We present an advanced mCRPC case treated with combined 177LuLu-PSMA-617 and 223RaRadiumdichloride. The regimen was well tolerated, with mild xerostomia, fatigue (CTCAE 1), and moderate anemia (CTCAE 2). Initial imaging and serologic parameters demonstrated a favorable treatment response; however, subsequent evaluations showed progression driven by a dedifferentiated pelvic recurrence, increasingly FDG-avid osseous lesions, and new PSMA-negative lymph node metastases. Early biochemical improvement, including PSA and alkaline phosphatase decline, later transitioned to progression consistent with imaging. This case highlights the feasibility and safety of dual α/β- radionuclide therapy in heavily pretreated mCRPC.
Hügle et al. (Fri,) studied this question.