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The Outcome and Safety of Re-challenge Lutetium-177 PSMA (177Lu-PSMA) Therapy with Low-Dose Docetaxel as a Radiosensitizer—a Promising Combination in Metastatic Castrate-Resistant Prostate Cancer (mCRPC): a Case Report

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Abstract

Prostate-specific membrane antigen (PSMA)-directed radioligand therapy (PSMA-RLT) with lutetium-177 (177Lu-PSMA) has been used in metastatic castrate-resistant prostate cancer (mCRPC), and retrospective data have shown this therapy to be favourably safe with attractive clinical responses. Re-challenge 177Lu-PSMA therapy in early responders has been shown to be safe and effective. We report the use of low-dose Taxol-based chemotherapy (modified dose 25 mg/m2 weekly × 6 weeks) as a radiosensitizer with re-challenge 177Lu-PSMA therapy (4 cycles). In a period of 3 years, the patient underwent a total of 8 cycles of 177Lu-PSMA with a cumulative dose of 51.8 GBq. All therapies were uneventful and well tolerated. There was a good response to re-challenge 177Lu-PSMA therapy and low-dose docetaxel (Taxol-177Lu-PSMA) with no recorded tumour resistance.

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Authors and Affiliations

  1. Department of Nuclear Medicine, Imaging and Therapy Centres of Excellence, Durban, KwaZulu Natal, South Africa

    Masha Maharaj & Trisha Govender

  2. Durban Oncology Centre, West Ridge, Durban, South Africa

    Lucille Heslop

  3. Division of Nuclear Medicine, Tygerberg Hospital, Stellenbosch University, Stellenbosch, South Africa

    Nisaar Korowlay

  4. Theranostics Center for Molecular Radiotherapy and Molecular Imaging (PET/CT) ENETS Center of Excellence, Zentralklinik Bad Berka GmbH, Bad Berka, Germany

    Aviral Singh

  5. Department of Nuclear Medicine, Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India

    Partha Choudhary

  6. Department of Nuclear Medicine, University of Pretoria & Steve Biko Academic Hospital, Pretoria, South Africa

    Mike Sathekge

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  1. Masha Maharaj
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  2. Lucille Heslop
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  7. Mike Sathekge
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Correspondence to Masha Maharaj.

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Masha Maharaj, Lucille Heslop, Trisha Govender, Nisaar Korowlay, Aviral Singh, Partha Choudhary and Mike Sathekge declare no conflict of interest.

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Maharaj, M., Heslop, L., Govender, T. et al. The Outcome and Safety of Re-challenge Lutetium-177 PSMA (177Lu-PSMA) Therapy with Low-Dose Docetaxel as a Radiosensitizer—a Promising Combination in Metastatic Castrate-Resistant Prostate Cancer (mCRPC): a Case Report. Nucl Med Mol Imaging 55, 136–140 (2021). https://doi.org/10.1007/s13139-021-00696-5

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