[177Lu]Lu-PSMA radioligand therapy as an initial approach in hormone-sensitive metastatic prostate cancer: a case report.

The [177Lu]Lu-PSMA radioligand therapy is a prostate-specific membrane antigen (PSMA) targeting treatment approved for patients with metastatic castration-resistant prostate cancer, after failure of androgen deprivation therapy or taxane-based chemotherapy. We report a unique case of a patient with metastatic hormone-sensitive prostate cancer (mHSPC) who received PSMA radioligand therapy as the sole treatment, without any prior or additional systemic treatment. Over a span of 8 years, the patient underwent 12 cycles of [177Lu]Lu-PSMA radioligand therapy, demonstrating favorable therapeutic response and a prolonged androgen deprivation therapy-free period. This case highlights the potential of long-term PSMA radioligand therapy as a standalone option in selected mHSPC patients.