Vikas Prasad1, Friedemann Zengerling2, Jochen P Steinacker3, Christian Bolenz2, Meinrad Beer4, Thomas Wiegel5, Matthias Eiber6, Neil Fleshner7, Ambros J Beer3. 1. Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany; vikas.prasad@uniklinik-ulm.de. 2. Department of Urology, Ulm University Hospital, Ulm, Germany. 3. Department of Nuclear Medicine, Ulm University Hospital, Ulm, Germany. 4. Department of Radiology, Ulm University Hospital, Ulm, Germany. 5. Department of Radiation Oncology, Ulm University Hospital, Ulm, Germany. 6. Department of Nuclear Medicine, Technical University of Munich, Munich, Germany; and. 7. Division of Urology, University of Toronto, Toronto, Ontario, Canada.
Abstract
Synergistic effects of immunotherapy with pembrolizumab or drugs targeting DNA damage, such as olaparib, might be used to overcome the limitations of radioligand therapy (RLT) with 177Lu-prostate-specific membrane antigen (PSMA) in metastasized castration-resistant prostate cancer. Here, we present 2 patients receiving such combination or sequential therapies. Methods: RLT was performed at 6- to 8-wk intervals after the patients either exhausted or were considered unfit for all approved conventional treatments. Patient 1 was on pembrolizumab for his squamous cell carcinoma of the skin, whereas patient 2 received RLT sequentially 4 wk after 3 mo of monotherapy with olaparib. Results: Both patients tolerated RLT without any significant hematotoxicity. Patient 2 showed a radiologic and biochemical response, whereas patient 1 achieved prostate-specific antigen stabilization after 3 therapy cycles. Conclusion: These cases indicate that RLT in combination with pembrolizumab or sequentially after olaparib might be well tolerated in single patients.
Synergistic effects of immunotherapy with pembrolizumab or drugs targeting DNA damage, such as olaparib, might be used to overcome the limitations of radioligand therapy (RLT) with 177Lu-prostate-specific membrane antigen (PSMA) in metastasized castration-resistant prostate cancer. Here, we present 2 patients receiving such combination or sequential therapies. Methods: RLT was performed at 6- to 8-wk intervals after the patients either exhausted or were considered unfit for all approved conventional treatments. Patient 1 was on pembrolizumab for his squamous cell carcinoma of the skin, whereas patient 2 received RLT sequentially 4 wk after 3 mo of monotherapy with olaparib. Results: Both patients tolerated RLT without any significant hematotoxicity. Patient 2 showed a radiologic and biochemical response, whereas patient 1 achieved prostate-specific antigen stabilization after 3 therapy cycles. Conclusion: These cases indicate that RLT in combination with pembrolizumab or sequentially after olaparib might be well tolerated in single patients.
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