Abiraterone
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Lack of efficacy: case report An 84-year-old man exhibited lack of efficacy with abiraterone, while being treated for metastatic prostate cancer. The man, who underwent radical prostatectomy 20 years before, presented with metastatic prostate cancer. He had experienced biochemical failure, after 3 years of the initial surgery. After that, he had received androgen-deprivation therapy. He remained without symptom for 6 years. However, he suffered from bone pain and an increase in prostate-specific antigen. On examination at current presentation, metastasised pelvic bones and femurs were noted. Therefore, he received docetaxel; but his prostate-specific antigen levels persistently increased. Hence, docetaxel was discontinued, and he started receiving abiraterone [dosage and route stated]. However, no benefit was obtained from abiraterone treatment (lack of efficacy). Subsequently, the man was shifted to the nuclear medicine department and received off label treatment with lutetium-177-PSMAtherapy [Lu-PSMA]. At that time, increased uptake of tracer in some parts of the sclerotic pelvic bones and right femur were noted. On further investigation, additional metastatic sites in lumbar vertebra and sacrum were observed. Subsequently, he received 2 cycles of 7.4 GBq lutetium-177-PSMA-therapy. After that, a subjective reduction in pain was observed, but the prostate-specific antigen elevated further. Also, the progression was noted on a subsequent examination. Tuncel M, et al. Clinical impact of PET imaging in patients with metastatic prostate cancer. Clinical Nuclear Medicine 45: 757-764, No. 10, Oct 2020. Available from: URL: 803515320 http://doi.org/10.1097/RLU.0000000000003126
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Reactions 14 Nov 2020 No. 1830
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