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.

Can Lu PSMA Therapy Defer ADT- by Dr. Ishita B Sen

Lu PSMA has been approved by the US FDA for Metastatic Catsration Resistant Prostate Cancer, but many patients ask me, can we not use Lutetium PSMA therapy early on? Can we not use it in Hormone sencstive prostate Cancer.

There are many studies and in our own experience as well patients can opt for Lutetium Therapy in hormone sensitive Prostate Cancer or Oligo-metastatic prostate Ca or small volume metatstatic disease. It does help in deferrring ADT (Androgen Deprivation Therapy), there are many patient for whom the side effects of Androgen Deprivation Therapy (ADT) are unacceptable. These may include:

Loss of Muscle
Loss of Hair
Loss of Libido
Gynecomastia - where the breasts of male patients enlarge

These are known side effects of Androgen Deprivation Therapy (ADT) which may not be acceptable to many men.

And in this kind of cases and specially in patient with small volume metatstic disease, patients can have Metastatis Directed Lutetium PSMA therapy even in Hormone Sensitive or Early On Prostate Cancer treatment.

Caution: There is no hard and large data available to support this but Anecdotal data is available which supports the fact that Lu PSMA therapy does help in defrerring Andorgen Deprivation Therapy (ADT)

Read Also: Prostate Cancer Treatment

Note:
The content provided on this video is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

Can Lu PSMA therapy defer ADT? by Dr. Ishita B Sen

Consult Dr Ishita B Sen