Care Pathway at a Cancer Center for the Administration of Radiometabolic Therapy with 177Lu-PSMA in Patients with Metastatic Castration-resistant Prostate Cancer

Abstract

Objectives: To present a clinical care model for the administration of 177Lu-labeled prostate-specific membrane antigen (PSMA) in radiometabolic therapy for metastatic castration-resistant prostate cancer (mCRPC) at the National Cancer Institute (NCI) of Bogotá, Colombia. Methods: A care model was designed for patients with mCRPC based on the VISION study, a prospective, phase III, multicenter, open-label, randomized study in patients with positive 68 Ga-PSMA positron emission tomography/computed tomography who had progressed to taxane and androgen therapy, to receive 177Lu-PSMA-617 combined with the best standard of care vs. the best standard of care alone. The care pathway provided to patients was developed by the Nuclear Medicine Group of the NCI and is the result of adjustments and improvements in the care process and the updating of the literature. Results: A systematic and efficient care model was formalized and implemented for the administration of 177Lu-PSMA therapy in patients with mCRPC who had previously been treated with at least one androgen receptor pathway inhibitor and one or two taxane regimens, with evidence of disease progression. Conclusion: An optimized process of care based on the determinants of clinical outcomes was developed for patients who received this type of radiometabolic therapy.