title: [PSMA-targeted radioligand therapy in prostate cancer].
abstract: Radioligand therapy (RLT) directed against prostate-specific membrane antigen (PSMA) enables tumor-specific treatment directed against PSMA-overexpressing prostate cancer cells. Several PSMA ligands such as PSMA-617 or PSMA-I&T have been developed that can be labeled with β‑radiating lutetium-177. These are currently applied in compassionate use programs to treat metastatic castration-resistant prostate cancer (mCRPC). PSMA-directed RLT is currently being offered in several nuclear medicine departments throughout Germany. Several retrospective case series demonstrate its activity with a prostate-specific antigen (PSA) decrease >50% in 30-60% of mCRPC patients. The toxicity seems to be low. Hematologic grade 4 toxicity has not been observed and grade 3 toxicities rarely occur. The main nonhematologic adverse events are intermittent dry mouth because of unspecific PSMA expression in the salivary glands as well as fatigue and nausea. Currently there are no prospective studies available for evaluation of PSMA-targeted RLT and a survival benefit over approved standard therapies such as abiraterone, enzalutamide, radium-223-dichloride, docetaxel or cabazitaxel has not been shown. PSMA-targeted RLT should therefore currently only be offered after critical evaluation in patients who exhausted the approved standard therapies.
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland. matthias.heck@tum.de.
authors.forename: M M
authors.initials: MM
authors.lastname: Heck
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Retz
authors.affiliation: Klinik und Poliklinik für Urologie, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Tauber
authors.affiliation: Institut für Nuklearmedizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Knorr
authors.affiliation: Radiologische Klinik und Poliklinik, Abteilung Nuklearmedizin, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Deutschland.
authors.forename: C
authors.initials: C
authors.lastname: Kratochwil
authors.affiliation: Institut für Nuklearmedizin, Klinikum rechts der Isar, Technische Universität München, Ismaninger Straße 22, 81675, München, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Eiber
mesh_terms: D000954:Antigens, Surface / Q000378:metabolism*; D004151:Dipeptides / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D043425:Glutamate Carboxypeptidase II / Q000378:metabolism*; D006573:Heterocyclic Compounds, 1-Ring / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D006801:Humans; D007553:Isotope Labeling / Q000379:methods; D008187:Lutetium / Q000493:pharmacokinetics / Q000627:therapeutic use*; D008297:Male; D058990:Molecular Targeted Therapy / Q000379:methods; D017430:Prostate-Specific Antigen; D011471:Prostatic Neoplasms / Q000378:metabolism* / Q000532:radiotherapy*; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics / Q000627:therapeutic use; D011878:Radiotherapy / Q000379:methods; D016896:Treatment Outcome
chemical_list: C000610110:Pluvicto; D000954:Antigens, Surface; D004151:Dipeptides; D006573:Heterocyclic Compounds, 1-Ring; C000602389:PSMA-617; D019275:Radiopharmaceuticals; D008187:Lutetium; C473848:FOLH1 protein, human; D043425:Glutamate Carboxypeptidase II; D017430:Prostate-Specific Antigen
keywords: Hormone therapy; Metastasis; Radioligand therapy; Radiotherapy; Systemic therapy