Nucl Med Mol Imaging.  2021 Jun;55(3):136-140. 10.1007/s13139-021-00696-5.

The Outcome and Safety of Re-challenge Lutetium-177 PSMA (¹⁷⁷Lu-PSMA) Therapy with Low-Dose Docetaxel as a Radiosensitizer—a Promising Combination in Metastatic Castrate-Resistant Prostate Cancer (mCRPC): a Case Report

• Maharaj M
• Heslop L
• Govender T
• Korowlay N
• Singh A
• Choudhary P
• Sathekge M

• KMID: 2516692
• DOI: http://doi.org/10.1007/s13139-021-00696-5

Abstract

Prostate-specific membrane antigen (PSMA)-directed radioligand therapy (PSMA-RLT) with lutetium-177 ( ¹⁷⁷Lu-PSMA) has been used in metastatic castrate-resistant prostate cancer (mCRPC), and retrospective data have shown this therapy to be favourably safe with attractive clinical responses. Re-challenge ¹⁷⁷Lu-PSMA therapy in early responders has been shown to be safe and effective. We report the use of low-dose Taxol-based chemotherapy (modified dose 25 mg/m 2 weekly × 6 weeks) as a radiosensitizer with re-challenge ¹⁷⁷Lu-PSMA therapy (4 cycles). In a period of 3 years, the patient underwent a total of 8 cycles of ¹⁷⁷Lu-PSMA with a cumulative dose of 51.8 GBq. All therapies were uneventful and well tolerated. There was a good response to re-challenge ¹⁷⁷Lu-PSMA therapy and low-dose docetaxel (Taxol- ¹⁷⁷Lu-PSMA) with no recorded tumour resistance.

Keyword

¹⁷⁷Lu; PSMA; Prostate cancer; Docetaxel; Radiosensitizer; Re-challenge