Drug-Induced Liver Injury Secondary to Radionuclide Therapy With Lutetium-177 Vipivotide Tetraxetan in a Patient With Metastatic Castrate-Resistant Prostate Cancer

Lutetium-177 vipivotide tetraxetan (LuPSMA) is a small molecule inhibitor with high affinity to prostate-specific membrane antigen and is currently used in the treatment of metastatic castrate-resistant prostate cancer. Hepatotoxicity has seldom been reported. This is a case of drug-induced liver injury presenting in a patient who received 5 cycles of LuPSMA for metastatic castrate-resistant prostate cancer. In this report, we provide a probable case of drug-induced liver injury with imaging and histologic findings of cholestatic liver injury and stricturing cholangiopathy related to LuPSMA. This is the first report of LuPSMA as a probable cause of hepatotoxicity.