One side-effect of Pluvicto is risk of damage to the kidneys, TLX591 results in a much lower radiation dose to the kidneys. This paper says the long term risks of Pluvicto need further study. This could be an important difference if LU177 is to be used safely in earlier treatment lines.
https://jnm.snmjournals.org/content/early/2023/10/19/jnumed.123.265986
Long-Term Nephrotoxicity of 177Lu-PSMA Radioligand Therapy
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