Rechallenge With 177Lu-PSMA Radioligand Therapy in Metastatic Castration-resistant and Hormone-sensitive Prostate...

Area of Science:

• Oncology
• Nuclear Medicine
• Radiopharmaceutical Therapy

Background:

• Metastatic prostate cancer, including hormone-sensitive (mHSPC) and castration-resistant (mCRPC) forms, presents significant treatment challenges.
• 177Lu-PSMA-617 radioligand therapy (RLT) has emerged as a promising treatment modality for advanced prostate cancer.

Purpose of the Study:

• To evaluate the efficacy and safety of 177Lu-PSMA-617 RLT in patients with metastatic prostate cancer.
• To assess the feasibility and outcomes of RLT rechallenge in patients who progressed after initial treatment.

Main Methods:

• Retrospective case series of 4 patients with mHSPC or mCRPC treated with 177Lu-PSMA-617 RLT.
• Patients received initial RLT, and some were retreated upon disease progression.

Main Results:

• Initial RLT resulted in significant prostate-specific antigen (PSA) declines, pain relief, and radiographic responses.
• Rechallenge with 177Lu-PSMA-617 led to further PSA reductions, sustained symptom improvement, and favorable safety.
• No grade III-IV hematologic or renal toxicities were observed during rechallenge.

Conclusions:

• 177Lu-PSMA-617 RLT is effective in both mHSPC and mCRPC settings.
• RLT rechallenge is feasible and effective, even after prior progression, supporting its dynamic application across disease stages.