Research Progress of ¹⁶¹Tb-PSMA Radioligand Therapy for Prostate Cancer

Prostate specific membrane antigen (PSMA) radioligand therapy (PRLT) has become an important new therapy, especially suitable for the treatment of metastatic castration resistant prostate cancer (mCRPC) which cannot be effectively controlled by conventional therapy. PRLT, represented by Lutetium-177 (¹⁷⁷Lu)-PSMA-617, has good safety, can effectively prolong the survival time of mCRPC patients, and improve their quality of life. Despite the success of ¹⁷⁷Lu-PSMA-617 in the treatment of mCRPC, some patients are still insensitive or even unresponsive to treatment, so the disease progresses and relapse is inevitable. Terbium-161 (¹⁶¹Tb) has the same β-rays as ¹⁷⁷Lu, but its biggest advantage compared with ¹⁷⁷Lu is to release Auger electrons and internal conversion electrons for the treatment of small lesions. This synergistic therapy of β-rays and Auger electron has the advantage of meeting the treatment of lesions of different sizes, which has led to a rising interest in ¹⁶¹Tb for tumor therapy worldwide. In this paper, the preparation, labeling, quality control, radiation dose, preclinical research, clinical research and prospects of ¹⁶¹Tb-PSMA will be reviewed, aiming to provide references for medical staff and patients who carry out PRLT.