Lutetium-specific prostatic membrane antigen (luPSMA) treatment for metastatic castration- resistant prostate cancer

Abstract

Introduction: Cancer is one of the leading causes of death globally, with the majority of cases occurring in low-income countries. There are more than a hundred types, divided into sarcomas and carcinomas. Prostate cancer is the most common cancer among men and is usually asymptomatic. Treatment depends on the stage of the disease and may include surgery, hormone therapy, and radiation therapy. In advanced stages, new treatments such as the radiopharmaceutical LuPSMA are investigated to improve patients' quality of life. Objective: To analyze the efficacy of treatment with the radiopharmaceutical LuPSMA in patients diagnosed with metastatic prostate cancer through a literature review. Methodology: An exploratory-descriptive literature review with a qualitative approach was conducted, based on books and scientific articles. Data collection took place between 2019 and 2024, including complete and relevant documents on the topic, without language restriction, and excluding irrelevant, duplicate, or incomplete materials. The databases used were LILACS, SciELO, and PubMed, using the descriptors "Prostate Neoplasms," "Lutetium," and "Positron Emission Tomography combined with Computed Tomography" in Portuguese and English, added by the boolean operator "AND". Results: A total of 189 articles were found, of which only 30 were selected, after reading the titles and abstracts, according to the inclusion criteria, showing that theranostics with LuPSMA presents significant results in the quality and survival of patients with mCRPC. Conclusion: The results showed that LuPSMA significantly increased overall survival and progression-free survival compared to standard treatment, while being well tolerated with manageable adverse effects. However, there are uncertainties about the therapeutic response and prognosis in patients with low PSMA expression, indicating the need for further research. The study has contributed to imaging and oncology, offering new perspectives on alternative therapies for metastatic cancer and serving as a basis for future investigations into imaging-guided radionuclide therapies.