177Lu-PSMA Therapy for Metastatic Testicular Mixed Germ Cell Tumor

Prostate-specific membrane antigen (PSMA) overexpression in various tumors are demonstrated in both in vitro and in vivo studies. Prostate-specific membrane antigen-directed radionuclide therapies are generally used in prostate cancer and could be also useful in PSMA-avid other malignancies. Herein, we present a case of a 46-year-old male patient who had progressive metastatic testicular mixed germ cell tumor, despite repeated operations and treatments. Ga-68-PSMA PET/CT was performed to assess eligibility for Lu-177-PSMA therapy. Patient had intense PSMA uptake in metastatic lesions, and Lu-177-PSMA has been given to control of disease. However, alpha-fetoprotein level progressed, and mixed therapy response was detected in Ga-68-PSMA PET/CT.

Automated summary

Overexpression of prostate-specific membrane antigen (PSMA) is demonstrated in various tumors, and radionuclide therapies directed at PSMA might be effective in treating PSMA-avid malignancies. A case study of a 46-year-old male with progressive metastatic testicular mixed germ cell tumor showed mixed response in Ga-68-PSMA PET/CT after Lu-177-PSMA therapy, suggesting the need for further optimization of treatment strategies.