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

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.

Clinical nuclear medicine. 2021 Oct 12 [Epub ahead of print]

Sharjeel Usmani, Fareeda Al Kandari, Ibrahim Alrekhais, Shatha N Khalaf, Najeeb Ahmed

From the Department of Nuclear Medicine, Kuwait Cancer Control Center (KCCC) Jack Brignall PET/CT Centre, Castle Hill Hospital, Cottingham, United Kingdom.

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