Lutetium-177-PSMA therapy for prostate cancer patients—a brief overview of the literature

Abstract

AbstractRadioligand therapy with lutetium-177 prostate specific membrane antigen ([177Lu]Lu-PSMA) represents a promising treatment for metastatic castration-resistant prostate cancer patients. In this paper, we aim to summarize the current knowledge derived from the literature as well as the authors’ experiences on [177Lu]Lu-PSMA therapy. Various systematic reviews, mostly including small retrospective studies, summarized efficacy and oncological outcomes of [177Lu]Lu-PSMA therapy. Any therapy-related prostate-specific antigen (PSA) response was reported in the majority of the patients (68–75%); >50% PSA decline was demonstrated in 34.5–51% of the patients. Incidence of side effects was low and in most patients, hematological toxicity remained limited to Common Terminology Criteria for Adverse Events (CTCAE) grade 1–2. Also, favorable efficacy was shown with regard to tumor response on imaging, pain symptoms and quality of life. In the near future, results of the awaited pivotal prospective studies (NCT03511664, NCT03392428) will define efficacy of [177Lu]Lu-PSMA therapy and its oncological value for metastatic castration-resistant prostate cancer patients.