Lutetium-177 PSMA for the treatment of metastatic castrate resistant prostate cancer: a systematic review.

Metastatic castrate resistant prostate cancer (mCPRC) remains an aggressive form of prostate cancer that no longer responds to traditional hormonal treatment alone. Despite the advent of novel anti-androgen medications, many patients continue to progress and as a result, there is a growing need for additional treatment options.

Lutetium-177 (177Lu)-PSMA-617 has become one of the new frontline treatment options for refractory metastatic castrate resistant prostate cancer after failure of novel anti-androgen therapy. Lu-177 has been used in real world prospective trials and is now becoming utilized in newer phase III clinical trials. Here, we present a comprehensive overview of the current literature, covering retrospective studies, prospective studies, and clinical trials that established Lutetium-177-PSMA-617 (177Lu-PSMA-617) for the treatment of mCRPC.

177Lu-PSMA-617 has been approved for treatment of mCRPC based on positive phase III studies. While this treatment is tolerable and effective, biomarkers are necessary to determine which patients will benefit. In the future, radioligand treatments will likely be utilized in earlier lines of therapy and potentially in combination with other prostate cancer treatments.

Expert review of anticancer therapy. 2023 May 16 [Epub ahead of print]

Kanchi Patell, Matthew Kurian, Jorge A Garcia, Prateek Mendiratta, Pedro C Barata, Angela Jia, Daniel E Spratt, Jason R Brown

University Hospitals Seidman Cancer Center, Cleveland, OH, USA.