Dramatic cessation of gross sustained treatment resistant hematuria after [۱۷۷Lu]Lu-PSMA-۶۱۷ therapy: A case report

We report a patient with locally invasive metastatic castration resistant prostate adenocarcinoma, which had massive invasion to the bladder and caused frequent gross hematuria. The patient had received more than ۱۰ units of packed cell at the time he was referred for [۱۷۷Lu]Lu-PSMA-۶۱۷ therapy, but despite frequent transfusions his serum hemoglobin level had been under ۸ g/dl most of the time. He had received first generation androgen deprivation therapy (ADT) from ۳ years previously and the second generation since ۱ year ago and had undergone multiple procedures for cessation of hematuria, such as multiple cystoscopies, bladder irrigations and angioembolizations. We performed [۹۹mTc]Tc-PSMA whole body and SPECT/CT scan, which demonstrated a large PSMA avid prostate mass invading the urinary bladder wall. All components of the locally invasive tumor were present demonstrating high PSMA avidity, so he was scheduled for [۱۷۷Lu]Lu-PSMA-۶۱۷ therapy. One week after the diagnostic scan, therapeutic dose of [۱۷۷Lu]Lu-PSMA-۶۱۷ was administered. The patient reported no hematuria ۴ days after the [۱۷۷Lu]Lu-PSMA-۶۱۷ administration. In the follow up, no recurrent hematuria was reported, too. The PSA level also declined from ۴۰.۵ ng/ml to ۱۸.۷ ng/ml, ۱ month after the first treatment.

کلیدواژه ها:

Castration resistant prostate adenocarcinoma ، Androgen deprivation therapy ، Hematuria ، [۱۷۷Lu]Lu-PSMA-۶۱۷