Lu-177 PSMA Prostate Cancer Therapy in Europe

Lutetium-177 PSMA therapy (often written as Lu-177 PSMA) has quickly become one of the most talked-about options for men with advanced prostate cancer.^[1][2]

It’s a targeted radioligand nuclear medicine therapy when a small molecule seeks out PSMA (a marker commonly overexpressed on prostate cancer cells) and delivers radiation directly to tumor sites.^[3] Read more details about Lutetium treatment for prostate cancer here or detailed Lu-177 specifics.

In this article, we’ll break down the prostate cancer terrain in Europe. We’ll explain what makes the region attractive for Lu-177 PSMA, compare how prostate cancer treatment in the EU can differ across countries, and define the best nuclear medicine centres in the area.

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Why Europe for Lu-177 PSMA Therapy?

Europe is a leading hub for Lu-177 PSMA therapy. Many centers have invested heavily in building top-notch nuclear medicine facilities. They have focused on theranostics and developed strong clinical protocols. This investment has led to extensive clinical experience, high imaging standards, and reliable tracer chains. All of these factors are crucial for effective therapy.

Innovations & Historical Lead

Europe didn’t just “adopt” Lu-177 PSMA therapy - it helped build the modern PSMA radioligand playbook.

The PSMA-617 ligand, which later became the backbone of Pluvicto, was originally developed in Heidelberg under the leadership of the German Cancer Research Center (DKFZ) and the University Hospital Heidelberg.^[4][5] It was licensed for further development to ABX GmbH before progressing through subsequent commercial stages (including Endocyte and ultimately Novartis).^[6][7] Find out more about Lutetium 177 treatment in Germany here.

Long before formal U.S. availability, European nuclear medicine teams had already used Lutetium 177 PSMA therapy in clinical research and real-world settings. This accelerated practical know-how in patient selection, dosimetry culture, and side-effect management.^[8]

In addition, many European centers developed integrated “theranostics” routines early. That early operational experience is a major reason Europe still has a dense network of expertise today.

Availability

Availability in Europe often means two practical advantages. The first is access to multiple PSMA ligands, and the second is hospital infrastructure already in place for repeated radioligand cycles.

It is worth mentioning that both PSMA-617 and PSMA-I&T are used clinically in Europe. Patients commonly see centers offering Lu-PSMA-617 (the molecule associated with Pluvicto) and Lu-PSMA-I&T, another widely used ligand family with strong European roots.^[9]

Large European nuclear medicine departments frequently have: established radiopharmacy/radiochemistry teams (or tight partnerships with GMP suppliers), predictable cycle scheduling, and multidisciplinary tumor boards that decide eligibility for Lu-177 therapy and sequencing.

A key patient-facing point: “Pluvicto eligibility” is not always the same thing as “PSMA radioligand eligibility.” Even if a patient doesn’t neatly match one specific branded label or trial-derived criteria, European clinics may still be able to consider PSMA-I&T or other PSMA ligands through local clinical protocols or clinical trials.^[10]

Europe is also active in the “next-generation” radionuclide pipeline. Terbium-161 (Tb-161) is a close cousin of Lutetium PSMA therapy. With additional electron emissions that may, in theory, improve micro-lesion kill, it might be named the next new prostate cancer treatment in Europe.^[11] It’s already a serious research focus in PSMA-targeted therapy.

Tracer & Isotopes Supply

PSMA therapy is only as reliable as the supply chain behind it. Europe’s advantage is less about one single factory and more about a network. Europe produces over 60% of the world's medical isotopes. It comprises isotope production, radiopharmaceutical manufacturing, and rapid logistics for high-volume hospitals.^[12]

Europe has several major research reactors and isotope-production ecosystems that support the production of medical radionuclides (including therapeutic isotopes such as Lu-177). EU-level supply planning explicitly addresses European reactor infrastructure and replacement/new-build projects designed to support therapeutic radionuclide production.

Examples of European reactor-linked supply collaborations include Lu-177-related production partnership announcements involving the Institut Laue-Langevin in France and industrial radiopharma partners, as well as expansion plans in the Petten ecosystem via NRG|PALLAS with Curium.^[13]

For PSMA PET tracers (the diagnostic “gatekeeper” before treatment), Europe benefits from a wide range of cyclotron/generator capacity and distribution models. It is often hospital-based or regional, which makes day-to-day imaging logistics more resilient in many regions.

A robust tracer supply results in fewer canceled cycles for patients, tighter scheduling, and more predictable care pathways. Additionally, the waiting list for Pluvicto Europe is typically shorter than that for other destinations.^[14]

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Comparing Lutetium 177 PSMA Therapy in Different EU Countries

Searching for targeted prostate cancer treatment in Europe is leading to comparing Lutetium PSMA destinations. See our cumulative comparison table, which presents the key criteria and decision factors typically considered for cross-border medical treatment.

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Best European Nuclear Medicine Hospitals & Clinics

Explore the list of leading nuclear medicine centers in Europe. Each facility offers a high level of medical services, extensive research capabilities, and availability, and can serve international patients.

9.90

Helios Hospital Berlin-Buch

9.90

University Hospital Rechts der Isar Munich

9.90

University Hospital Heidelberg

9.90

University Hospital Saarland Homburg

9.80

University Hospital Ludwig-Maximilians Munich

9.80

University Hospital Vienna (AKH)

9.80

University Hospital Zurich

9.80

University Hospital de Navarra Pamplona

9.70

Wiener Private Clinic Vienna

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clinics

How to Choose a European Clinic?

Selecting a clinic for Lu-177 PSMA therapy is largely about one thing: how reliably they can perform the full theranostics treatment protocol. This starts with confirming you’re a good candidate, then delivering multiple cycles safely, and finally monitoring the response. Here’s a detailed way to evaluate EU-based clinics.

• Patient Selection Process & Criteria. A strong center won’t accept you based on a single message or a PSA number. They will request your treatment history, recent labs, and recent PSMA PET/CT. Ask what they consider “PSMA-expressing tumors” to rule out mismatch disease. If the clinic can’t clearly explain its selection logic, that’s a warning sign. Lu 177 PSMA nuclear medicine therapy is effective only when the biology and imaging align.
• University Hospital vs. Medical Centre vs. Clinic. In Europe, the label often signals how “broad” the infrastructure is. University hospitals typically have the deepest multidisciplinary support (e.g., nuclear medicine, oncology/urology, hematology) and are more likely to manage complex cases and offer clinical trials. Medical centres or large hospitals can be just as strong clinically, but quality depends on whether they run a high-volume theranostics program or only occasionally provide Lu-PSMA. Finally, private clinics may be faster and more concierge-like, but you should confirm where imaging, radiopharmacy, and complication management actually happen (in-house vs outsourced to a partner hospital).
• The Facility Runs The Whole Program. Lu-177 PSMA is typically administered in several cycles with planned intervals, and decisions are made after each cycle based on response and blood counts. The best clinics operate like a system: intake review, multidisciplinary decision-making (nuclear medicine + oncology/urology), cycle planning, toxicity monitoring, and a clear follow-up schedule. Ask who is responsible for you between cycles and what happens if side effects appear after you’ve left the country.
• Compare Day-of-Treatment Workflow. The infusion is just one part of the treatment day. Request a clear timeline outlining the process from arrival to discharge. High-quality treatment centers typically follow standard procedures, including confirming laboratory results near the time of treatment, developing a hydration and anti-nausea plan when necessary, establishing a clear radiation safety protocol, and defining an observation period afterward. They should also explain the post-therapy imaging they conduct, as many centers perform scans to document uptake and distribution. Additionally, it's important for them to clearly communicate the discharge criteria. If the center is accustomed to treating international patients, it should provide travel-ready paperwork for radiation detectors.
• Treatment Adaptation Between Cycles. Two patients can start with similar scans and then diverge: one tolerates therapy well, another develops blood-count suppression or needs timing adjustments. If their answer is “we always do the same dose and schedule,” that may still be acceptable in some settings, but it’s not ideal for complex cases. The best centers have a structured plan for adjusting timing, dose, and monitoring based on your labs and symptoms.
• Patient's Experience. Look for feedback specifically mentioning Lu-177 PSMA, nuclear medicine, theranostics (not just “nice rooms”). Consistent feedback highlights prompt communication, effective coordination for international patients, and clear information on costs and inclusions. However, significant concerns include repeated complaints about last-minute cancellations, unclear paperwork, and inadequate follow-up after patients leave the country.
• Research Involvement. Research-active centers typically stay up to date on patient selection, imaging interpretation, and protocol adjustments. They are also more likely to offer alternative options if you do not fit into one specific pathway. This might include various PSMA ligands, compassionate-use options when applicable, or participation in clinical trials evaluating next-generation treatments, such as Tb-161. Even if you choose not to join a study, being at such a center generally means you will receive more structured monitoring and have access to additional options if the initial treatment plan is not ideal.
• Inpatient vs. Outpatient. Across Europe, rules differ on whether Lu-177 treatment is delivered as an outpatient, in a day-stay, or with short inpatient isolation. You should ask what your clinic requires and why. This affects your total trip time, where you can stay afterward, and when you can safely be around family members.
• Offerings Beyond Brand Pathway. Some patients don’t meet the strictest criteria for a specific labeled product pathway (often referred to as the “Pluvicto criteria”), but may still be candidates for PSMA-targeted radioligand therapy depending on clinical context, local protocols, or trials. Ask directly whether they can evaluate alternatives, such as PSMA-I&T, Terbium-161, research options, or alternative radiopharmaceuticals, such as Ac225. A clinic that only offers one rigid option may be fine for straightforward cases, but it can be limiting if your imaging or prior therapy history is nuanced.
• Response Assessment & Follow-Up. Before you commit, ask how they measure success and when they measure it. Most clinics will combine symptom review, PSA trend, laboratory tests, and follow-up imaging at defined intervals. You should also ask what they consider a reason to continue versus switch the strategy (e.g., stable disease but worsening marrow tolerance). Strong clinics are conservative in promises and precise in monitoring.
• Compare Offers. Two “prices” can be impossible to compare unless you understand what’s bundled. Ask whether the quote includes the pre-therapy consult, lab checks, imaging, the radiopharmaceutical itself, hospital stay (if any), post-therapy scan, discharge documentation, and coordination with your home oncologist.

Explore Offerings

Each patient, particularly those traveling from abroad, should be informed of the Lutetium PSMA therapy cost, including any additional charges and related diagnostic procedures. Check ready-to-go medical offerings from different facilities across Europe.

• Lutetium-177 PSMA therapy + Ga-68 PSMA PET scan | 1 cycle for 23,117€
• Lutetium-177 PSMA therapy + Ga-68 PSMA PET scan | 1 cycle - VIP package for 26,063€
• Lutetium-177 PSMA therapy for prostate cancer | 1 cycle - basic package for 20,540€
• Lutetium-177 PSMA Therapy for Prostate Cancer - 1 cycle

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FAQ

References

1. European Medicines Agency. (2022). Pluvicto (lutetium (177Lu) vipivotide tetraxetan): EPAR — Product information. Retrieved February 2026.
2. Novartis. (2022, December 13). Novartis receives European Commission approval for Pluvicto® as first targeted radioligand therapy for treatment of progressive PSMA-positive metastatic castration-resistant prostate cancer. Retrieved February 2026.
3. Kratochwil, C., Fendler, W. P., Eiber, M., Hofman, M. S., Emmett, L., Calais, J., Osborne, J. R., Iravani, A., Koo, P., Lindenberg, L., Baum, R. P., Bozkurt, M. F., Delgado Bolton, R. C., Ezziddin, S., Forrer, F., Hicks, R. J., Hope, T. A., Kabasakal, L., Konijnenberg, M., … Hermann, K. (2023). Joint EANM/SNMMI procedure guideline for the use of 177Lu-labeled PSMA-targeted radioligand-therapy (177Lu-PSMA-RLT). European Journal of Nuclear Medicine and Molecular Imaging, 50(9), 2830–2845. https://doi.org/10.1007/s00259-023-06255-8. Retrieved February 2026.
4. Benesova, M., Schafer, M., Bauder-Wust, U., Afshar-Oromieh, A., Kratochwil, C., Mier, W., Haberkorn, U., Kopka, K., & Eder, M. (2015). Preclinical Evaluation of a PSMA-Specific Radioligand (68Ga-PSMA-617) for PET Imaging of Prostate Cancer. Journal of Nuclear Medicine, 56(6), 914–920. Retrieved February 2026.
5. German Cancer Research Center (DKFZ). Award-winning agent developed for prostate cancer diagnosis and treatment. Retrieved February 2026.
6. ABX advanced biochemical compounds. 177Lutetium-PSMA-617: A success story. Retrieved February 2026.
7. U.S. Securities and Exchange Commission. (2017). Exhibit 99.1: Endocyte Reports Third Quarter Financial Results. Retrieved February 2026.
8. University Hospital Bonn. Lutetium-177 PSMA. Retrieved February 2026.
9. Chatalic, K. L. S., Heskamp, S., Konijnenberg, M., Molkenboer-Kuenen, J. D. M., Franssen, G. M., Clahsen-van Groningen, M. C., Schottelius, M., Wester, H. J., van Weerden, W. M., Boerman, O. C., & de Jong, M. (2016). Towards Personalized Treatment of Prostate Cancer: PSMA I&T, a Promising Prostate-Specific Membrane Antigen-Targeted Theranostic Agent. Theranostics, 6(6), 849–861. Retrieved February 2026.
10. Ling, S. W., de Lussanet de la Sablonière, Q., Ananta, M., de Blois, E., Koolen, S. L. W., Drexhage, R. C., Hofland, J., Robbrecht, D. G. J., van der Veldt, A. A. M., Verburg, F. A., & Brabander, T. (2025). First real-world clinical experience with [177Lu]Lu-PSMA-I&T in patients with metastatic castration-resistant prostate cancer beyond VISION and TheraP criteria. European Journal of Nuclear Medicine and Molecular Imaging. Retrieved February 2026.
11. Liang, S. H. (2025). From lutetium to terbium: a new era in PSMA-targeted radioligand therapy for mCRPC patients. American Journal of Nuclear Medicine and Molecular Imaging, 15(5), 219–222. Retrieved February 2026.
12. European Nuclear Society. (2022, April 14). World-first Lutetium-177 produced at commercial nuclear reactor. Retrieved February 2026.
13. ITM Isotope Technologies Munich SE. (2024, June 18). ITM and ILL extend collaboration on the manufacturing and supply of medical Lutetium-177 radioisotope. Retrieved February 2026.
14. Ravi, P., Whelpley, B., Kelly, E., Wolanski, A., Ritzer, J., Robertson, M., Shah, H., Morgans, A. K., Wei, X. X., Sunkara, R., Pomerantz, M., Taplin, M. E., Kilbridge, K. L., Choudhury, A. D., & Jacene, H. (2023). Clinical implementation of 177Lu-PSMA-617 in the United States: Lessons learned and ongoing challenges. Journal of Clinical Oncology, 41(6_suppl), 108–108. Retrieved February 2026.