memo - Magazine of European Medical Oncology

, Volume 11, Issue 4, pp 301–304 | Cite as

Lutetium-PSMA therapy—a new therapeutic option in metastatic castration-resistant prostate cancer?

  • Michael Ladurner
  • Wolfgang Horninger
  • Jasmin Bektic
short review


Although localized prostate cancer (PC) is a curable disease, a significant proportion of patients progress from advanced PC to metastatic castration-resistant prostate cancer (mCRPC). Several new treatments for mCRPC were approved including new hormonal therapies, chemotherapies, and radium-223. For patients with disease progression after the standard therapies, lutetium-prostate-specific membrane antigen (Lu-PSMA) therapy could be an option.

The aim of this short review is to give an overview of the available evidence of the efficacy and toxicity of Lu-PSMA therapy. To date, one prospective phase II trial and several small retrospective studies have been published including almost 400 patients. Primary endpoint of all available trials was a decline in PSA of >50%, which was achieved in 30–70% of men treated with Lu-PSMA therapy. A PSA decline was observed in 70–91% of cases. Overall survival was reported only in small retrospective subgroups, and no prospective data are available. Progressive disease was observed in 11–32% of patients after Lu-PSMA treatment.

Lu-PSMA treatment seems to be well tolerated and safe. One common treatment-related grade 1 adverse event is dry mouth in up to 87% of men after radioligand therapy (RLT). Therefore, in the vast majority no treatment is needed. Hematologic toxicity such as thrombocytopenia caused serious grade 3–4 adverse events in 27% of patients in the prospective trial. No immediate adverse events after radioligand infusion and no treatment-related deaths were reported.

According to preliminary data, Lu-PSMA therapy seems to be well tolerated and safe for progressive end-stage mCRPC patients. Further prospective trials are needed.


Prostate cancer Lutetium PSMA Radioligand therapy mCRPC 


Conflict of interest

M. Ladurner, W. Horninger, and J. Bektic declare that they have no competing interests.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyMedical University of InnsbruckInnsbruckAustria

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