177Lu-NY108

The study aims to evaluate the radiation safety conditions by detecting the patient's urine excretion rate, calculating the effective half-life, and determining the retention of 177Lu-PSMA in the body. Urine samples of patients were collected for 24 hours (6, 12, 18, and 24 hours) following the infusion, excretion rate and retention of 177Lu-PSMA in the body of patients were calculated. The measurements of dose rate were performed. Effective half-life calculated from dose rate measurements was found as 18.5 ± 11 h within the first 24 h and 48.1 ± 22.8 h between 24 and 72 h. Excreted activity in urine was found as 33.8 ± 20.7, 40.4 ± 20.3, 46.1 ± 22.4, and 53.3 ± 21.5% of total doses at 6, 12, 18, and 24 h after administration, respectively. External dose rates for 4 h and 24 h were 24.51 μSv/h, 16.14 μSv/h, respectively. Our results showed that 177Lu-PSMA treatment was suitable for outpatient treatment in terms of radiation safety.

Few life-prolonging treatment options are available for patients with metastatic castration-resistant prostate cancer (mCRPC). This article provides an overview of the current systemic treatments available for mCRPC and reviews studies that investigate the optimal timing for the use of radium-223. The aim is to illustrate possible systemic treatment sequences to maximize benefit from radium-223 therapy.

Prostate cancer is called mCRPC when it spreads to organs outside of the prostate (such as the lymph nodes, bones, liver, or lungs) and no longer responds to hormonal therapy. There are several treatment options available for mCRPC, such as abiraterone, enzalutamide, radium-223, docetaxel, cabazitaxel, olaparib, rucaparib, sipuleucel-T, and 177Lu-PSMA. It is important to understand the risks and benefits associated with each treatment and whether current use may have an impact on future treatment options, including eligibility in certain clinical trials. Maintaining bone health is also an important part of prostate cancer care.

Radium-223 is a radioactive molecule that releases strong radiation within a very small range around itself. It mainly travels to the bone where the prostate cancer has spread and kills the cancer cells in that area. Results from a clinical study named ALSYMPCA showed that men who received radium-223 lived longer in addition to having less bone pain. The most common side effects of radium-223 are nausea, vomiting, and diarrhea. Radium-223 minimally suppresses the bone marrow, which means that it slightly reduces the levels of red and white blood cells.