Achieving consensus for the management of Lutetium-PSMA radioligand therapy in metastatic castration-resistant prostate cancer in Sicily

期刊论文
发表日期：

2026年6月10日

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Riccardo Laudicella,
Daniele Galanti,
Pierpaolo Alongi,
Demetrio Aricò,
Luigi Castorina,
Giuseppe Cicero,
Giovanni D’Agostino,
Alessandro D’Angelo,
Manuela Federico,
Massimo Ippolito,
Francesco Marletta,
Carlo Messina,
Lucia Motta,
Rosario Paratore,
Maurizio Schifilliti,
Giovanna Sciortino,
Maria Rosaria Valerio,
Francesco Verderame,
Sergio Baldari,
Nicolò Borsellino

摘要

Purpose

Lutetium-177 bound with prostate-specific membrane antigen-617 ([¹⁷⁷Lu]Lu-PSMA-617) is the first radioligand therapy (RLT) approved and reimbursed in Italy for the treatment of patients affected by PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) that have progressed after ≥1 androgen receptor-targeted agent (ARTA) and after chemotherapy with docetaxel and cabazitaxel. Furthermore, patients pretreated with docetaxel and ≥1 ARTA may receive [¹⁷⁷Lu]Lu-PSMA-617 if they are unfit for cabazitaxel. Due to the lack of Italian real-world data about the management of [¹⁷⁷Lu]Lu-PSMA-617 in mCRPC, we performed a consensus conference to provide clinicians with guidance on best practices.

Methods

A group of Sicilian nuclear medicine physicians, medical and radiation oncologists, experts on prostate cancer, used a round-robin variant of the focus group method to generate a series of consensus statements that may be helpful for the management of patients treated with [¹⁷⁷Lu]Lu-PSMA-617 for mCRPC.

Results

In the absence of unsolved disagreement, a consensus was obtained for various areas of controversy and clinical questions in six major topics regarding [¹⁷⁷Lu]Lu-PSMA-617 RLT: (1) indication; (2) patient’s selection; (3) administration; (4) radiation protection; (5) follow-up; (6) patients’ access.

Conclusions

Experts’ considerations are of particular importance in one of the largest Italian regions, where ~180 patients would potentially receive [¹⁷⁷Lu]Lu-PSMA-617 per year. It is hoped that clinicians treating patients with [¹⁷⁷Lu]Lu-PSMA-617 in daily practice will find this sharing of expert opinion of value.