177 Lutetium-PSMA Therapy in a Patient With Concurrent Prostate Cancer and Renal Cell Carcinoma.

A 77-year-old man with metastatic prostate cancer presented with debilitating bone pain and rising PSA despite anti-androgen therapy. 68 Ga-PSMA PET/CT scan revealed widespread PSMA-positive bone metastases with an incidental PSMA-avid renal mass, later confirmed as renal cell carcinoma (RCC). The patient received four cycles of 177 Lu-PSMA-617, which resulted in complete pain resolution, marked improvement in bone metastases, and PSA reduction; while no change in the renal mass is noted. Despite the beneficial effects of 177 Lu-PSMA therapy in metastatic prostate cancer, its efficacy in nonprostatic malignancies is under investigation. In this case, 177 Lu-PSMA-617 did not show remarkable therapeutic efficiency in RCC.