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

Affiliations
  • 1Department of Nuclear Medicine, Imaging and Therapy Centres of Excellence, Durban, KwaZulu Natal, South Africa
  • 2Durban Oncology Centre, West Ridge, Durban, South Africa
  • 3Division of Nuclear Medicine, Tygerberg Hospital, Stellenbosch University, Stellenbosch, South Africa
  • 4Theranostics Center for Molecular Radiotherapy and Molecular Imaging (PET/CT) ENETS Center of Excellence, Zentralklinik Bad Berka GmbH, Bad Berka, Germany
  • 5Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
  • 6Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

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
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