Terbium-161 PSMA Therapy in mCRPC Patient Based on an Optimized Radiolabeling Protocol

Abstract

This study presents a novel radiolabeling technique for [161Tb]-PSMA-617 in metastatic castration-resistant prostate cancer (mCRPC). The research focused on assessing the radiochemical yield, in vivo stability, and pharmacokinetics of [116 Tb]-PSMA-617 in a clinical setting. Using a sodium acetate buffer and ascorbic acid, a high radiochemical yield (97.98% +/- 2.01) was achieved, ensuring stability and purity. The therapy was evaluated to a 77-year-old mCRPC patient resistant to [177Lu]-PSMA-617, showing favorable biodistribution and urinary excretion. Despite initial stability, disease progression occurred, with a TP53 mutation identified via liquid biopsy. While the method holds promise for targeted radionuclide therapy, resistance mechanisms remain a challenge, necessitating further research for optimized patient selection and treatment strategies.