Upfront 177 Lu-PSMA Radioligand Therapy With Concurrent Androgen-deprivation Therapy Producing Dramatic Clinical and Biochemical Response : A Case Report.
Haniye Elahifard, Amin Saber Tanha, Salman Soltani et al.
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Case in brief
A 72-year-old man presented with severe weight loss, anemia, and a PSA of 73 ng/mL. Bone scintigraphy and 99m Tc-PSMA imaging showed extensive skeletal metastases. In a clinical trial, he received upfront 177 Lu-PSMA radioligand therapy alongside androgen-deprivation therapy. After the second cycle, imaging showed complete resolution of PSMA-avid lesions, and PSA had fallen by 99% to <0.4 ng/mL. Radioligand therapy was stopped after this molecular and biochemical response. At 8 months of follow-up, his disease remained controlled.
What made this case unusual
The report describes upfront 177 Lu-PSMA therapy given concurrently with ADT in hormone-sensitive metastatic disease, with complete imaging response and a marked PSA decline after the second cycle.
Diagnostic / clinical pearl
In this case, serial PSMA imaging and PSA assessment documented a complete molecular and biochemical response, informing discontinuation of radioligand therapy.
Why it matters
The case illustrates the potential value of early 177 Lu-PSMA integration in hormone-sensitive metastatic prostate cancer, while a single case cannot establish broader efficacy.