New research highlighting the growing potential of radiopharmaceutical therapies (RPT) to improve outcomes for people with cancer will be presented at the inaugural Multidisciplinary Radiopharmaceutical Therapy Symposium, taking place in Palm Desert, California, and online starting today. Studies at the meeting, sponsored by the American Society for Radiation Oncology (ASTRO), span established uses of RPT and early signals for new indications, while also addressing what clinics need in place to safely offer these treatments as they move into routine care.

Noteworthy abstracts are highlighted below, including a meta-analysis showing longer progression‑free survival with Lu‑177 PSMA‑617 and a national review documenting a twenty‑fold rise in Medicare claims for RPT over the past decade. ASTRO experts are available to comment on these and other studies presented at the meeting. Media information is available in the meeting press kit, and abstracts and general registration are available via the meeting website.

Radiopharmaceuticals are a specialized type of injectable cancer drug that deliver targeted radiation directly to cancer cells while limiting exposure to surrounding tissues, offering the potential for better tumor control with fewer side effects. While standard radiation therapy typically involves external-beam treatments or brachytherapy, RPTs are delivered systemically with radioactive agents that target specific biomarkers on tumor cells. When the treatments, also known as radioligand therapies, bind to these biomarkers, they release radiation directly to the tumor cells. A growing body of research indicates that RPTs offer an important new option for people with cancer.

Only two RPTs have been approved by the U.S. Food and Drug Administration (FDA) in the past decade, though many additional agents are being tested in clinical trials. Studies at the meeting reflect the expanding pipeline of next-generation agents, collectively addressing a wide range of disease sites under active investigation including hematologic, gastrointestinal and other common cancers.

As more agents reach clinics and patient demand grows, providers are also seeking expert guidance to build and sustain RPT services in their local communities. This new ASTRO-sponsored symposium pairs science with operational insight, offering practical guidance for multidisciplinary teams delivering RPT in clinical settings.

Highlighted studies and meeting keynotes include:

Meta-analysis shows RPT consistently prolongs progression-free survival without adding severe side effects for patients with advanced prostate cancer

Abstract 1: Safety and efficacy of Lu-177 PSMA-617 versus established therapies in mCRPC: Pooled evidence from randomized phase II/III trials

In a pooled analysis of seven randomized trials involving more than 2,500 patients with metastatic castration-resistant prostate cancer (mCRPC), the radiopharmaceutical drug Lu-177 PSMA-617 significantly improved progression-free survival rates compared with standard-of-care systemic therapy. Patients who received the radiopharmaceutical drug commonly known as Pluvicto did not experience significantly more severe (grade 3 or higher) side effects than those who received standard treatments, including hormone-based drugs. The meta-analysis did not show a difference in overall survival, though researchers noted this finding may be influenced by patients in control arms receiving RPT after their cancer progressed in some trials.

“PSMA-targeted radioligand therapy works differently than traditional androgen-signaling therapies by delivering radiation directly to prostate cancer cells. Across randomized trials, the consistency of progression-free survival benefit with favorable tolerability was striking, and the absence of a clear overall survival signal likely reflects post-progression treatment patterns rather than a lack of efficacy. Together, these data support continued evaluation of radiopharmaceutical therapy earlier in the disease course and in combination with other systemic therapies,” said lead author Mohammad Arfat Ganiyani, MBBS, postdoctoral research fellow at the Miami Cancer Institute, part of Baptist Health South Florida. The study was conducted under the leadership of Rohan Garje, MD, principal investigator and senior author.

Lu-177 PSMA-617 is currently the only FDA-approved RPT targeting PSMA for patients with mCRPC, although studies such as the phase II LUNAR trial suggest the potential of additional radiopharmaceutical approaches for this disease.

Dr. Ganiyani will present this study during Plenary Session I on February 17 at 1:30 p.m. Pacific time.

Study indicates 20-fold increase in RPT use over the past decade, with growth across multiple specialties

Abstract 11: Multispecialty expansion in radiopharmaceutical therapy: National trends in Medicare from 2013-2023

A new analysis of Medicare claims data points to dramatic growth in radiopharmaceutical therapy delivery over the past decade. Intravenous administrations increased from 529 instances in 2013 to 12,395 instances in 2023, representing a rise of more than 2000%.

Researchers also examined the medical specialties responsible for delivering RPT, finding substantial growth across diagnostic and interventional radiology (45% of 2023 claims), nuclear medicine (37%), radiation oncology (15%) and medical oncology/hematology (2.5%). RPT administrations increased in absolute volume across specialties during the study period, though the relative distribution of administrations changed as intravenous RPT scaled nationally. Radiology accounted for the largest shift during the study period (growing from 24% to 45% of claims), while nuclear medicine (from 53% to 37%) and radiation oncology (from 23% to 15%) accounted for smaller shares of RPT administrations over time.

“Despite widespread recognition that radiopharmaceutical therapies are expanding rapidly, the scale and pace of adoption had not been well characterized using national data,” said lead author Sean Maroongroge, MD, MBA, an assistant clinical professor of radiation oncology at the City of Hope comprehensive cancer center in Duarte, California. “We observed substantial growth in overall use across specialties, with measurable shifts in relative participation over time. These findings reflect the evolving multidisciplinary nature of radiopharmaceutical therapy and underscore the need for cross-disciplinary research, training, credentialing and clinical workflows as adoption continues to expand.”

The analysis was based on Medicare Part B professional claims, which do not fully capture some treatments delivered in hospital outpatient settings and may therefore undercount total RPT use, researchers explained.

Dr. Maroongroge will present this study during Plenary Session II on February 18 at 1:40 p.m. Pacific time.

Models for radiopharmaceutical delivery

Several abstracts share guidance for establishing and maintaining high-quality RPT programs, including those in community-based settings (abstract 17) and large academic health systems (abstract 13). Studies also describe clinical pathways and models for multidisciplinary care integrating radiation oncology, nuclear medicine and other specialties (e.g., abstract 14, abstract 16). ASTRO also recently published a white paper outlining safety and quality considerations for RPT delivery and launched training centers to increase the number of physicians certified to provide these treatments.

Keynote speakers and educational sessions

Additional meeting highlights include keynote remarks from former FDA Commissioner Stephen M. Hahn, MD, FASTRO, currently the CEO and Board Chair of Nucleus RadioPharma, and Johannes Czernin, MD, who leads the Ahmanson Translational Imaging Division at UCLA Health. Educational sessions also include panels and case-based discussions on emerging RPT agents, regulatory concerns and radiation safety, as well as networking opportunities for clinicians, physicists, researchers and industry partners. Full schedule details are available in the conference planner.

ABOUT ASTRO
The American Society for Radiation Oncology (ASTRO) is the world’s largest professional society dedicated to advancing radiation oncology, with 10,000 members including physicians, nurses, physicists, radiation therapists, dosimetrists and other professionals who work to improve patient outcomes through clinical care, research, education and policy advocacy. Radiation therapy is integral to 40% of cancer cures worldwide, and more than one million Americans receive radiation treatments for their cancer each year. For information on radiation therapy, visit Speed of Light - The ASTRO Foundation. To learn more about ASTRO, visit our website and media center and connect with us on social media.

Media Contacts: Liz Gardner, Jeff White, [email protected], 703-286-1600