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.

Dr. Dharmender Malik - DNB, MNAMS, FANMB | Nuclear Medicine Expert in India

Dr. Dharmender Malik is currently a Senior Consultant at the Department of Nuclear Medicine, Fortis Memorial Research Institute (FMRI) in Gurugram, Harayana. Before joining FMRI, Dr. Malik was the Head of the Department of Nuclear Medicine at Paras Hospital in Gurugram. At Paras Hospital, Dr. Malik led the team that set up the state-of-the-art PET-CT Department at Paras Hospital.

Dr. Malik is a Radiation Safety Officer (RSO Level II), started off as an intern at the Pt. B. D. Sharma Post Graduate Institute of Medical Sciences, Rohtak India. He then moved on to become a Resident in the Department of Nuclear Medicine at the Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Srinagar. In his career, Dr. Malik has worked with India’s premier Medical Institutions – he was a Senior Resident at Chandigarh’s Post-Graduate Institute of Medical Education & Research (PGIMER) and a Nuclear Medicine Consultant at Sir Ganga Ram Hospital, Delhi.

Dr. Malik’s extensive experience includes scanning & interpretation of PET-CT; numerous guided biopsies with various radiopharmaceuticals; 131-I MIBG whole-body scans in pheochromocytoma, paraganglioma, MTC & neuroblastoma patients; myocardial perfusion imaging (SPECT-MPI) with radiopharmaceuticals such as 201Thallium, 99mTc-sestamibi & 99mTc-tetrofosmin;

Equilibrium Radionuclide Angiography (MUGA) scans; renal dynamic scintigraphy, renal cortical scintigraphy, direct radionuclide cystography, brain perfusion scintigraphy, cisternography, liver & spleen imaging, lymphoscintigraphy, gastric emptying scintigraphy; administration of 177Lu-DOTANOC (PRRT) for Neuroendocrine Tumors (NETs); administration of 188Re-Tin-colloid for radio synovectomy among others.

Dr. Malik has participated in several Academic & Teaching Programs involving fields of nephron-urology, oncology, lymphoma, paediatric surgery, endocrinology, pulmonology, radiotherapy, etc. He has also co-authored and published several papers & abstracts in various international and national medical journals including JNM, EJNMMI among others.

Dr. Malik is a member of several medical bodies such as The Society of Nuclear Medicine (SNM), India, and the Society of Nuclear Medicine & Molecular Imaging (SNMMI), USA. He is also a Fellow of the Asian Board of Nuclear Medicine (FANB) and a Reviewer of the Asia Oceania Journal of Nuclear Medicine & Biology (AOJNMB).

Dr. Dharmender Malik

Experience

Consult Dr Ishita B Sen