Lutetium-177 PSMA therapy in patients with advanced prostatic tumors


Prostate cells have a specific enzyme on their surface, the so-called “prostate-specific membrane antigen” (PSMA). Prostate cancer cells contain this enzyme in significantly large quantities, and therefore PSMA can be chosen as a target for targeted therapy of cancer. Similar to the diagnosis with PSMA, specific therapy can be carried out using PSMA ligands labelled with the radioactive nuclide Lutetium-177. Due to the binding of PSMA ligands to the target molecule in the tumor cells, the latter are subjected to targeted irradiation for several days (beta radiation, electron radiation). This results in the death of tumor cells with a decrease of tumor size and the number of metastases.

What can cause prostate cancer?

Prostate cancer is the most common cancer in men over the age of 50. Currently, researchers cannot determine exactly what causes prostate cancer. It is believed that DNA changes that are inherited or caused by certain environmental factors play a role in the development of prostate cancer. It is believed that exposure to radiation, chronic inflammation, chemicals, high levels of androgen, or insulin-like growth factor-1 (IGF-1) also causes gene changes that lead to cancer.

Most often, the development of a tumor is preceded by:

  • Hormonal disbalance. An increase in the concentration of male sex hormones cause the growth of the gland and the multiplication of tumor cells.
  • Prostate adenoma and other benign changes cause the growth of cells that should not be in the gland.
  • Prostatitis. Chronic inflammation in the prostate causes circulatory disorders and a lack of oxygen.

Is this treatment safe?

The irradiation used in the treatment with Lutetium-177 PSMA is intended only for the destruction of cancer cells. Only cancer cells are irradiated and destroyed during the procedure. To confirm that radiation does not damage healthy tissue, blood tests are done. Side effects of therapy may include:

  • Dry mouth.
  • Fatigue.
  • Nausea and vomiting.
  • Lowering of white blood cell and platelet counts.

Treatment, as a rule, is tolerated very well and does not cause serious side effects. However, the condition of the glands, including salivary, and renal function should be evaluated after the procedure clinically and by the dynamics of laboratory parameters.

The effectiveness of therapy with Lutetium-177

Clinical studies comparing the efficacy of Lutetium-177 PSMA with other third-line therapies for metastatic prostate cancer, which no longer respond to hormonal treatment, have shown that Lutetium treatment was more effective and led to fewer side effects. An additional study evaluating the effectiveness and safety of therapy, as well as the quality of life of patients with castration-resistant prostate cancer, have shown a good response in most participants. In 57% of patients, the PSA level decreased by more than 50% (in 37%, PSA decreased by more than 80%); a reduction in tumor volume was observed in 70% of patients. Alleviation of pain and improvement in overall well-being were also registered. At the same time, only minimal side effects were observed.

How is the treatment performed?

Before starting treatment, a thorough diagnostic is carried out, including a PSMA PET/CT study (it allows doctors to determine the stage of the disease and calculate the necessary dosage of Lutetium), blood tests (including PSA level) and a histological study. Lutetium-177 therapy can be prescribed for metastatic prostate cancer or in cases when other treatments for prostate oncology have been ineffective. The technique is not suitable for 5-10% of patients whose disease does not connect with the overexpression of PSMA.

Treatment is carried out in a hospital. The procedure itself takes only a few minutes. Most patients are discharged in 2 days. To assess the distribution of Lutetium in the body, an additional visualization study is performed before the discharge. A repeated procedure (in presence of medical indications) may be carried out in 1.5-2 months. As part of monitoring the patient’s condition, blood tests are regularly performed during treatment.

The benefits of Lutetium therapy

Thanks to the precise definition of the affected area, doctors get more opportunities for effective cancer treatment, focusing on this area and not affecting healthy tissue. New technology used for metastatic or immune cancer therapy allows you to:

  • Visualize the effectiveness of tumor treatment.
  • Prevent further spreading of the disease.
  • Reduce tumor size.
  • Reduce pain.

In order to find a suitable prostate cancer clinic abroad, you just need to contact Booking Health. Specialists of the company will help you find the best clinics abroad for you. With the help of Booking Health, many patients have successfully undergone cancer treatment abroad in the best hospitals and were satisfied.

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