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.

131 Iodine MIBG Therapy for Pediatric Neuroblastoma

131 Iodine MIBG Therapy For Pediatric Neuroblastoma

Summary (10 sec read)

Neuroblastoma and Targeted Radionuclide Therapy

Neuroblastoma is a rare and aggressive pediatric cancer originating from neural crest cells. Primarily affecting children under five, it often manifests in the adrenal glands but can occur anywhere along the sympathetic nervous system. Advanced-stage disease, characterized by MYCN oncogene amplification, carries a poor prognosis despite intensive multimodal therapy.

Targeted Therapy with 131I-MIBG

Metaiodobenzylguanidine (MIBG) is a norepinephrine analog selectively concentrated in adrenergic tissues, including neuroblastoma cells. When labeled with radioactive iodine isotopes such as iodine-131 (131I), MIBG delivers targeted radiotherapy to malignant cells, sparing normal tissues.

Mechanism of Action

131I-MIBG therapy exploits the active uptake of MIBG by neuroblastoma cells via the norepinephrine transporter. Once internalized, the radioactive iodine emits beta particles, causing DNA damage and cell death. This targeted delivery minimizes systemic toxicity compared to conventional chemotherapy.

Clinical studies have demonstrated the efficacy of 131I-MIBG therapy in pediatric neuroblastoma:

Single-agent 131I-MIBG: Response rates in relapsed or refractory neuroblastoma range from 30-40%, with complete or partial responses in 36% of treated patients.

Combination Therapy: Combining 131I-MIBG with chemotherapy agents like irinotecan and vincristine has improved response rates to over 60%.

These findings highlight the potential of 131I-MIBG as a valuable treatment option, particularly for high-risk and relapsed neuroblastoma. Ongoing research at institutions like Fortis Memorial Research Institute (FMRI) in Gurugram aims to further refine and expand the applications of this targeted therapy, offering new hope to children battling this challenging disease.

Dr. Ishita B. Sen, a leading nuclear medicine expert and Director and Head of the Department of Nuclear Medicine & Molecular Imaging at Fortis Memorial Research Institute (FMRI), Gurgaon, brings her extensive knowledge and experience to the field of targeted radionuclide therapy for neuroblastoma. With over 20 years of experience, Dr. Sen has a special interest in Nuclear Oncology, Radionuclide Therapy, PET Guided Interventional Procedures and Infection Imaging.

About Author / Manav Sadhwani

Hi, I am Manav. I have spent over 7 years working in the Healthcare Industry. My experience spans marketing and treatment management of oncology patients from across the globe.