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New therapeutic strategies for metastatic castration-resistant prostate cancer (mCRPC) have been developed in the past to achieve the best response rates. Most recently, the use of combination therapies has been explored to optimize patient outcomes. Poly(ADP-ribose) polymerase inhibitors (PARPi) may help to treat mCRPC more effectively.

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Background: Approximately 10%-20% of prostate cancers progress to metastatic and castration-resistant forms (mCRPC). Radioligand (RLT) therapy with [Lu]Lu-prostate-specific membrane antigen (PSMA) is an approved treatment for metastasized mCRPC. Moreover, Actinium-225 (Ac), an alpha-emitter isotope, has also been used to label PSMA and, recently, to treat mCRPC patients with encouraging results.

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Recent advances have broadened the range of therapeutic options for mCRPC, with several new treatments, including novel hormonal therapies (enzalutamide, abiraterone), chemotherapeutic agents (docetaxel, cabazitaxel), immunotherapies (sipuleucel-T), and bone targeting radiopharmaceuticals (radium-223) showing improved clinical outcomes and receiving U.S. Food and Drug Administration approval.

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Radiopharmaceutical therapies (RPTs) based on fibroblast activation protein (FAP) and FAP inhibitors (FAPIs) are a new option for progressive metastatic cancer in patients pretreated multiple times. To date, published in-human data refer to initial experiences with β-emitting Y- and Lu-based RPT. However, the short tumor retention time of FAPI ligands is considered a major limitation of FAPI RPT.

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Article Synopsis
  • Pancreatic cancer has limited treatment options, and a new method called Alpha DaRT, using alpha-particle radiation therapy, is being tested to improve outcomes.
  • A study evaluated the safety and feasibility of using EUS-guided Alpha DaRT to treat patients with advanced, inoperable pancreatic cancer, with procedures conducted successfully between March and September 2023.
  • Results showed that while some adverse events occurred, most were related to disease progression rather than the treatment, and preliminary findings indicate that this approach is both feasible and safe, warranting further investigation.
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