Treatment of brain metastases of castration-resistant prostate cancer with ²²⁵Ac-PSMA-617

Excerpt

Brain metastases are not common in prostate cancer; they typically occur in patients with end-stage disease who are castrate-resistant. Patients with brain metastases have very limited survival [1]. Traditionally, the mainstays of therapy have been surgical resection, chemotherapy and external beam radiotherapy. Recently, combination of ¹⁷⁷Lu-Prostate-specific membrane antigen (PSMA)-617 and external radiotherapy for the treatment of cerebral metastases in patients with castration-resistant metastatic prostate cancer (mCRPC) showed significant regression in the sizes and PSMA-ligand avidity of the lesions over time [2]. Recent studies have demonstrated that targeted α-radiation therapy with ²²⁵Ac-PSMA-ligand can significantly benefit patients with mCRPC in the appropriate setting [3, 4]. Targeted α-radiation therapy may be more effective for the treatment of mCRPC, and has been shown, in a limited number of patients, to be effective in the setting of resistant to ¹⁷⁷Lu-PSMA-617 therapy [5]. …