Thrombotic Microangiopathy From Peptide Receptor Radionuclide Therapy

Lutetium-177 prostate-specific membrane antigen (Lu-PSMA) is a peptide receptor radionuclide therapy recently approved by the US Food and Drug Administration and the European Medicines Agency, for PSMA-positive metastatic castration resistant prostate cancer.1 The recommended dose is 7.4 gigabecquerels i.v. every 6 weeks for up to 6 doses, until disease progression or unacceptable toxicity.2 However extended therapy has not been associated with increase in grade 3 to 4 toxicity.3 This treatment targets the PSMA-expressing cells to deliver radiotherapy on specific tissues.