Lutetium-177 PSMA (prostate-specific membrane antigen) is a radionuclide therapy which aims to destroy prostate cancer cells that have spread to body parts, such as lymph nodes and bone marrow.
Destroying cells of the prostate cancer may prolong the survival and has the potential to alleviate symptoms, such as bone pain related to residues of cancer in the skeletal tissue.
Lutetium-177 is a radionuclide substance that emits radiation which is destructive enough to kill the nearby cells. It is combined with PSMA which is a protein that searches and finds the PSMA receptors on the surface of prostate cancer cells.
When transferred to bloodstream of the patient, Lutetium-177 PSMA targets and attaches to the PSMA receptors on prostate cancer cells.
The radiation emitted by Lutetium-177 kills the prostate cancer cells over time.
Lutetium-177 PSMA is employed for metastatic prostate cancer patients, for whom other treatment modalities, such as hormone therapy or chemotherapy, have failed.
The patients should have a PSMA PET-CT scan before the treatment and PSMA receptors to be targeted in Lutetium-177 PSMA and their presence on cancer cells should be verified.
Positive outcomes will be obtained in approximately 60 to 70% of the patients (for instance, alleviation of symptoms) and long-term regression of the disease can be achieved in certain cases. Moreover, expected survival time can also be prolonged.
Large-scale trials are maintained in Australia and the U.S. to determine the full range of benefits.
Lutetium-177 PSMA is performed with injections into bloodstream at 6- to 8-week intervals. On the day of treatment, an intravenous access is inserted and Lutetium-177 PSMA is administered into the blood vessel for 30 minutes.
Moreover, antiemetic drugs and diuretic agents (to increase urination) are simultaneously administered.
A SPECT scan is performed 24 to 72 hours after the treatment to make sure that the agent reaches to the diseased body parts.
4 sessions of treatment are required for most of the patients. PSMA PET-CT scan is repeated to evaluate treatment response at the end of the second session. If PSA level decreases and positive findings are noted in repeated PSMA scan, the remaining 2 sessions can be performed to complete the therapy to 4 sessions.
The most common side effects are a dry mouth and eyes. Nausea and vomiting can be seen in some cases, although rarely. Mild somnolence is also among the side effects. Most of these effects are transient and they generally disappear after several days.
For patients with diffused bone disease, suppression of bone marrow is also a potential side effect and this condition is caused by collateral damage to neighboring bone marrow by the radiation.
Your treatment plan and estimated cost will be discussed in your pre-treatment visit. Cost of treatment is divided into two parts and involves at least 2 sessions, subsequent scans and consultations. If the initial therapy offers positive outcome, the second part of the treatment cost will be collected.
The PSMA PET-CT scanned to evaluate your eligibility before the treatment will be charged.
You are not fit-to-fly for 3 days after Lutetium-177 PSMA therapy; therefore, the patients who will fly to home should also consider accommodation expenses.
Patients should be referred by the oncologist/urologist, who follows them up, to receive Lutetium-177 PSMA therapy.
You can send the referral documents to firstname.lastname@example.org or you can call +90 212 385 31 00.