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.

Lu-PSMA Therapy: A Breakthrough in Prostate Cancer Treatment

Summary (10 sec read)

Lu-177 PSMA therapy is a targeted treatment for metastatic prostate cancer, using Lutetium-177 to selectively destroy cancer cells while minimizing damage to healthy tissue. Clinical studies confirm its efficacy in improving survival and reducing tumor burden. The therapy is well-tolerated, with mild side effects like fatigue and dry mouth. At FMRI Gurugram, specialists Dr. Ishita B. Sen, Dr. Parul Tyagi, and Dr. Dharmender Malik use advanced dosimetry for customized patient care. With its growi

Lu-177 PSMA therapy is a targeted treatment for metastatic castration-resistant prostate cancer (mCRPC), particularly effective when conventional therapies like chemotherapy and androgen receptor inhibitors fail. This therapy exploits the overexpression of Prostate-Specific Membrane Antigen (PSMA) on prostate cancer cells. By attaching a radioactive isotope, Lutetium-177, to a PSMA-targeting molecule, the treatment delivers precise radiation to cancerous cells, sparing healthy tissue and reducing systemic toxicity.

How Lu-177 PSMA Therapy Works

The therapy involves an intravenous administration of the radiopharmaceutical, which binds to PSMA receptors on prostate cancer cells. The Lutetium-177 emits beta radiation, destroying the cancer cells while limiting collateral damage. The treatment is typically given in cycles, usually spaced 6 to 8 weeks apart, depending on the patient’s response and overall health.

Before starting therapy, essential imaging such as a PSMA PET/CT scan is performed to confirm PSMA expression in tumors. Additionally, kidney function tests, including a MAG3 or EC scan, are conducted since the radiopharmaceutical is primarily excreted through the kidneys. Intravenous hydration is administered before and after the therapy to ensure the safe elimination of radioactive material.

More details: https://nuclearmedicinetherapy.in/treatments/lu-psma-therapy

Clinical Efficacy of Lu-177 PSMA Therapy

Numerous clinical studies have confirmed the effectiveness of Lu-177 PSMA therapy in advanced prostate cancer cases.

A landmark trial published in The New England Journal of Medicine (VISION Trial) demonstrated that patients receiving Lu-177 PSMA therapy, in combination with standard care, had a significantly prolonged progression-free survival compared to those receiving standard care alone. The therapy reduced the risk of disease progression or death by 38% and improved overall survival.

Study link: https://www.nejm.org/doi/full/10.1056/NEJMoa2107322

Another study published in European Urology in 2024 highlighted the superior tumor response rates with Lu-177 PSMA therapy. The research concluded that a majority of patients experienced a PSA reduction of ≥50%, indicating a significant tumor burden reduction.

Study link: https://www.sciencedirect.com/science/article/pii/S0302283823032979

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Patient Experience and Side Effects

Lu-177 PSMA therapy is generally well-tolerated. Most patients experience mild-to-moderate side effects such as:

Dry mouth (xerostomia) – due to salivary gland uptake of PSMA-targeted radiotracers.
Fatigue – common in the weeks following treatment.
Nausea – mild and transient in most cases.
Mild bone marrow suppression – slight reductions in white blood cell and platelet counts, typically resolving without intervention.

Serious side effects are rare, but patients with pre-existing kidney conditions require careful monitoring due to the renal clearance of the radiopharmaceutical.

Expertise in Lu-177 PSMA Therapy at Fortis Memorial Research Institute (FMRI)

At Fortis Memorial Research Institute (FMRI) in Gurugram, a team of highly experienced nuclear medicine specialists ensures the safe and effective administration of Lu-177 PSMA therapy. Dr. Ishita B. Sen, Dr. Parul Tyagi, and Dr. Dharmender Malik bring extensive expertise in precision nuclear medicine and patient-specific treatment planning.

FMRI uses scientifically customized dosing protocols, ensuring that each patient receives an optimized treatment plan tailored to their tumor burden, overall health, and prior therapies. The center employs state-of-the-art radiolabeling techniques and advanced dosimetry algorithms to maximize therapeutic efficacy while minimizing side effects.

More details on FMRI’s expertise: https://nuclearmedicinetherapy.in/treatments/lu-psma-therapy

The Future of Lu-177 PSMA Therapy

With accumulating evidence supporting its efficacy, Lu-177 PSMA therapy is gaining widespread adoption for managing advanced prostate cancer. Ongoing research is exploring potential enhancements, including combination therapies with checkpoint inhibitors and second-generation radiopharmaceuticals for even better outcomes.

For patients and caregivers considering this therapy, consulting with experienced specialists at FMRI can provide clarity on whether Lu-177 PSMA therapy is the right choice based on disease stage, prior treatments, and overall health.

For appointments or further inquiries: https://nuclearmedicinetherapy.in/contact

Also Read

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

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Lu-177, Ac-225, and Tb-161 Therapy for Prostate Cancer: A Comparative Analysis

Patient Case Study - Results of Lutetium 177 PSMA Therapy ( Pluvicto ) in Metastatic Prostate Adenocarcinoma

Metastasis directed Lu-177 PSMA Therapy in Prostate Cancer Patients with Oligometastatic Disease

Lu177 PRRT For Neuroendocrine Tumors (Nets)

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