Super Responder of 177 Lu-PSMA-617 PSMA Therapy in Patient With End-Stage Renal Disease on Hemodialysis.

PSMA-targeted radioligand therapies with 177 Lu-PSMA-617 have shown promising response rates with favorable toxicity in patients with metastasized castration-resistant prostate cancer. We report a case of a 72-year-old man with metastatic castration-resistant prostate cancer having comorbidities of DM, HTN, and end-stage renal disease (ESRD) on regular hemodialysis. The patient received 2 doses of 7.4GBq of 177 Lu-PSMA-617, 6 weeks apart. There was complete resolution of prior 68 Ga-PSMA avid lesions, a significant decrease in serum PSA level, and symptomatic response after therapy. We suggest that patients with ESRD on dialysis can be safely treated with 177 Lu-PSMA radionuclide therapy.