First-Line [177Lu]Lu-PSMA-617 Therapy Without ADT, Chemotherapy, or Local Therapy for Metastatic Hormone-Sensitive Prostate Cancer

TL;DR

A prostate cancer patient avoided traditional therapies and used [177Lu]Lu-PSMA-617 as first-line treatment, showing a strong response in both primary and metastatic tumors.

Contribution

Demonstrates the potential of [177Lu]Lu-PSMA-617 as a first-line therapy without ADT or chemotherapy in metastatic hormone-sensitive prostate cancer.

Findings

The patient showed a significant response in the primary tumor after two doses of [177Lu]Lu-PSMA-617.

Metastatic foci also responded positively to the treatment.

The treatment was effective without using androgen deprivation therapy or chemotherapy.

Abstract

The treatment of metastatic prostate cancer relies on the use of androgen deprivation therapy, which is associated with many side effects, including adverse cardiovascular outcomes. 177Lu-vipivotide tetraxetan ([177Lu]Lu-PSMA-617) is used in the treatment of prostate-specific membrane antigen–expressing metastatic castration-resistant prostate adenocarcinoma. We present the case of a patient with prostate cancer with numerous metastatic lesions who declined androgen deprivation therapy, chemotherapy, and local therapy to the prostate gland and instead received first-line systemic [177Lu]Lu-PSMA-617. He exhibited a significant response in both the primary cancer and its metastatic foci after 2 doses of the treatment.

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