Radioligand therapy with 177Lu-PSMA in castration-resistant prostate cancer: a literature review and case series

Overexpression and ligand-dependent internalization of prostate-specific membrane antigen (PSMA), followed by its accumulation in prostate cancer (PCa) cells, make this glycoprotein a good target for radionuclide-based targeted therapy. Currently, the only drug in this group with efficacy proven in a large randomized clinical study in patients with metastatic castration-resistant PCa is 177Lu-PSMA-617. The article presents an overview of the data on the mechanism of action and the results of completed studies of radioligand therapy (RLT) with 177Lu-PSMA for PCa, the current indications for this type of treatment in patients with a castration-resistant phase of the disease, and practical guidelines for RLT, including its planning, implementation, monitoring of effectiveness, and radiation protection measures. Clinical cases of patients with partial response/stabilization of the disease during RLT, significant improvement/complete response, and progression of PCa are presented.