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Cancer Treatment With Lutetium-177 PSMA

Cancer Treatment With Lutetium-177 PSMA

Approaches to treating malignant tumors have undergone significant changes over the past decade. As scientists learn more about the changes in cells that cause cancer, they have been able to develop new types of drugs. 

Lu 177 psma is a promising option for radionuclide cancer therapy. The drug is delivered directly to the affected tissue, creating a significant concentration. In addition, lutetium-177 treatment has optimal characteristics that make it possible to destroy malignant tumors and metastases up to 1-3 mm in size.

What is Lutetium-177 PSMA therapy?

Radionuclide lu 177 psma therapy is mainly used for prostate cancer in men. Another area of use of lutetium 177 is the treatment of rare neuroendocrine tumors in the stomach, pancreas, rectum, and thyroid glands. Lu 177 psma therapy can be used effectively in all these cases. Currently, studies are being conducted in Germany, Austria, and other European countries that allow oncologists to learn more about Lu-177 treatment and use it for tumors of the meninges. 

Lutetium-177 does not penetrate deep into the human tissues and practically does not affect healthy structures. Instead, the real impact falls on tumor cells. Beta radiation, reaching several millimeters in the tissue, allows targeted local irradiation of cancer cells, preventing their growth, and destroying them, while healthy tissue is largely preserved.

Lu 177 psma therapy can be used if previous methods, such as hormone treatment, chemo, or radiation therapy, have already been performed or are contraindicated, unsuitable or intolerant.

How Does Lu-177 Therapy Work?

In the search for new methods for advanced cancer, scientists from the German Cancer Research Center (Deutsche Krebsforschungszentrum, DKFZ) have created a unique molecule called PSMA -617. PSMA is a Specific Prostate Membrane Antigen. It is a kind of protein that is found on the surface of prostate cells. It is important to note that its content in cancer cells is hundreds of times higher than in healthy ones. 

Lu 177 PSMA consists of a carrier molecule PSMA and a radioactive isotope lutetium-177, a beta radiation source.

The radiopharmaceutical is slowly injected into the vein with a syringe. The PSMA-617 molecule purposefully finds prostate cancer cells, including primary tumors and distant metastases, and binds to them. When these substances decay, they emit radioactive radiation. After administration of these drugs, PSMA-617 binds to prostate cancer cells, and the tumor is subjected to targeted radiation. As a result, cancer cells die, and the surrounding healthy tissues remain viable. As a result, the primary tumor size is significantly reduced, and most of the metastases disappear. Thanks to this method, therapy is tolerated better than conventional radiation. 

After the introduction of lutetium-177, the patient should stay in the hospital for up to 48 hours. Then doctors do a diagnostic imaging of the whole body to assess the distribution of Lu 177 psma. If necessary, the lutetium-177 treatment is repeated after eight weeks. The doctor determines the number of cycles by evaluating the body’s response to treatment.

What is the Success Rate for Lutetium-177?

Lu 177 psma therapy is carried out in several cycles with an interval of eight weeks. The results show excellent effects after two or three courses of lutetium-177 treatment. Even in patients who have already developed metastases in the bones, lymph nodes, or a local recurrence in the prostate, an apparent decrease in tumor foci is visible.

The ability of lutetium 177 to purposefully bind to malignant prostate cells minimizes the risk of its negative impact on healthy tissues. As a result, lu 177 psma therapy is much safer than other types of radiation therapy and standard chemotherapy.

According to the results of clinical trials, patients did not experience any severe side effects after lutetium-177 treatment. The side effects were moderate and quickly disappeared on their own. These were mainly dry mouth, increased fatigue, and disorders in the work of the hematopoietic system and kidneys.

Experts note that during lu 177 psma therapy, it is necessary to do laboratory blood tests to ensure that it does not harm health.

Results and Statistics

The first clinical, biochemical, and radiological results of lu 177 psma therapy appear within a few weeks after the completion of the procedure. The most notable aspects among them are PSA level. PSA is the primary oncological marker associated with prostate cancer. After lutetium-177 treatment, its level decreases by 50% or more in all patients. In addition, the results of tomography showed a decrease in the number and size of metastases and regression of the primary tumor.

Lu 177 psma therapy reduced the likelihood of disease progression by 60%, the risk of death by 38%, and the risk of bone metastases by 50%.

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Best Hospital for Lutetium-177 therapy

The homeland of PSMA therapy is Germany. For several years, thousands of patients from different countries have successfully undergone lu 177 psma therapy in Europe, Israel, and Turkey. The best clinics for lutetium-177 treatment are:

1University Hospital ChariteBerlin, Germany
2Beta ClinicBonn, Germany
3University Hospital rechts der IsarMunich, Germany
4Helios Hospital Berlin-BuchBerlin, Germany
5Teknon Medical CentreBarcelona, Spain
6Ichilov Sourasky Medical CentreTel Aviv, Israel
7SHEBA Medical CentreRamat Gan, Israel
8University HospitalVienna, Austria
9University HospitalKrakow, Poland
10Anadolu Medical CentreGebze, Turkey

Lutetium-177 treatment cost varies depending on the country, the chosen hospital, the number of treatment courses, and the necessary examinations. For example, in Germany, the quality and safety of lu 177 psma therapy are strictly monitored at the legislative level, regardless of whether a person is a resident of this country. For this reason, any treatment in this country is accompanied by numerous, sometimes overlapping, tests and examinations. Nevertheless, the cost in German clinics remains fixed and does not change during lu 177 psma therapy.

In Israel and Turkey, on the contrary, there are no strict treatment requirements for non-citizens of these countries. Instead, they believe that a patient who has come for lutetium-177 treatment should choose the procedures necessary for him. All other responsibility for the life and safety of the patient is assigned to medical insurance companies. Thus, in most cases, when a person requests the cost of one course of lu 177 psma therapy, they can only name the price of the injection, keeping silent about the cost of tests and examinations associated with such treatment. These questions need to be clarified when choosing a hospital.

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