ABSTRACT
ABSTRACT: A 52-year-old woman with metastatic pancreatic adenocarcinoma underwent imaging with 18F-FDG PET/CT and 68Ga-FAPI-46 PET/CT, which demonstrated malignancy recurrence in the surgical bed with multiple metastatic lesions, more extensive on 68Ga-FAPI-46 PET/CT. The patient was a candidate for therapy with 177Lu-FAPI-46 due to high uptake of lesions in 68Ga-FAPI-46 images and no other available therapeutic option. Posttreatment 177Lu-FAPI-46 scans showed rather rapid washout of the radiopharmaceutical from tumoral lesions. This case report suggests that, although 68Ga-FAPI-46 is a promising agent for tumor imaging, 177Lu-FAPI-46 may not be an optimal compound for theranostic applications.
Subject(s)
Adenocarcinoma , Pancreatic Neoplasms , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/radiotherapy , Female , Fluorodeoxyglucose F18 , Humans , Middle Aged , Neoplasm Recurrence, Local , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/radiotherapy , Positron Emission Tomography Computed TomographyABSTRACT
Prostate-specific membrane antigen (PSMA) is a transmembrane protein that is highly expressed on the surface of prostate cancer (PC) cells, making it an excellent radiotracer for both therapeutic and diagnostic purposes. In this prospective study, we investigated the efficacy and toxicity of 177Lutetium (Lu)-PSMA in metastatic castration-resistant PC (mCRPC) patients for the establishment and approval of this therapy in Iran. Fourteen mCRPC patients (mean age 70.57 ± 7.3 years) were treated with a single dose of 177Lu-PSMA. Complete blood count, liver function tests (aspartate aminotransferase and alanine aminotransferase), alkaline phosphatase levels, renal function tests (urea and creatinine), and prostate-specific antigen (PSA) levels were obtained for the patients at baseline and every 2 weeks. A majority of the patients (11 patients, 64.2%) experienced a decline in their PSA levels; in 5 (45.4%) of these patients, the PSA levels declined > 50%.The severity of pain decreased in 8 (57.1%) patients, and performance status was improved in 5 (45.4%) patients. The treatment was well tolerated, and no severe hematological or nonhematological side effects were observed. Our findings show that 177Lu-PSMA had a high efficacy and a low toxicity in an Iranian population and is a promising treatment option for PC patients.
ABSTRACT
A 68-year-old man with metastatic castration-resistant prostate cancer and widespread bone metastases as well as a history of kidney transplant, underwent 5 cycles of Lu-prostate-specific membrane antigen 617 therapies in our department. Being more cautious of the radiation burden imposed on the transplanted kidney, a lower average dose of 4 GBq per cycle was administered (instead of the more routine 6.0-7.4 GBq per cycle). However, excellent response was noted and serum creatinine level of 0.8 mg/dL remained stable.
