Lutetium in the treatment of metastatic prostate cancer
In January 2017 our hospital became the first in Finland to introduce cancer treatments with the new Lu-PSMA* radiopharmaceutical in treating advanced prostate cancer. The treatment enables effective destruction of prostate cancer metastases outside the skeleton without any major adverse effects.
The radiopharmaceutical lu-PSMA is able to bind to PSMA molecules found on the cell surface of prostate cancer cells regardless of their location. The radiation source can thus be directed directly into the cancer cells or their immediate vicinity. A PET-CT examination with F-68-PSMA tracer is required prior to the treatment in order to make sure that the metastases react to lu-PSMA.
Lu-PSMA treatment is administered intravenously and its most common side effect is dryness in mouth. The treatments are given in line with the patient’s individual treatment plan, generally 2-6 times every 4-6 weeks.
A multi-professional team, led by nuclear medicine specialist Jukka Kemppainen is in charge of peptide receptor treatment at Docrates Cancer Center.
**Lutetium-PSMA is still experimental treatment, and has a special permission for compassionate use by the Finnish Medicines Agency (Fimea). The international randomised controlled trials are also in their third phase, after which official and more detailed Current Care Guidelines can probably be issued for the cancer cases selected for treatment. However, some results were already presented in October’s ESMO2018 conference, according to which the dose escalation study had shown that even a dose three times larger than that proved effective at Docrates was found safe and well tolerated without the appearance of the toxicity that restricts the dosage.
