Journal of Modern OncologyJournal of Modern OncologyСовременная онкология1815-14341815-1442LLC Obyedinennaya Redaktsiya69658510.26442/18151434.2025.4.203504ArticlesСтатьиReview ArticleRadioligand therapy with 177Lu-PSMA in castration-resistant prostate cancer: a literature review and case seriesРадиолигандная терапия 177Lu-ПСМА при кастрационно-резистентном раке предстательной железы. Обзор литературы и серия клинических примеровhttps://orcid.org/0000-0001-7754-66248942-0678VolkovaMaria I.ВолковаМария Игоревна
Russian Federation

D. Sci. (Med.), Moscow State Budgetary Healthcare Institution «Oncological Center No. 1 of Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department», Russian Medical Academy of Continuous Professional Education

д-р мед. наук, врач-онколог онкологического отд-ния №8 Онкологического центра №1 ГБУЗ «ГКБ им. С.С. Юдина», проф. каф. онкологии и паллиативной медицины им. А.И. Савицкого ФГБОУ ДПО РМАНПО

mivolkova@rambler.ruhttps://orcid.org/0000-0002-8476-78794254-3930KrylovAlexander S.КрыловАлександр Сергеевич
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, зав. лаб. радиоизотопной диагностики отд. радиоизотопной диагностики и терапии Научно-исследовательского института клинической и экспериментальной радиологии

mivolkova@rambler.ruhttps://orcid.org/0000-0001-8415-5197NosovDmitry A.НосовДмитрий Александрович
Russian Federation

D. Sci. (Med.), Prof.

д-р мед. наук, проф., рук. онкологического отд-ния

mivolkova@rambler.ruhttps://orcid.org/0000-0002-3398-4128AlekseevBoris Ya.АлексеевБорис Яковлевич
Russian Federation

D. Sci. (Med.), Prof.

д-р мед. наук, проф., зав. каф. онкологии ФГБОУ ВО РОСБИОТЕХ, зам. ген. дир. по науке ФГБУ «НМИЦ радиологии»

mivolkova@rambler.ruMoscow State Budgetary Healthcare Institution "Oncological Center No. 1 of Moscow City Hospital named after S.S. Yudin, Moscow Healthcare Department"Онкологический центр №1 ГБУЗ «Городская клиническая больница им. С.С. Юдина» Департамента здравоохранения города МосквыRussian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииBlokhin National Medical Research Center of OncologyФГБУ «Национальный медицинский исследовательский центр онкологии им. Н.Н. Блохина» Минздрава РоссииCentral Clinical Hospital with PolyclinicФГБУ «Центральная клиническая больница с поликлиникой» Управления делами Президента РФRussian Biotechnological UniversityФГБОУ ВО «Российский биотехнологический университет (РОСБИОТЕХ)»National Medical Research Radiological CentreФГБУ «Национальный медицинский исследовательский центр радиологии» Минздрава России1102202627433133920112025Copyright ©; 2026, Consilium MedicumCopyright ©; 2026, ООО "Консилиум Медикум"2026Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://modernonco.orscience.ru/1815-1434/article/view/696585

Overexpression and ligand-dependent internalization of prostate-specific membrane antigen (PSMA), followed by its accumulation in prostate cancer (PCa) cells, make this glycoprotein a good target for radionuclide-based targeted therapy. Currently, the only drug in this group with efficacy proven in a large randomized clinical study in patients with metastatic castration-resistant PCa is 177Lu-PSMA-617. The article presents an overview of the data on the mechanism of action and the results of completed studies of radioligand therapy (RLT) with 177Lu-PSMA for PCa, the current indications for this type of treatment in patients with a castration-resistant phase of the disease, and practical guidelines for RLT, including its planning, implementation, monitoring of effectiveness, and radiation protection measures. Clinical cases of patients with partial response/stabilization of the disease during RLT, significant improvement/complete response, and progression of PCa are presented.

Гиперэкспрессия и лиганд-зависимая интернализация простатического специфического мембранного антигена (ПСМА) с последующим накоплением связывающей молекулы в клетках рака предстательной железы (РПЖ) делает данный гликопротеин удобной мишенью для таргетной терапии с использованием радионуклидов. В настоящее время единственным препаратом данной группы с эффективностью, доказанной в крупном рандомизированном клиническом исследовании при метастатическом кастрационно-резистентном РПЖ, является 177Lu-ПСМА-617. В статье представлены обзор данных о механизме действия и результатах завершенных исследований радиолигандной терапии (РЛТ) 177Lu-ПСМА при РПЖ, актуальных показаниях к данному виду лечения у пациентов с кастрационно-резистентной фазой заболевания, практические рекомендации по проведению РЛТ, включая ее планирование, проведение, мониторинг эффективности и меры радиационной защиты. Приведены клинические случаи пациентов с частичным ответом/стабилизацией заболевания на фоне РЛТ, выраженной положительной динамикой/полным ответом и прогрессированием РПЖ.

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