Excellent and Durable Response to Lutetium177 PSMA Therapy in a Metastatic Prostate Cancer Patient Refractory to Docetaxel Therapy: An Illustrative Case Report

Journal of Case Reports

article

Smriti Srivastava¹  Ajeet Kumar Gandhi¹  Madhup Rastogi¹  Rohini Khurana¹  Avinash Poojari¹  Vachaspati Kumar Mishra¹ 

[1] Department of Radiation Oncology, RML Institute of Medical Science

关键词: Metastasis;    Prostate Cancer;    Prostate Specific Antigen;    Radionuclide Therapy;    Targeted Therapy.;   

DOI  :  10.17659/01.2022.0027

学科分类：生理学

来源: Journal of Case Reports

【 摘 要 】

Background: Prostate specific membrane antigen (PSMA) is a membrane-bound protease largely overexpressed in all prostate cancers. Differential expression of PSMA in tumor and non-tumor tissue has led to evolution of several targeted therapeutic interventions in metastatic castration resistant prostate cancer (mCRPC). Case Report: Here we present the case of 66-year-old male of advanced carcinoma prostate with multiple skeletal metastasis. He underwent bilateral orchidectomy and started on abiraterone followed by enzalutamide. Being unresponsive to both these treatments, he received 6 cycles of chemotherapy with docetaxel but had continuously rising PSA. His genomic analysis did not reveal any DNA repair defects. After performing 68Ga-PSMA-PETCT scan, he was started on 177-Lu-PSMA therapy. On receiving three cycles of Lu-177 DKFZ-PSMA-617, good clinical and biochemical response was obtained. However, on further PSA rise he was started on actinium 225-PSMA therapy. Till date three cycles of Actinium-225 PSMA therapy has been given and 68Ga-PSMA-PETCT scan demonstrated good partial response at metastatic sites with corresponding decrease in sPSA levels. The patient is now on follow up and receiving zoledronic acid at 3 months interval and is presently asymptomatic at the time of last follow up. Conclusion: PSMA directed radionuclide therapy is a promising treatment option in patients of mCRPC refractory to docetaxel therapy yielding excellent and durable biochemical control.

【 授权许可】

Unknown