3x ¹⁷⁷Lu-PSMA and 1x ¹⁶¹Tb-PSMA, at 4-Week Intervals

Mr. J. Low, 67 years old, was first diagnosed with prostate cancer in February 2011. After multiple prior treatments—including primary external beam radiation, ADT, ARPI, three cycles of immunotherapy, cryotherapy, and irreversible electroporation (IRE)—in 2024 he experienced a slow rise in PSA despite ongoing ADT, suggesting decreasing efficacy of hormone therapy.

Concerned about the long-term effects of continuous antiandrogen therapy and chemotherapy, he opted for PSMA radioligand therapy. Following a cycle of ¹⁷⁷Lu-PSMA therapy at our institution, PSMA PET/CT still showed residual PSMA expression in the prostate tumor and two very small lymph node lesions. To address this, treatment was complemented with CyberKnife radiotherapy at our partner clinic CyberKnife Salzburg and one additional session of ¹⁶¹Tb-PSMA radioligand therapy—an ideal combination for relatively localized oligometastatic disease, small metastases and possible micrometastases.

As a result, the lymph node metastases disappeared on PSMA PET/CT and local disease in the prostate was effectively and safely treated by Cyberknife despite having a history of external radiation of the prostate.

Read his personal testimonial here.