Excellent Response to Adapted Low-Dose 177Lu-PSMA-617 PSMA Therapy in Renal Compromise Patient.

Usmani, Sharjeel; Al Kandari, Fareeda; Alrekhais, Ibrahim; N Khalaf, Shatha; Ahmed, Najeeb · Clin Nucl Med · 2022

case_report · Level V

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Abstract

Prostate-specific membrane antigen (PSMA)-targeted radioligand therapy with 177Lu-PSMA-617 has shown promising results in patients with metastasized castration-resistant prostate cancer. We report a case of a 74-year-old man with metastatic prostate cancer with comorbidities of diabetes mellitus, hypertension, and chronic kidney disease. In order to minimize radiation burden to kidneys, a lower dose of 4 GBq of 177Lu-PSMA-617 was prescribed instead of the usual 6 to 7 GBq. There was significant decrease in prostate-specific antigen levels and symptoms. Renal profile remained stable. This case highlights that compromised renal function is not a definite contraindication to radionuclide therapy, and doses can be modified based on risk versus benefits.

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