[177Lu]Lu–Prostate-specific Membrane Antigen Radioligand Therapy Combined With a PARP Inhibitor in Treatment-emergent Neuroendocrine Prostate Cancer With Rare Metastases: A New Try

A 64-year-old man with treatment-emergent neuroendocrine prostate cancer underwent multitracer PET/CT, which demonstrated low somatostatin receptor expression but marked prostate-specific membrane antigen expression in multiple systemic lesions, including a protruding right abdominal wall metastasis. The patient subsequently received [ 177 Lu]Lu–prostate-specific membrane antigen radioligand therapy combined with olaparib. Follow-up PET/CT showed marked reductions in tracer uptake and tumor burden, accompanied by normalization of the neuron-specific enolase level.