We report our initial real-world experience with ¹⁷⁷Lu-PSMA-617 radioligand therapy. Methods: We performed a retrospective review of patients treated with ¹⁷⁷Lu-PSMA-617. Pretreatment PSMA PET, laboratory findings, overall survival, a fall in prostate-specific antigen by 50% (PSA50), and toxicities were evaluated. Results: Ninety-nine patients were included. Sixty patients achieved a PSA50. Seven of 18 (39%) patients who did not meet the TheraP PSMA imaging criteria achieved a PSA50. Nineteen of 31 (61%) patients who did not meet the VISION laboratory criteria achieved a PSA50. Sixty-three patients had a delay or stoppage in therapy, which was due to a good response in 19 patients and progressive disease in 14 patients. Of 10 patients with a good response who restarted treatment, 9 subsequently achieved a PSA50 on retreatment. The most common toxicities were anemia (33%) and thrombocytopenia (21%). Conclusion: At our center, patients who did not meet the TheraP PSMA imaging criteria or the VISION laboratory criteria benefited from ¹⁷⁷Lu-PSMA-617 radioligand therapy.

^{我们报告了177} Lu-PSMA-617 放射性配体治疗的初步实际经验。方法：我们对接受¹⁷⁷ Lu-PSMA-617治疗的患者进行了回顾性评价。对治疗前 PSMA PET、实验室检查结果、总体生存率、前列腺特异性抗原下降 50% (PSA50) 和毒性进行了评估。结果：纳入了 99 名患者。 60 名患者达到了 PSA50。 18 名不符合 TheraP PSMA 成像标准的患者中有 7 名 (39%) 达到了 PSA50。 31 名不符合 VISION 实验室标准的患者中有 19 名 (61%) 达到了 PSA50。 63 名患者延迟或停止治疗，其中 19 名患者反应良好，14 名患者病情进展。在 10 名反应良好并重新开始治疗的患者中，9 名随后在重新治疗时达到了 PSA50。最常见的毒性是贫血（33%）和血小板减少症（21%）。结论：在我们中心，不符合 TheraP PSMA 成像标准或 VISION 实验室标准的患者受益于¹⁷⁷ Lu-PSMA-617 放射性配体治疗。