An Update to the Pilot Study of 177Lu-PSMA in Low Volume Hormone-Sensitive Prostate Cancer

Bastiaan M Privé; Constantijn H J Muselaers; Inge M van Oort; Marcel J R Janssen; Steffie M B Peters; Willemijn A M van Gemert; Maike J M Uijen; Melline M G Schilham; J P Michiel Sedelaar; Harm Westdorp; Niven Mehra; Martin Gotthardt; Jelle O Barentsz; Winald R Gerritsen; J Alfred Witjes; James Nagarajah

doi:10.3389/fnume.2022.863101

An Update to the Pilot Study of ¹⁷⁷Lu-PSMA in Low Volume Hormone-Sensitive Prostate Cancer

Front Nucl Med. 2022 May 3:2:863101. doi: 10.3389/fnume.2022.863101. eCollection 2022.

Authors

Bastiaan M Privé¹, Constantijn H J Muselaers², Inge M van Oort², Marcel J R Janssen¹, Steffie M B Peters¹, Willemijn A M van Gemert¹, Maike J M Uijen¹, Melline M G Schilham¹, J P Michiel Sedelaar², Harm Westdorp³, Niven Mehra³, Martin Gotthardt¹, Jelle O Barentsz¹, Winald R Gerritsen³, J Alfred Witjes², James Nagarajah¹

Affiliations

¹ Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, Netherlands.
² Department of Urology, Radboudumc, Nijmegen, Netherlands.
³ Department of Medical Oncology, Radboudumc, Nijmegen, Netherlands.

Abstract

¹⁷⁷Lu-PSMA-617 radioligand therapy is a novel treatment for end-stage prostate cancer, which could also be applied to patients with hormone-sensitive prostate cancer with high expression levels of prostate-specific membrane antigen (PSMA). In this perspective, we review the recent results of toxicity, radiation doses, and treatment effect of ¹⁷⁷Lu-PSMA in patients with low volume metastatic hormone-sensitive prostate cancer. Moreover, we present long-term follow-up data, such as toxicity and time without androgen deprivation therapy (ADT), of the patients who participated in this trial. Overall, ¹⁷⁷Lu-PSMA appeared to be a feasible and safe treatment modality in this setting, as well as in long-term follow-up. We observed that men with a prostate-specific antigen (PSA) response of more than 50% seemed to especially benefit from this therapy by postponing ADT and thus preserving the quality of life.

Keywords: hormone sensitive; lutetium-177-PSMA-617; metastases-directed therapies; prostate cancer; radioligand therapy; urologic oncology.