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.

Order, Map & Treat (OMT) Breakthrough for Tare Procedures

When we talk about trans-arterial radio embolization, it involves two separate processes. In the first procedure, the patient gets admitted and has an angiography to map the tumor to see where the blood supply. How much data isotope is going to be administered. Then comes to phase of ordering the radio isotope, and then the review isotope usually comes in about a week’s time. And the patient is then, after about one week, he’s again admitted in the hospital. Again, undergoes an angiography, and the Y90s spheres are delivered into the tumor.

Now, to reduce this whole process and to make it more cost effective for the patient, there is a new system which is used at high volume centres. So, in centres where you have all the paraphernalia for doing high volume studies, you have the dosimetry software, you have the manpower which is trained to do these things quickly, there is a process called OMT. OMT stands for order, map, and treat in the same setting. So, the isotope is ordered.

We do the mapping of the tumor. So, you know which part is to be administered, how much radioisotope, and how much radioisotope the dozymemetry scan is done on specialised dosimetry software, and then the patient is immediately shifted back into the Cath lab and the doors are administered. So, the entire process of mapping and administration is done in a single procedure. This reduces the patient’s procedure time, reduces the cost to the patient, and reduces the waiting time which the patient has to have between the mapping and the actual administration of the Y90. So OMT is something which is available only at specialized high, volume centres, and we are one of these centres in the country. Which practices OMT.

So, for the trans-arterial radio embolization, be sure to ask for OMT from you.

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.

Order, Map & Treat (OMT) Breakthrough for Tare Procedures

Consult Dr Ishita B Sen