Liver Enzyme Elevation After 177Lu-PSMA Radioligand Therapy for Metastasized Castration-Resistant Prostate Cancer

J Nucl Med. 2021 Jul 1;62(7):1016-1019. doi: 10.2967/jnumed.120.258533. Epub 2021 May 14.

Abstract

177Lu-PSMA radioligand therapy is a promising new option for patients with metastasized castration-resistant prostate cancer, and the spectrum of adverse events with this treatment has to be evaluated. Here, we describe the case of a patient with M1c disease (metastasis to the mediastinum, lungs, bones, and liver) who presented with elevated liver enzyme levels after receiving 177Lu-PSMA radioligand therapy for castration-resistant prostate cancer. Pretreatment 68Ga-PSMA PET/CT showed at least 4 liver lesions with low uptake. Overall, the liver uptake was inhomogeneous. Liver biopsy was performed subsequently.

Keywords: 177Lu-PSMA RLT; PSMA radioligand therapy; genitourinary oncology; mCRPC; prostate cancer; radionuclide therapy.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Dipeptides / therapeutic use
  • Humans
  • Ligands
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / radiotherapy
  • Liver Neoplasms / secondary
  • Liver* / diagnostic imaging
  • Lutetium* / therapeutic use
  • Male
  • Neoplasm Metastasis
  • Positron Emission Tomography Computed Tomography
  • Prostate-Specific Antigen
  • Prostatic Neoplasms, Castration-Resistant* / pathology
  • Prostatic Neoplasms, Castration-Resistant* / radiotherapy
  • Radioisotopes / therapeutic use
  • Radiopharmaceuticals / therapeutic use

Substances

  • Lutetium
  • Pluvicto
  • Radioisotopes
  • Ligands
  • Dipeptides
  • Radiopharmaceuticals
  • Lutetium-177
  • Prostate-Specific Antigen