 2026 --> Dec 2026

We conclude that the optimal use of PARP inhibitors, PSMA-targeted RLT, and ARPIs requires a personalized strategy guided by molecular profiling, functional imaging, prior treatment exposure, and safety considerations. This clinically focused overview aims to support evidence-based decision-making in an increasingly complex treatment landscape.

P2, N=15, Recruiting, Fred Hutchinson Cancer Center | Trial primary completion date: Dec 2025 --> Jul 2026

Available therapeutic options include radioligand therapy (e.g. lutetium-177-PSMA-617), cabazitaxel, PARP inhibitors (particularly for patients with DNA repair gene alterations), second-line ARTAs, further chemotherapy and immunotherapeutic approaches. Finally, the review provides an overview of promising emerging therapies poised to expand the treatment landscape for mCRPC. These include bispecific T cell engagers, androgen receptor degraders, and antibody-drug conjugates, which are currently under investigation in clinical trials and may soon offer new avenues for treatment beyond traditional mechanisms.