ABSTRACT
On March 23, 2022, the U.S. Food and Drug Administration (FDA) approved Pluvicto (lutetium Lu 177 vipivotide tetraxetan), also known as 177Lu-PSMA-617, for the treatment of adult patients with metastatic castration-resistant prostate cancer (mCRPC) who have highly expressed prostate-specific membrane antigen (PSMA) and have at least one metastatic lesion. It is the first FDA-approved targeted radioligand therapy for eligible men with PSMA-positive mCRPC. Lutetium Lu 177 vipivotide tetraxetan is a radioligand that strongly binds to PSMA, making it ideal for treating cancers of the prostate by targeted radiation, resulting in DNA damage and cell death. PSMA is overexpressed in cancer cells while being lowly expressed in normal tissues, which makes it an ideal theranostic target. As precision medicine advances, this is a thrilling turning point for highly individualized treatments. This review aims to summarize the pharmacology and clinical studies of the novel drug lutetium Lu 177 vipivotide tetraxetan for the treatment of mCRPC, emphasizing its mechanism of action, pharmacokinetics and safety.
Subject(s)
Lutetium , Prostatic Neoplasms, Castration-Resistant , Male , Humans , Lutetium/adverse effects , Prostatic Neoplasms, Castration-Resistant/drug therapy , Prostate-Specific Antigen/therapeutic use , Treatment OutcomeABSTRACT
Background: As there are comparative studies between 68Ga-PSMA and 99mTc-PSMA and spectrum of PSMA expression, this is the first case report that notifies distribution of 99mTc-PSMA on COVID-19 pneumonia era on the literature. Case presentation An asymptomatic 70-Y-old male who is known case of prostate adenocarcinoma underwent initial staging. SPECT/CT of the chest region reveals bilateral peripheral multifocal ground glass opacities which shows 99mTc-PSMA uptake. Diagnosis of corona virus was confirmed by positive RT-PCR. Discussion: Unexclusive role of radiotracers in nuclear medicine has an importance for wide range of applications. Comparison between 68Ga-PSMA and 99mTc-PSMA in detection of metastatic disease in prostate cancer is also under evaluation. Conclusions: This case implicates possible role of PSMA imaging in inflammation/infection process as well as necessity for lung review in hybrid imaging especially during this recent pandemic.
ABSTRACT
The COVID-19 pandemic has now reached most countries. However, the referred patients to a nuclear medicine department will be primarily the asymptomatic ones. We report the case of a patient (84-year-old male) who was sent for18F-prostate-specific membrane antigen positron emission tomography computed tomography (PSMA PET-CT) with suspicion of recurrent disease after prostate cancer and total prostatectomy 2 years prior to the examination. He suffered from COVID-19 pneumonia 4 weeks prior to PET-CT examination. The18F-PSMA PET-CT revealed moderate elevated uptake in the area of previous pneumonia in the right lung. The radiological findings showed ground glass changes in this area indicating possible residual inflammatory disease even weeks after infection.