Evaluating the response and side effects of [177Lu]Lu-PSMA therapy in mCRPC patients: A single-center experience from Iran

Articles in Press

Document Type : Original Article

Authors

1 Kidney Transplantation research center, Mashhad University of Medical Sciences, Mashhad, Iran

2 Department of Nuclear Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

3 Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran

4 Department of Nuclear Medicine, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

5 Nanotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran

10.22034/irjnm.2025.130185.1700

Abstract

Introduction: To evaluate clinical and laboratory findings in patients undergoing [177Lu]Lu-PSMA treatment for metastatic castration-resistant prostate cancer (mCRPC).
Methods: This cross-sectional study included mCRPC patients treated with [177Lu]Lu-PSMA. Patients underwent regular evaluations by a nuclear medicine specialist, with laboratory tests (CBC, serum PSA, creatinine, and liver functions) conducted before each treatment cycle and at 1-, 4-, and 8-weeks post-treatment. Treatment cycles were repeated every 8-10 weeks to assess response and side effects. Patients received [177Lu]Lu-PSMA intravenously, followed by a 6-hour monitoring period. A pre-designed checklist was used to collect demographic data, clinical manifestations (pain assessment via VAS), treatment complications, and laboratory parameters. The relationships among PSA level changes, age, and radiopharmaceutical dosage were analyzed, along with side effects related to blood cell counts and serum creatinine levels.
Results: This study evaluated the efficacy and safety of [177Lu]Lu-PSMA treatment in 133 metastatic castration-resistant prostate cancer (mCRPC) patients. PSA level decreases in 122 patients (92%), with 39 (29%) achieving a ≥50% reduction. Disease stabilization occurred in 79 patients (59%), while 34 patients (26%) experienced disease progression. Bone pain relief in 41% of 72 patients complaining of baseline pain. Hematological toxicity was observed mostly as grade 1 (67%) and as grade 2 (34%) of the patients. No renal or hepatic complications were observed.
Conclusion: The results suggest that [177Lu]Lu-PSMA treatment is effective in managing metastatic castration-resistant prostate cancer, with a favorable therapeutic response and limited side effects.

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References

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Iranian Journal of Nuclear Medicine

Articles in Press, Accepted Manuscript
Available Online from 27 December 2025

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