Lutetium in the treatment of metastatic prostate cancer
In January 2017, we were the first health care provider in Finland to use Lu-PSMA* drug therapy in the treatment of advanced prostate cancer, which enables destroying metastases outside the bones efficiently without any severe adverse effects.
Lu-PSMA seeks prostate cancer cells regardless of their location, so the radiation source can be inserted directly into the cancer cell or in its immediate vicinity as a form of HDR-brachytherapy. Before the treatment, we carry out a diagnostic PET scan using F-PSMA tracers to ensure that Lu-PSMA uptake occurs in the metastases.
Lu-PSMA therapy is administered intravenously, and its most common side effect is a dry mouth. Depending on the individual, the treatment is typically performed 2–6 times approximately every 4–6 weeks.
The multidisciplinary team in charge of peptide-receptor therapies at Docrates Cancer Center is led by Chief Physician in Nuclear Medicine Jukka Kemppainen.
**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.