lutetium-lu-177-dotatate and Prostatic-Neoplasms--Castration-Resistant

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.

Topics: Aged; Dipeptides; Heterocyclic Compounds, 1-Ring; Humans; Male; Neoplasm Recurrence, Local; Octreotide; Organometallic Compounds; Prostatic Neoplasms, Castration-Resistant; Radiopharmaceuticals; Treatment Outcome

Prostate cancer with neuroendocrine differentiation is associated with a poor prognosis, rapid disease progression, and treatment resistance, and constitutes a diagnostic and therapeutic dilemma. We present images of Lu-DOTATATE scan and Ga-DOTATATE PET/CT scan conducted on a 65-year-old man with prostate cancer with neuroendocrine differentiation, whose disease progressed despite conventional treatment and Lu-PSMA radioligand therapy; however, an extraordinary radiographic tumor remission, biochemical response, and improvement of clinical symptoms were observed after the patient underwent Lu-DOTATATE peptide receptor radionuclide therapy.

Topics: Aged; Dipeptides; Heterocyclic Compounds, 1-Ring; Humans; Lutetium; Male; Neuroendocrine Tumors; Octreotide; Organometallic Compounds; Positron Emission Tomography Computed Tomography; Prostate-Specific Antigen; Prostatic Neoplasms, Castration-Resistant; Receptors, Peptide; Treatment Outcome

We presented a promising result of radionuclide therapy using Lu-PSMA and Lu-DOTATATE in a patient with prostatic adenocarcinoma and neuroendocrine differentiation. Functional imaging of somatostatin receptors in patients with metastatic castration-resistant prostate cancer may pave the way toward implementation of novel radionuclide targets for the treatment of this aggressive subtype of prostate cancer.

Topics: Antigens, Surface; Carcinoma, Neuroendocrine; Glutamate Carboxypeptidase II; Humans; Male; Middle Aged; Neoplasm Metastasis; Octreotide; Organometallic Compounds; Prostatic Neoplasms, Castration-Resistant; Receptors, Somatostatin