What is Lu PSMA (Lutetium-Prostate Specific Membrane Antigen) Therapy?

Lu177 PSMA Therapy is a treatment for patients with prostate cancer, especially those who have become refractory to conventional therapy. Lutetium PSMA therapy helps to slow down the growth of the cancer cells, reduce the size of the tumours and most importantly improve the quality of life of the patients by reducing the pain caused by the cancer.

Many prostate cancers, in particular those that have spread or become resistant to hormonal therapies, express a unique receptor on their cell surface called Prostate Specific Membrane Antigen (PSMA). When Prostate Cancer metastasizes i.e. spreads to other parts of the body, the PSMA receptor is expressed over the sites of metastases as well.

How does Lu PSMA Therapy Work?

Lutetium-177 is a radioactive substance that emits beta radiation, a destructive kind of radiation. Lutetium-177 is bound to a small peptide which attaches to the PSMA receptor expressed on the cancer cell surface. The Lutetium 177 – PSMA complex, thus attached to the prostate cancer cell, then emits killing radiation causing cell death of the cancer cell. Since the penetration of the emitted beta particle is very small, the surrounding normal cells are spared.

How is the Therapy Done?

Lu177 PSMA is administered intravenously. The patient is admitted to the hospital for 24 hours. A kidney function scan called a MAG3/EC scan is done prior to the administration of the Lu177 PSMA.

What are the Side Effects of Lu PSMA Therapy?

Lu177 PSMA is well tolerated. The most common side effects are a slightly dry mouth, fatigue and nausea. There may also be a slight fall in the white blood cells and platelets about 2 – 3 weeks after the Lu177 PSMA administration.

What is the Response Rate With Lu PSMA Therapy?

The response rates of Lu177 PSMA depend on the tumour biology of prostate cancer, the initial Gleason Score, the extent of disease and the responses to prior therapies. Typically, more than 70% of patients demonstrate a reduction in S. PSA and a shrinkage of tumours following Lu177 PSMA therapy.

When would the doctor consider using this Therapy?

Lu PSMA Therapy is a very specific therapy and is used for managing metastatic Prostate Cancer or when Prostate Cancer is no longer responsive to other types of treatment.

What are the Treatment Schedules with Lu PSMA Therapy?

Most patients undergo three-four treatment cycles at intervals of 8-12 weeks. The number of cycles and the interim duration may vary between individuals depending on the response and interim assessments.

Why should I choose the nuclear medicine therapy center at Fortis Memorial & Research Institute (FMRI), Gurugram (Haryana, India)?

The Nuclear Medicine Therapy Centre at FMRI was one of the first institutes to offer Radio-ligand Therapy with Lu PSMA, and today, the center receives patients from the country and from across the world.

About Us | Who are we? | Nuclear Medicine Therapy in India

The team of Nuclear Oncology Experts (www.nuclearmedicinetherapy.in) is a group of dedicated Nuclear Medicine Physicians, Dosimetrists, Radiation Oncologists and Technicians with extensive experience in Nuclear Medicine Diagnostics & Therapies. Operating from the Department of Nuclear Medicine & Molecular Imaging, Fortis Memorial Research Institute (FMRI), Gurgaon in the state of Haryana, India, the centre is the first-of-its-kind dedicated Nuclear Oncology Diagnostic & Therapeutic setup in India.

With internationally trained experts and world class facilities, the regimens and protocols followed at the centre are at par with the highest world standards. All cases that come before the team are first discussed in a multi-disciplinary board that includes Medical, Radiation & Surgical Oncologists; Pathologists; Physiologists and Radiologists.

Technology

The centre boasts of the most advanced Time of Flight PET CT from Philips that offers the best-in-class small lesion detection and accuracy. The Time of Flight technology allows the machine to detect lesions as tiny as 2mm. The machine also boasts of an award winning open design which makes the scan seamless for patients with claustrophobia. The newer reconstruction techniques allows scans to be completed almost twice as fast as the other machines with much less radiation exposure.

Apart from the conventional F18 FDG PET CT, the department also offers the highly sophisticated Ga68 DOTANOC PET CT scans for imaging Neuroendocrine Tumours and APUDOMAs, Ga68 PSMA Scan for imaging Prostate Cancer and Ga 68 Exendin Scan for Insulinomas and Nesedioblastomas. The Centre is also one of the few centres in the country routinely performing PET CT Guided Biopsies and Interventional Procedures. PET CT scan based radiation treatment planning including 4D PET CT scans are also performed routinely.

Gamma Camera – The Brightview X Dual Head Gamma Camera from Philips is one of the most versatile dual Head Gamma Cameras available in the industry. Allowing a range of detector movements and a range of protocols the system is capable of performing all nuclear medicine procedures with superior patient ease and comfort.

The department performs all routine Nuclear Medicine Procedures like Bone Scans, Renal Scans, Stress Myocardial Perfusion Scans, Parathyroid Scans, Brain SPECTS, Ventilation Perfusion Scans, Venographies and Lymphangiography etc. In addition the department also offers some extremely sophisticated studies not available at most centres in the region including in-vitro studies like plasma GFR assessment, Labelled leucocyte scans and Trodat Imaging.

Radioiodine Probe: The department is equipped with a dedicated radioiodine Uptake Probe used for Iodine Studies.

Nuclear Medicine Therapy Unit: The department of Nuclear Medicine has a dedicated Therapy Unit where a host of Radioisotope therapies are routinely performed. The centre is the primary referral centre for Iodine therapy for thyroid cancer in the region. The Department is one of the pioneers in Lutetium based therapies for Neuroendocrine tumour and was the first in the country to start Lutetium PSMA therapy. The centre is also at present the only centre in the country offering myeloablative MIBG therapy for high risk neuroblastomas in children. The Centre is also the first centre to offer Targeted alpha therapy for neuroendocrine tumours, prostate cancer and certain brain tumours. What sets the Nuclear Medicine Experts apart is their ability to personalize therapies while maintaining the highest safety ethical and quality standards

Highly Qualified Medical Professionals

Technology

Consult Dr Ishita B Sen