Abstract:
Prostate-specific membrane antigen radioligand therapy
(PSMA-RLT) with 177Lu-PSMA holds great promise as a
safe treatment option in patients with metastasized
castration-resistant prostate cancer (mCRPC) with appropriate
selection. This approach, together with 68Ga-PSMA PET/CT, is an excellent example of theranostic
nuclear medicine. However, more structured data have
recently shown that despite a marked response to PSMARLT,
some patients are refractory to 177Lu-radioligand
therapy. Fortunately recent studies have demonstrated
that targeted α-radiation therapy with 225Ac-PSMA can
significantly benefit mCRPC patients. Similarly, 213Bi-DOTATOC may be able to break the radioresistance to β-emitters while simultaneously reducing haematological
toxicity in patients with diffuse red marrow infiltration
by neuroendocrine tumour.
