¹⁷⁷Lu-PSMA radioligand therapy for metastatic castration-resistant prostate cancer

Tidsskr Nor Laegeforen. 2024 Jul 30;144(9). doi: 10.4045/tidsskr.23.0478. Print 2024 Aug 20.
[Article in English, Norwegian]

Abstract

Background: Treatment of castration-resistant metastatic prostate cancer with [¹⁷⁷Lu]PSMA radioligand.

Case presentation: A man in his seventies with metastatic prostate cancer received castration therapy for four years, developing castration-resistant disease. PET/CT with [⁶⁸Ga]PSMA-11 showed high uptake in metastatic lymph nodes. The patient received 7.4 GBq [¹⁷⁷Lu]PSMA-I&T (Curium, Finland) as five treatments at five-week intervals. Five weeks after the first treatment, p-PSA dropped from 154 to 53 µg/L. Five weeks after the fifth treatment, p-PSA was 1.8 µg/L. [⁶⁸Ga]PSMA-11 PET/CT showed significant reduction in the size of metastases, with the largest decreasing in diameter from 10 to 4 mm. Seven months after the fifth treatment, p-PSA increased to 14.3 µg/L, and [⁶⁸Ga]PSMA-11 PET/ CT revealed additional skeletal metastases, while the lymph node metastases remained unchanged. Thus, the treatment had a good but temporary effect on the metastases.

Interpretation: Treatment with [¹⁷⁷Lu]PSMA radioligand resulted in a temporary regression of the metastases.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Dipeptides / pharmacokinetics
  • Dipeptides / therapeutic use
  • Gallium Isotopes
  • Gallium Radioisotopes*
  • Humans
  • Lutetium* / therapeutic use
  • Lymphatic Metastasis
  • Male
  • Oligopeptides
  • Positron Emission Tomography Computed Tomography*
  • Prostate-Specific Antigen* / blood
  • Prostatic Neoplasms, Castration-Resistant* / pathology
  • Prostatic Neoplasms, Castration-Resistant* / radiotherapy
  • Radiopharmaceuticals* / pharmacokinetics
  • Radiopharmaceuticals* / therapeutic use

Substances

  • Radiopharmaceuticals
  • Prostate-Specific Antigen
  • Lutetium
  • Gallium Radioisotopes
  • Dipeptides
  • gallium 68 PSMA-11
  • Oligopeptides
  • Gallium Isotopes