New combo attack on returning prostate cancer shows promise in early trial

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * Oligorecurrent prostate cancer as determined by the presence of 1-5 asymptomatic lesions outside the prostate or prostate bed identified on PSMA PET/CT by local readers * Age \>= 18 years * Eastern Cooperative Oncology Group (ECOG) performance status =\< 2 * No indication for urgent or emergent radiation * Histologic confirmation of prostate adenocarcinoma (histology from original treatment acceptable) * White blood cell count \>= 2.5 × 10\^9/L * Platelets \>= 100 × 10\^9/L * Hemoglobin \>= 9 g/dL * Total bilirubin =\< 1.5 × institutional upper limit of normal (ULN); or up to 3 × ULN if known history of Gilbert's syndrome * Alanine aminotransferase or aspartate aminotransferase =\< 3.0 × ULN or =\< 5.0 × ULN for patients with liver metastases * Serum creatinine =\< 1.5 × ULN or creatinine clearance \>= 50 mL/min * Serum albumin \> 3.0 g/dL * Partner and patient must use a method of birth control with adequate barrier protection, deemed acceptable by the principal investigator during the study and for 3 months after last study drug administration * Ability to understand, and willingness to sign, the written informed consent Exclusion Criteria: * Patients with neuroendocrine or small cell carcinoma of the prostate * Patients with castrate-resistant disease (i.e., PSA \> 0.5 ng/mL with serum testosterone \< 150 ng/dL) * Patients who received androgen deprivation therapy within 6 months of trial enrollment * Concurrent systemic therapy for a solid organ malignancy * Spinal cord compression * Inability to lie flat * Known hypersensitivity to components of 177Lu-PNT2002 * Serum creatinine \> 1.5 × ULN or creatinine clearance \< 50 mL/min * Total bilirubin \> 1.5 × ULN or \> 3.0 × ULN if known history of Gilbert's syndrome * Alanine aminotransferase or aspartate aminotransferase \> 3 × ULN (or 5 × ULN for patients with known liver metastases) * De novo oligometastatic disease