Targeted Radiation, Unintended Evolution.

Lueckerath, Katharina; Hadaschik, Boris; Herrmann, Ken; von Amsberg, Gunhild · Clin Cancer Res · 2026

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Abstract

Radioligand therapy exemplifies precision oncology, yet its consequences remain incompletely understood. A recent article shows that [177Lu]Lu-PSMA promotes emergence and expansion of clonal hematopoiesis enriched for DNA damage response gene mutations, reframing bone marrow effects as treatment-emergent clonal selection rather than collateral toxicity and informing biology-guided patient monitoring and theranostics.