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Radionuclide (Lutetium) Therapy

Prostate cancer is the fourth most common cancer affecting Malaysian men, with rates expected to escalate in the coming years, but a new treatment for prostate cancer that has spread to other parts of the body (metastatic) is showing promise that might lead to reduction in tumour burden without severe side effects, even in men who previously have received many other lines of treatment including chemotherapy, radiotherapy and hormonal therapy.

Prostatespecific membrane antigen (PSMA) is a receptor on the surface of prostate cancer cells that is revolutionizing the way consultants image and treat men with prostate cancer. New small molecular peptides with highbinding affinity for the PSMA receptor have allowed high quality, highly specific PET/CT imaging, in addition to the development of targeted radionuclide therapy for men with prostate cancer.

This targeted therapy for advanced prostate cancer has, to date, predominantly used Lutetium- 177 (177Lu) labeled PSMA peptides. Early clinical studies evaluating the safety and efficacy of 177Lu-PSMA therapy have demonstrated promising results with a significant proportion of men with advanced metastatic castrate resistant prostate cancer, who have already failed other therapies, responding clinically to 177Lu-PSMA.

177Lu-PSMA is a treatment that is increasingly being used for people with advanced castrate resistant prostate cancer in Europe and other parts of the world since 2015. This therapy aims to reduce the size of the tumor and halt them from multiplying, as well as ease the symptoms that patients may get with these tumors. Multiple clinical trials are currently being conducted worldwide to evaluate the possible therapeutic role of 177Lu in other malignancies such as breast and kidney cancers.

177Besides 177Lu-PSMA, at Beacon we treat neuroendocrine tumors with Lu 177 as well. Neuroendocrine tumours are group of rare cancers that develop in the neuroendocrine system (a system made up of nerve and gland cells that produces hormones). Lutetium-177-DOTATATE therapy is a type of therapy known as a targeted radionuclide therapy or peptide receptor radionuclide therapy (PRRT). The aim of this lutetium therapy is to inhibit tumour growth and reduce symptoms associated with the tumour.

Targeted radionuclide therapies such as 177Lu-PSMA and 177Lu-DOTATE are promising to be a viable therapeutic options for metastatic prostate cancer and neuroendocrine tumours. Beacon Hospital is delighted to be the first in ASEAN to have this procedure done here.

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