On October 7, 2025 Blue Earth Therapeutics reported new modelling results demonstrating that front-loaded dosing of its radiohybrid lutetium labelled, PSMA targeted, investigational radioligand therapy Lutetium (177Lu) rhPSMA-10.1 Injection may increase cumulative tumour absorbed radiation dose without a proportional increase in normal organ exposure or total administered radioactivity (Press release, Blue Earth Therapeutics, OCT 7, 2025, View Source [SID1234656493]). These findings are being presented at the European Association of Nuclear Medicine (EANM) Annual Meeting (poster EPS-187) and have been used to shape the design of the Phase 2 portion of the Phase 1/2 clinical trial (NCT05413850). The model was built from patient data from the Phase 1 portion of the trial.
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In the Phase 1 study, tumor absorbed radiation doses in cycles 2 and 3 declined by 37% and 56% respectively from cycle 11. In contrast, healthy organ-absorbed doses remain broadly the same across cycles. In the model, maximum cumulative administered radioactivity was defined by the current limit of 23 Gy absorbed dose to kidneys. With the Phase 1 trial showing 0.30 Gy/GBq absorbed dose to the kidneys, administration of up to 60GBq or more was possible.
The model assessed three dosing scenarios, all with dosing at six-weekly intervals:
10 GBq in cycles 1 and 2, followed by five cycles of 7.4 GBq
14.8 GBq in cycles 1 and 2, followed by four cycles of 7.4 GBq
7.4 GBq in each of cycles 1-8 (flat dosing)
The model extrapolated the reductions in tumour-absorbed radiation doses across each of cycles 4-8 using data available from cycles 1-3 and predicted the cumulative tumour absorbed radiation dose for each dosing scenario. The results showed that the front-loaded regimens both increase tumour-absorbed radiation dose; by 15% for regimen #1 and by 34% for regimen #2 vs. a flat dosing regimen (#3).
Commenting on the results, Dr Dan Stevens, Blue Earth Therapeutics’ Chief Medical Officer, said, "There is increasing interest in exploring alternative dosing schedules for radiopharmaceutical therapies to try and optimise the potential for clinical benefit. We are taking observed data from our Phase 1 and attempting to apply this scientifically in testing different front-loading approaches in our ongoing Phase 2 study. The data collected should allow us to assess the potential benefit and any risks."
About metastatic prostate cancer
In 2025 it is estimated that there will be 50,055 new cases of metastatic prostate cancer in the United States (de novo diagnoses plus recurrence from earlier stage diagnoses).2 Five-year survival for newly diagnosed metastatic prostate cancer is low, 36.6%.3 While death rates from prostate cancer have declined over the past three decades3, there is still considerable room to improve patient outcomes.
About Radiohybrid Prostate–Specific Membrane Antigen (rhPSMA)
rhPSMA compounds are referred to as radiohybrid ("rh"), as each molecule possesses four distinct domains. The first consists of a Prostate–Specific Membrane Antigen–targeted receptor ligand. It is attached to two labelling moieties which may be radiolabeled with diagnostic isotopes such as 18F or 68Ga for PET imaging, or with therapeutic isotopes such as 177Lu or 225Ac for radioligand therapy, all of which are joined together by a modifiable linker which can be used to modulate important pharmacokinetic characteristics. Radiohybrid PSMA offers the potential for targeted treatment for men with prostate cancer and originated at the Technical University of Munich, Germany. Blue Earth Diagnostics acquired exclusive worldwide rights to rhPSMA diagnostic imaging technology from Scintomics GmbH in 2018, and therapeutic rights in 2020, and has sublicensed the therapeutic application to its sister company Blue Earth Therapeutics.