Andrei Gafita, MD, Department of Nuclear Medicine, Klinikum Rechts der Isar, Technical University Munich in Germany, discusses sequencing lutetium-177 PSMA-617 (¹⁷⁷Lu-PSMA-617) in metastatic castration-resistant prostate cancer (mCRPC).

Typically, men with prostate cancer are given androgen deprivation therapy (ADT) as initial treatment, says Gafita. However, the majority of patients will eventually progress on ADT.

In mCRPC, patients will likely receive chemotherapy such as docetaxel, anti-androgen agents such as abiraterone acetate (Zytiga) or enzalutamide (Xtandi), or radium-223 dichloride (Xofigo), says Gafita. Additionally, PARP inhibitors have also become available for patients with mCRPC who harbor homologous recombination repair gene mutations.

Despite this, many patients exhaust all available treatment modalities, says Gafita. As such, ¹⁷⁷Lu-PSMA-617 may have utility in patients who have progressed on all conventional therapeutic options.