177Lu-PSMA-617治疗转移性去势抵抗性前列腺癌新进展

姑息性手术、试验性局部治疗、外放射治疗、内分泌治疗、化学治疗等常规治疗手段对转移性去势抵抗性前列腺癌(mCRPC)患者的预后和生活质量改善效果有限.以前列腺特异性膜抗原(PSMA)为靶点的放射性配体治疗(RLT)有望改变mCRPC患者生存期短、生活质量差的现状.177镥(177Lu)标记的PSMA-617(177Lu-PSMA-617)的理化性质和药代动力学特性优异,与其他放射性核素标记的治疗探针相比,已积累了较多临床研究数据和经验,有效性、安全性、易获得性高,显示出了较好的临床价值和应用前景,但尚存在一些局限.目前,177Lu-PSMA-617RLT仍以小样本单中心研究为主,但随着全球研究大数据的积累,其有望成为mCRPC临床常规治疗的延伸和补充.

177Lu-PSMA-617 in treatment of metastatic castration-resistant prostate cancer: an update

Conventional therapy (such as palliative surgery, experimental local therapy, external radiotherapy, endocrine therapy and chemotherapy) has limited effect on the prognosis and quality of life in patients with metastatic castration-resistant prostate cancer (mCRPC). Radioligand therapy (RLT) with prostate-specific membrane antigen (PSMA) targeted probe is expected to change the situation (short survival and poor quality of life in mCRPC patients). ¹⁷⁷Lutetium labelled PSMA targeted ligand PSMA-617 (¹⁷⁷Lu-PSMA-617) has excellent physical and chemical properties and pharmacokinetic properties. Compared with other radionuclide labelled probes, we have accumulated more clinical research data and experience on ¹⁷⁷Lu-PSMA-617. High efficacy, safety and easy availability, endowed it with high clinical value and application prospects in spite of several limitations. Although research on RLT with ¹⁷⁷Lu-PSMA-617 is still based on small sample size and single center research at present, it is expected to become an extension and supplement to clinical conventional therapy for mCRPC patients with the accumulation of big data of global research.