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.

Alpha Emitters Are 5 Times More Potent Than Beta Emitters By Dr. Ishita B. Sen

So all of us know about PSMA therapy It's been around for almost the last 10-15 years now and you use the PSMA target on the prostate cancer cells to deliver high dose radiation to the both the prostate cancer in the prostate as well as to the metastatic sites and it has traditionally been done with beta emitters like Lutetium now the next generation of psma therapy works on Alpha Emitters now alpha emitters like Actinium or PB 212 or Bismuth these have got a potency of almost 5 times that of lutetium and how they do that is that they create double stranded DNA breaks in the tumor cells which the tumor is unable to repair and this is different from the single strand DNA breaks which lutetium will create So alpha PSMA is utilizing the targeting of alpha radiopharmaceuticals with PSMA to deliver very very high targeted radiation to the tumor cells.

Also Read

Side effects of Nuclear Medicine Treatment - Overview Lutetium-177, Actinium-225, and Yttrium-90 therapy

Can you live for 20 years after prostate removal?

PSMA Therapy Gives Control Over Prostate Cancer For 15-18 months

Medical Imaging: Shedding Light on Cancer Diagnosis and Treatment

What are the adverse effects of PSMA Therapy

Terbium-161 for PSMA-targeted radionuclide therapy of prostate cancer

Consult Dr Ishita B Sen

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