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.

225ac-psma-617 – A New Beginning in the Treatment of Chemotherapy-Naïve Prostate Cancer Patients

Summary (10 sec read)

Actinium 225 (Ac 225 PSMA) offers a promising new treatment for metastatic castration-resistant prostate cancer (mCRPC), especially in chemotherapy-naive patients. Prostate cancer is a prevalent malignancy, particularly in men over 60. Conventional treatments often fall short for advanced or metastatic cases. Nuclear Medicine and Molecular Imaging provide a personalized approach to managing this cancer. Targeted Alpha Therapy (TAT) using alpha-emitting isotopes like Actinium 225 has shown significant efficacy. Studies confirm Ac 225 PSMA's remarkable therapeutic success, particularly in patients who have relapsed after initial therapies.

At Fortis Memorial Research Institute (FMRI), pioneering efforts in Alpha PSMA Therapy have yielded encouraging results. The treatment has improved patients quality of life, reduced symptoms and pain, and significantly lowered serum PSA levels, indicating decreased tumor burden. Ga68 PSMA scans reveal up to 70% tumor reduction after a single cycle. The high-quality radioisotope and peptides used ensure the therapy's effectiveness. FMRI's Department of Nuclear Medicine and Molecular Imaging remains at the forefront, offering this innovative therapy in India and Asia. For more details, contact +91 98111 27080 or info@nuclearmedicinetherapy.in.

Prostate Cancer, according to the World Cancer Research Fund, is not only one of the most common malignancy in men, but also one of the most commonly occurring cancer overall. The incidence of prostate cancer increases proportionally with age, especially in men above 60 years of age.

For advanced prostate cancer patients or metastatic castration-resistant prostate cancer (mCRPC) patients, conventional treatment modalities, such as surgery, chemotherapy etc. might not prove to be highly effective in terms of controlling the spread of the cancer. This is where Nuclear Medicine and Molecular Imaging are playing an important part in the management of cancer and that too in a personalized manner.

Several nuclear medicine clinics around world have confirmed that there is now a new hope for metastatic castrate-resistant prostate cancer (mCRPC) patients – Targeted Alpha Therapy of Alpha PSMA Therapy using radiolabeled PSMA inhibitors or alpha-emitting radioisotopes, such as 225Ac.

A NEW BEGINNING:

The treatment of metastatic castrate-resistant prostate cancer (mCRPC) using chemotherapy agents of often short-lived and also incomplete. The over-expression of prostate-specific membrane antigen (PSMA) in metastatic prostate cancer patients has proven to be a suitable target for imaging and therapy. Moreover, the 225Ac labeled derivative – 225Ac-PSMA-617, has shown remarkable therapeutic efficacy, especially in metastatic castrate-resistant prostate cancer (mCRPC) patients. And this was visible in a recently concluded study with a treatment group that comprised patients who relapsed after the initial therapy and presented with metastatic prostate carcinoma – 224Ac-PSMA-617 is definitely more effective for chemotherapy naïve metastatic castrate-resistant prostate cancer (mCRPC) patients.

While the treatment of metastatic castrate-resistant prostate cancer (mCRPC) is still evolving, this study has definitely marked a new beginning in the cancer’s treatment.

WHAT IS ALPHA PSMA THERAPY?

Alpha PSMA Therapy, to put in simpler terms, is a selective and targeted internal medicine cellular level radiotherapy that is administered to control advanced prostate and prostate cancer. The therapy uses alpha-emitting radioisotopes, such as 225Ac to control the cancer. It is completely safe and an effective therapy with minimal side effects.

ALPHA PSMA THERAPY USING 225Ac-PSMA-617 AT FORTIS MEMORIAL RESEARCH INSTITUTE (FMRI):

Fortis Memorial Research Institute’s Department of Nuclear Medicine and Molecular Imaging has been the pioneer of Targeted Alpha PSMA Therapy both in India and Asia as well. The centre is currently the only centre that offers this therapy in India and has completed 50 treatment cycles. The team of doctors at the centre is extremely excited with the initial results of each therapy cycle where post therapy, most of the patients have experienced a remarkable improvement in their quality of life because of reduced symptoms and pain. Apart from this, an associated biochemical response with a fall in serum PSA levels was observed that indicates reduced tumor burden in the body. Actually, most of the patients have also shown a prolonged duration of response with some of them being in near-complete biochemical and clinical remission for over a year.

Further, to understand the efficacy of Alpha PSMA Therapy better, the team at the centre performed Ga68 PSMA scans before each cycle and have had some extremely encouraging results. The scans have shown a nearly 70% reduction in tumor size in a single cycle in some of the patients.

A key factor that ensures the efficacy of Alpha PSMA Therapy in the treatment of advanced prostate cancer or metastatic castration-resistant prostate cancer (mCRPC) is the quality of the radioisotope used. The centre assures that the highest standards of quality are maintained at every level and it sources the radioisotope (225Ac) from Mssrs ITG Germany that has the approval from the European Medicines Association as wells as the Indian Pharmacopia.

The highly purified peptides are sourced from ABX Germany. The labelling of 225Ac with the peptide is done in-house.

For more information on the efficacy of Alpha PSMA Therapy using 225Ac-PSMA-617 , Visit Nuclear Medicine Therapy or do call us at +91 98111 27080 or write to us at info@nuclearmedicinetherapy.in.