When prostate cancer has metastasized, and hormone therapy is no longer effective, or when chemotherapy fails or causes severe toxic reactions, it may seem that treatment options are exhausted. However, alternatives still exist. In Europe, Lu-177 therapy is used to control cancer even after all other treatments have failed to contain the growth of malignant tumors.
What is 177Lu-PSMA-617?
The radiopharmaceutical for PSMA therapy was developed in Germany at Heidelberg Clinic in 2010, first used in clinical practice in 2015, and is now an approved treatment for metastatic castration-resistant prostate cancer (resistant to hormone therapy).
Due to its selective action, this drug allows for systemic therapy of prostate cancer. It targets the prostate-specific membrane antigen (PSMA), a peptide expressed by cancer cells but almost absent in normal tissues. PSMA is a target for targeted therapy.
The radiopharmaceutical consists of ligands targeting PSMA and a tumor-destroying radionuclide. Lutetium-177 is used as the radionuclide. Its short-range beta radiation destroys malignant tumors but causes minimal local side effects and systemic toxicity. This therapy is safer and better tolerated compared to most other cancer treatments.
Who is a Candidate for Lutetium Therapy?
PSMA therapy is prescribed as a last-line treatment for metastatic prostate cancer. It’s administered when other treatment methods have been tried and are no longer effective, including:
- Chemotherapy
- Hormone therapy
- Possibly targeted and/or immune therapy (if tests show patients are eligible for these treatment options)
Radionuclide therapy may also be offered to patients who have refused treatment with cabazitaxel or who have experienced severe side effects from treatment with docetaxel.
Lutetium therapy is preferred for visceral metastases (appearing in internal organs), while Radium-223 radionuclide therapy is typically used to suppress bone metastases.
How the Treatment Works
Patients undergo examinations, including PET/CT, clinical and biochemical blood tests, and PSA blood tests. About half an hour before the drug administration, salivary glands are cooled with gel pads pre-cooled in a freezer.
The treatment involves a single intravenous injection of the radiopharmaceutical. Pain and nausea medications may be administered simultaneously. The patient then spends 4 days in the hospital while the drug is eliminated from the body. They receive symptomatic therapy: analgesics, antiemetics (anti-nausea drugs), and prokinetics.
The course is repeated after 6 weeks. Patients typically undergo 4-6 cycles of such treatment. Therapy continues as long as it’s effective and doesn’t cause severe toxic reactions. A small percentage of patients achieve a complete response to treatment: all tumors disappear. In such cases, treatment is discontinued, and the focus shifts to observation and supportive care.
Lutetium therapy is not combined with chemotherapy but can be combined with anti-androgen therapy and drugs that reduce symptoms of bone metastases (anti-resorptive agents). The possibility of combination with targeted therapy is still being researched.
Are There Side Effects?
The drug is generally well-tolerated. Mild nausea occurs in 20% of patients. Fatigue is possible in the first 4 weeks, with a 25% risk of this side effect. Temporary dry mouth is noted in 20% of men. Grade I-II kidney damage occurs in 25% of cases.
If you’re considering undergoing Lutetium therapy in Europe, the Booking Health service can be an invaluable resource. This platform allows you to explore and compare various clinics offering this innovative treatment. You can access detailed information about each facility, including their experience with Lu-177-PSMA therapy, success rates, and patient reviews. This comprehensive approach helps you make an informed decision about where to receive your treatment.
Moreover, Booking Health provides a transparent pricing system, allowing you to compare costs across different clinics and countries. This can be particularly helpful in planning your medical trip, as prices for the same treatment can vary significantly between healthcare providers and regions.
The Booking Health team is experienced in medical tourism and can assist you in navigating the complexities of seeking treatment abroad.
Photo by Tara Winstead: Pexels
