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Pretargeted Radioimmunotherapy Based on the Inverse Electron Demand Diels-Alder Reaction

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Published on: January 29, 2019

Neurologic Symptoms After ¹⁷⁷Lu-Prostate-Specific-Membrane Antigen-617 Therapy: A Single-Center Experience.

Gokce Belge Bilgin¹, Brian J Burkett², Cem Bilgin²

¹Department of Radiology, Mayo Clinic, Rochester, Minnesota; belgebilgin.gokce@mayo.edu.

Journal of Nuclear Medicine : Official Publication, Society of Nuclear Medicine

|August 1, 2024

Summary

Lutetium-177 PSMA-617 (¹⁷⁷Lu-PSMA-617) therapy is effective for advanced prostate cancer. Neurologic side effects like altered taste and dizziness are most common, but severe issues requiring treatment cessation are rare.

Keywords:

177Lu-PSMA-617 neurologic findings prostate cancer radionuclide therapy theranostics

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Area of Science:

Oncology
Radiopharmaceuticals
Nuclear Medicine

Background:

¹⁷⁷Lu-prostate-specific membrane antigen (PSMA)-617 (¹⁷⁷Lu-vipivotide tetraxetan [Pluvicto]) offers survival benefits in metastatic castration-resistant prostate cancer (mCRPC).
Limited data exist on neurologic symptoms following ¹⁷⁷Lu-PSMA-617 treatment.

Purpose of the Study:

To investigate the incidence and nature of neurologic symptoms in mCRPC patients treated with ¹⁷⁷Lu-PSMA-617.
To assess the impact of these symptoms on treatment continuation.

Main Methods:

Retrospective review of clinical records and imaging for 185 mCRPC patients treated between March 2022 and November 2022.
Inclusion criteria: patients with new or worsening neurologic symptoms during follow-up.

Main Results:

27% of patients (50/185) experienced new or worsening neurologic symptoms.
Most common symptoms: dysgeusia (altered taste) in 11.9% and dizziness in 6%.
Severe neurologic events were rare; no patients discontinued therapy due to these symptoms.

Conclusions:

Dysgeusia and dizziness are the most frequent neurologic side effects of ¹⁷⁷Lu-PSMA-617 therapy.
Severe neurologic complications are uncommon and unlikely to necessitate treatment discontinuation in patients without pre-existing CNS metastases.