A promising achievement of radionuclide medicine was the radiopharmaceutical lutetium 177. This medication is designed to treat late-stage prostate cancer and neuroendocrine tumors. The lu 177 psma accumulates in cancer cells and irradiates them inside. The surrounding tissues, healthy structures, and the entire body are exposed to minimal exposure.

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The first task of lutetium 177 treatment is to destroy the maximum number of tumor cells in the patient’s body. Reducing the size of malignant foci and the destruction of individual metastases allows resorting to radical surgery to remove the neoplasm. In addition, it relieves the symptoms of the disease. Reducing the severity of pain and other manifestations is especially important since lu 177 therapy is usually prescribed at late stages or with too strong side effects from chemotherapy.

According to the world’s leading oncologists and radiologists, lutetium 177 treatment can help cancer patients who have lost hope of a cure.

What Is Lutetium-177 PSMA Therapy?

Healthy people have prostate-specific membrane antigens (PSMA) on their prostate cells. Prostate cancer patients have more of this antigen on cells and receptors that accept the PSMA protein. In addition, if cancer cells have spread to other organs, the PSMA protein also appears on their cells.

In therapy with Lu-177 PSMA, a molecule is injected intravenously into the body that attaches to PSMA receptors on cancer cells. Before the introduction, the PSMA molecule binds to the isotope lutetium 177, which emits beta radiation. As a result, it damages cancer cells when it is near them. And the PSMA molecule acts as a means of transporting radiation to the tumor site so that the entire body is not exposed to radiation.

What Is The Success Rate For Lutetium-177?

The long-term benefits of lutetium 177 treatment in prostate cancer are still being investigated, but the current results are very promising. Patients with stage 4 prostate cancer usually do not live longer than 9-12 months. However, lu 177 psma therapy significantly increases their survival rate: in 64% of patients, the tumor size decreased by more than half. In addition, the life expectancy of patients after lutetium 177 treatment increased by 50%.

Lu 177 psma therapy for patients with neuroendocrine tumors at the last stage increases the time and quality of life. According to the observations of American oncologists, 62% of patients with stage 4 midgut cancer lived for three years, thanks to the course of lutetium 177. Only 10% of patients with this diagnosis lived for three years without this therapy.

Today, research continues on new concepts aimed at further improving the targeted treatment of metastatic prostate cancer. In the future, the researchers plan to determine how effective lutetium 177 treatment is for prostate cancer in the early stages.

Lu 177 Side Effects?

Radionuclide treatment is indicated for weakened patients with advanced stages of cancer, so scientists and practitioners pay special attention to the effectiveness of therapy and its tolerability. The most common side effects of lu 177 psma therapy include nausea, swelling of the oral mucosa, impaired swallowing, and difficulty speaking. Most of the side effects are temporary and go away in a few days/weeks after the end of the treatment.

Lutetium 177 can accumulate in the salivary glands. Therefore, they are cooled before the drug is administered. Complications may include impaired liver and kidney function and inhibition of hematopoietic function.

For timely detection of emerging complications, the patient is given clinical and biochemical blood tests, and the condition of the kidneys is assessed before and after each session of radionuclide therapy.

Although lutetium 177 is not a 100% safe method, the benefits that a patient with a metastatic form of cancer receives exceed the likely harm to health.

Alternative Names For Lu-177

To date, the medical protocols for cancer treatment include several essential drugs. These are:

• Lutathera or Lutetium 177 Dotatate. In January 2018, the drug was approved by the FDA (U.S. Food & Drug Administration) for treating neuroendocrine tumors of the gastrointestinal tract or pancreas.
• Lutetium-177-PSMA-617. In the summer of 2021, the FDA approved the treatment of castration-resistant metastatic prostate cancer. Clinical studies of drug use at earlier stages of prostate cancer are also being conducted.
• Pluvicto (lutetium-177 vipivotide tetraxetan). Approved in April 2022 for the treatment of late-stage prostate cancer.

In addition, radionuclide medicine includes treatment with isotopes of actinium-225 and radium-223. That improves the condition of most patients with late-stage prostate cancer. In addition, this treatment method is indicated for men with hormone-resistant prostate cancer with metastases to the bones, lymph nodes, liver, and lungs.

Best Hospital For Lutetium 177 Therapy

To date, lu 177 psma therapy is not carried out in all countries. This innovative cancer treatment technique is available only in a few nuclear medicine centers and specialized departments of primary university clinics in Europe, Turkey, and Israel.

The leading medical centers that offer lutetium 177 treatment are listed below in the table:

The Lu-177 PSMA treatment cost depends on the level of the medical institution, the number of procedures, the need for hospitalization, and other factors.

Some clinics have facilities for manufacturing drugs for radionuclide lu 177 psma therapy on their own. At the same time, the medicine is selected individually for each patient. In addition, it is made “to order,” which significantly reduces the cost of therapy.

References:

1. National Cancer Institute: Lutetium Lu 177-Dotatate
2. AiroMedical: Lutetium 177 PSMA Therapy
3. The New England Journal of Medicine: Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer
4. Genesis Care: What is lutetium 177 PSMA therapy?
5. Mercy Radiology: What is Lutetium-177 PSMA