Prostate Cancer With Neuroendocrine Differentiation Recurring After Treatment With 177Lu-PSMA: A Chance for 177Lu-DOTATATE Therapy?

Prostate cancer with NED (neuroendocrine differentiation) may occur in various stages of the disease, which is associated with a poor prognosis and treatment resistance. We present a case of a patient with metastatic castration-resistant prostatic cancer, who was treated with 7 cycles of 177Lu-PSMA...

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Bibliographic Details
Published inClinical nuclear medicine Vol. 46; no. 9; p. e480
Main Authors Nesari Javan, Farnaz, Aryana, Kamran, Askari, Emran
Format Journal Article
LanguageEnglish
Published United States 01.09.2021
Subjects
Aged
Dipeptides
Heterocyclic Compounds, 1-Ring
Humans
Male
Neoplasm Recurrence, Local
Octreotide - analogs & derivatives
Organometallic Compounds
Prostatic Neoplasms, Castration-Resistant - diagnostic imaging
Prostatic Neoplasms, Castration-Resistant - radiotherapy
Radiopharmaceuticals
Treatment Outcome
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Summary:Prostate cancer with NED (neuroendocrine differentiation) may occur in various stages of the disease, which is associated with a poor prognosis and treatment resistance. We present a case of a patient with metastatic castration-resistant prostatic cancer, who was treated with 7 cycles of 177Lu-PSMA and a very good response. Although only few foci with PSMA uptake were remained in the last posttreatment images, PSA levels dramatically began to rise. This raised suspicion for NED, and 68Ga-DOTATATE was done showing sufficient uptake to consider a trial of 177Lu-DOTATATE. The patient reported pain response, and PSA levels dropped after 1 cycle of the treatment.
ISSN:1536-0229
DOI:10.1097/RLU.0000000000003685