177Lu-PSMA-617 radioligand therapy for a patient with lymph node metastatic prostate cancer.

Finn E Von Eyben,Timo Joensuu,Timo Kiljunen,Christian Uprimny,Irene Virgolini,Kalevi Kairemo

doi:10.18632/oncotarget.19805

Abstract

Prostate specific membrane antigen (PSMA) is expressed in unfavorable prostate cancer. PSMA is basis for new diagnostics and theranostics. PET/CT using PSMA is more sensitive than choline PET/CT. 177Lu-PSMA radioligand therapy is mainly used for patients with end-stage prostate cancer. This report describes a patient with a third recurrence in lymph nodes. The recurrence was treated with 177Lu-PSMA radioligand therapy instead of chemotherapy with docetaxel. The effect was in part evaluated relative to that of two established salvage treatments. Prior salvage radiotherapy and abiraterone of the first and second recurrence in lymph nodes had given only a partial reduction of PSA. Nevertheless within five months of follow-up, 177Lu-PSMA radioligand therapy of the third recurrence in lymph nodes reduced PSA for a period to unmeasurable levels. 177Lu-PSMA radioligand therapy gave only mild adverse effects. In conclusion, for a patient with lymph node metastatic prostate cancer, 177Lu-PSMA-617 radioligand therapy had an attractive therapeutic profile. A follow-up study of similar patients is being planned.

Highlights

Up to a third of patients with prostate cancer (PC) who undergo radical prostatectomy (RP) later develop a continuous rise of prostate specific antigen (PSA)
177Lu-Prostate specific membrane antigen (PSMA)-617 radioligand therapy (RLT) is mainly used for patients with end-stage mCRPC who had failed with established systemic treatments
We report treatment with 177Lu PSMA-617 RLT for a patient with a third episode of lymph node metastatic prostate cancer

Summary

Introduction

Up to a third of patients with prostate cancer (PC) who undergo radical prostatectomy (RP) later develop a continuous rise of prostate specific antigen (PSA). Prior salvage radiotherapy and abiraterone of the first and second recurrence in lymph nodes had given only a partial reduction of PSA. Within five months of follow-up, 177Lu-PSMA radioligand therapy of the third recurrence in lymph nodes reduced PSA for a period to unmeasurable levels.

Results

Conclusion