Lutetium-177 Prostate Specific Membrane Antigen Therapy in a Patient With Double Malignancy and Single Functioning Kidney: A Case Report

Lutetium-177 labeled with 617 types of Prostate Specific Membrane Antigen ((177)Lu PSMA-617) Radio-ligand Therapy (RLT) is an emerging modality of choice for the treatment of metastatic castration-resistant prostate carcinoma (mCRPC). After it is administered intravenously, it is excreted primarily through the kidneys. Physiological excretion and concomitant expression of PSMA receptors on renal tissues are associated with potential renal toxicity, a matter of concern while treating patients with multiple doses of RLT. There are published articles that have demonstrated the safe use of (177)Lu PSMA-617 in patients with bilateral fair-functioning kidneys; however, only a single study has been published that has evaluated its safety in patients with solitary-functioning kidneys. The uniqueness of this case report lies in the fact that we have documented the renal safety profile of (177)Lu PSMA-617 therapy after multiple doses in a patient who presented with double malignancy (metastatic castration-resistant prostate carcinoma and left renal cell carcinoma) and had a single-functioning right kidney.