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.

Prostate Cancer Treatment – Options, Side effect & Success Rate

Summary (10 sec read)

Prostate cancer treatments are advancing rapidly. Lu-177-based Pluvicto therapy and research into isotopes like Ac-225 and Pb-212 showcase the innovative approaches enhancing patient outcomes and quality of life.

Prostate cancer is a common malignancy in men, and its treatment has evolved significantly over the years. The choice of therapy depends on various factors, including the stage of the cancer, the patient's overall health, and personal preferences.

Traditional treatments such as surgery (radical prostatectomy), radiation therapy, and hormone therapy remain cornerstones in prostate cancer management. Surgery is often considered for localized disease, while radiation is an option for both localized and advanced stages. Hormone therapy, which deprives prostate cancer cells of essential hormones, is primarily used for metastatic disease.

In recent years, targeted therapies and nuclear medicine have emerged as promising avenues. Among these, Pluvicto therapy has garnered significant attention. This innovative treatment utilizes Lutetium-177, a radioactive isotope, to target and destroy prostate cancer cells that have spread to other parts of the body. By specifically delivering radiation to cancer cells, Pluvicto offers the potential for improved efficacy and reduced side effects compared to traditional systemic therapies.

Pluvicto Therapy, launched in March 2022, represents a significant breakthrough in the treatment of prostate cancer. Utilizing the radioisotope Lutetium-177 (Lu-177), this therapy targets prostate-specific membrane antigen (PSMA) on prostate cancer cells. Lu-177 emits beta particles, which effectively destroy cancer cells while sparing surrounding healthy tissue. Clinical studies have demonstrated that Pluvicto Therapy significantly improves survival rates and reduces tumor size in metastatic castration-resistant prostate cancer (mCRPC) patients. According to recent data, the therapy has shown a progression-free survival (PFS) rate of approximately 13-14 months and an overall survival (OS) rate extending beyond 15 months in many cases.

As a senior nuclear medicine expert, I, Dr. Ishita B Sen, have had the privilege of witnessing and contributing to these advancements in prostate cancer treatment. With over 30 years of experience, I have treated more than 500 patients using Pluvicto Therapy and Lutetium-177, observing remarkable improvements in patient outcomes and quality of life.

While Lutetium-177 has shown promising results, research into even more potent isotopes is ongoing. Actinium-225 (Ac-225), for instance, is another radioactive element with a higher energy level, potentially leading to enhanced cancer cell destruction. Studies indicate that Ac-225 PSMA therapy achieves remarkable responses in patients who have exhausted other treatment options, with substantial reductions in prostate-specific antigen (PSA) levels and prolonged survival rates. However, its clinical application is still in the investigational phase.

Lead-212 (Pb-212) is another radionuclide with potential applications in prostate cancer. It is currently under investigation for its ability to target and eradicate cancer cells with high precision. Preliminary results suggest significant tumor shrinkage and enhanced patient survival, though more extensive clinical trials are ongoing to establish its efficacy and safety profile.

The success rates of these treatments vary based on the stage of the cancer, the patient's overall health, and other factors. While surgery and radiation therapy can be highly effective for localized disease, the management of advanced prostate cancer remains a challenge. Nuclear medicine therapies like Pluvicto offer hope for improved outcomes, but larger-scale studies are needed to fully establish their benefits.

It is essential to emphasize that the goal of prostate cancer treatment is not only to prolong life but also to enhance quality of life. Modern therapies are increasingly focused on minimizing side effects and preserving patients' overall well-being. While there is no one-size-fits-all approach, advancements in the field continue to provide new hope for patients with prostate cancer. The progress we have made with therapies like Pluvicto and Lutetium-177 is a testament to the potential of nuclear medicine in transforming cancer treatment.

*Disclaimer: This information is intended for general knowledge and informational purposes only, and does not constitute medical advice. Please consult with a qualified healthcare professional for any medical concerns or treatment decisions.

Also Read

From Diagnosis to Cure: How Nuclear Medicine is Transforming the Fight Against Cancer

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

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

From Awareness to Action: How Prostate Cancer Month Can Save Lives

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

Frequently Asked Questions

What is prostate cancer, and how common is it among men?

Prostate cancer is a type of cancer that develops in the prostate gland, which is part of the male reproductive system. It is one of the most common cancers among men, with statistics indicating that approximately one in nine men will be diagnosed with prostate cancer during their lifetime.
What are the traditional treatments for prostate cancer?

Traditional treatments for prostate cancer include:
- Surgery (Radical Prostatectomy): Often used for localized disease to remove the prostate gland.
- Radiation Therapy: Used for both localized and advanced stages to target cancer cells.
- Hormone Therapy: Deprives prostate cancer cells of essential hormones and is primarily used for metastatic disease.
What is targeted nuclear medicine therapy?

Targeted nuclear medicine therapy is a treatment that uses radioactive isotopes attached to molecules that specifically bind to cancer cells. These radioactive isotopes deliver a lethal dose of radiation directly to the cancer cells, minimizing damage to healthy tissue and reducing side effects compared to traditional therapies.
What is Pluvicto Therapy?

Pluvicto Therapy is an innovative treatment for prostate cancer that uses the radioisotope Lutetium-177 (Lu-177). It targets prostate-specific membrane antigen (PSMA) on prostate cancer cells, emitting beta particles to destroy these cells while sparing healthy tissue. Pluvicto was launched in March 2022 and has shown significant improvements in survival rates and tumor size reduction for patients with metastatic castration-resistant prostate cancer (mCRPC).
How effective is Pluvicto Therapy?

Clinical studies have demonstrated that Pluvicto Therapy has a progression-free survival (PFS) rate of approximately 13-14 months and an overall survival (OS) rate extending beyond 15 months in many cases. It offers improved efficacy and reduced side effects compared to traditional systemic therapies.
Who is Dr. Ishita B Sen, and what is her experience with Pluvicto Therapy?

Dr. Ishita B Sen is a senior nuclear medicine expert with over 30 years of experience in the field. She has treated more than 500 patients using Pluvicto Therapy and Lutetium-177, observing remarkable improvements in patient outcomes and quality of life.
What is Precision Medicine in the context of prostate cancer?

Precision medicine, also known as personalized medicine, tailors treatments based on the individual characteristics of each patient and their cancer. It considers genetic, environmental, and lifestyle factors that influence how the cancer develops and responds to treatment. This approach ensures that patients receive the most effective treatment with the least side effects, improving overall outcomes and quality of life.
What are the emerging treatments in nuclear medicine for prostate cancer?

Emerging treatments in nuclear medicine for prostate cancer include:
- Actinium-225 (Ac-225) Therapy: Uses a higher energy radioactive element to potentially enhance cancer cell destruction. It has shown promising responses in patients who have exhausted other treatment options.
- Lead-212 (Pb-212) Therapy: Another radionuclide under investigation for its precision in targeting and eradicating cancer cells. Preliminary results suggest significant tumor shrinkage and enhanced patient survival.
What are the success rates of these nuclear medicine treatments?

The success rates of nuclear medicine treatments like Pluvicto Therapy vary based on factors such as the stage of the cancer and the patient's overall health. While surgery and radiation therapy are highly effective for localized disease, advanced prostate cancer remains challenging to manage. However, nuclear medicine therapies offer hope for improved outcomes, though larger-scale studies are needed to fully establish their benefits.
What is the goal of prostate cancer treatment?

The primary goal of prostate cancer treatment is not only to prolong life but also to enhance the quality of life. Modern therapies focus on minimizing side effects and preserving patients' overall well-being, providing new hope and improved outcomes for those diagnosed with prostate cancer.

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