Abstract
Treatment of castration-resistant metastatic prostate cancer with [¹⁷⁷Lu]PSMA radioligand. 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 4mm. 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. Treatment with [¹⁷⁷Lu]PSMA radioligand resulted in a temporary regression of the metastases.
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