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Beyond PSMA:

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What the graphic shows: The flowchart maps out: Entry point : PSA rising despite Pluvicto/Actinium Critical first decision : Comprehensive genomic profiling (the lynchpin of precision medicine) Three molecular outcomes : BRCA1/2 or ATM mutation → PARP inhibitors (best data: 19–24 month OS, 43–44% PSA50 response) MSI-H or dMMR → Checkpoint inhibitors like Pembrolizumab (50%+ response in this small subset) No actionable HRR mutation → Splits by performance status → either emerging non-PSMA targets (FG-3246 CD46-ADC, JANX007) or chemotherapy (cabazitaxel ± carboplatin) Secondary assessment : PSMA imaging status (all PSMA-positive vs. mixed/PSMA-negative) PSMA-positive nodes → Consider re-dosing PSMA therapy or sequencing with PARP/chemo PSMA-negative/mixed → Prefer non-PSMA mechanisms (FG-3246, cabazitaxel) Clinical trial opportunities : All pathways funnel through available trials Final recommendation : Three actionable next steps Key message embedded in the graphic:...
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Second Chances: The RE-LuPSMA Trial and Retreatment with Pluvicto

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Phase 2 Prospective Trial of Retreatment with [177Lu]Lu-PSMA-617 Molecular Radiotherapy for Metastatic Castration-Resistant Prostate Cancer—RE-LuPSMA | Journal of Nuclear Medicine BLUF (Bottom Line Up Front): A new clinical trial at UCLA called RE-LuPSMA is studying whether men whose prostate cancer came back after benefiting from Pluvicto can benefit from getting Pluvicto again. Early data suggests this approach may work—patients getting a second round of treatment show PSA declines and manageable side effects—and this trial aims to determine if it's a reliable option for men facing recurrence after their first Pluvicto course. The Problem: When Pluvicto Works, Then Stops Working For men with advanced metastatic castration-resistant prostate cancer (mCRPC)—cancer that has spread beyond the prostate and no longer responds to standard hormone therapies— Pluvicto (lutetium Lu-177 vipivotide tetraxetan, or 177 Lu-PSMA-617) has been a significant breakthrough. T...
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Preparing for Prostate Cancer Surgery:

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What the Research Says About Prehabilitation and Recovery The prostate cancer recovery few men are warned about IPCSG Newsletter | May 2026 BLUF (Bottom Line Up Front):   Recent clinical research demonstrates that men who undertake structured prehabilitation—combined pelvic floor exercises, aerobic training, and resistance training—before radical prostatectomy achieve significantly faster and more complete recovery of urinary continence. Those who begin training before surgery and continue afterward report better outcomes at 3, 6, and 12 months compared to those receiving standard care alone. This is not optional conditioning; it is a documented clinical intervention that can substantially improve your quality of life after surgery. Many men are not informed about this option despite robust peer-reviewed evidence supporting its effectiveness. The Problem We Know About When you receive a prostate cancer diagnosis and your surgeon discusses radical prostatecto...
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FDA Panel Endorses Capivasertib for PTEN-Deficient Prostate Cancer

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FDA Panel Endorses Capivasertib Use in Prostate Cancer | MedPage Today Patient-Friendly Overview of the CAPItello-281 Trial and May 1, 2026 ODAC Approval May 1, 2026 Bottom Line Up Front (BLUF) On April 30, 2026, the FDA's independent Oncologic Drugs Advisory Committee voted 7-1 to recommend approval of capivasertib (Truqap), a targeted drug that blocks a specific growth pathway, combined with abiraterone and prednisone for men with metastatic hormone-sensitive prostate cancer that carries a PTEN gene deficiency—a marker of more aggressive disease. The CAPItello-281 trial showed the combination delayed cancer progression by a median of 7.5 months. While the FDA is not required to follow the committee's recommendation, it typically does. What Happened and Why It Matters On Apr...
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