Lutetium 177 vs Chemotherapy for advanced prostate cancer

05/12/2022

What is metastatic prostate cancer?

Prostate cancer is a malignant prostate gland tumour with different stages depending on the size, engaging lymph nodes in the tumorous process and spreading. If the tumour is limited to the prostate and has not been extended, it is called localised prostate cancer. In locally advanced prostate cancer, the tumour has rolled out from the prostate to surrounding tissues.

If cancer develops further and extends to distant lymph nodes or other organs, it is called locally advanced or metastatic prostate cancer.

Signs of prostate cancer spreading

Signs of prostate cancer spreadingFirstly, the symptoms include the general complications of developing each kind of cancer (fatigue, tiredness, weight loss). Secondly, it is essential to understand that typical symptoms depend on the localisation of metastases.

For example, if prostate cancer has spread into the bones, which is the most common situation, the patient suffers from bone pain, characterised as a constant stubbing or dull ache.

Except for this, when the prostate gland is enlarged, it can put pressure on the nearest areas, including the urethra, which will impede the urea passage.

Furthermore, prostate malignancy is very likely to spread to groin lymph nodes. Such a condition is usually followed by swelling and pain in that region.

Options available for advanced prostate cancer

The choice of treatment methods for advanced prostate cancer depends on the type and localisation of the tumour, its stage and size.

The primary therapy options include chemotherapy, Prostate-Specific Membrane Antigen Therapy, radiotherapy, hormone therapy and symptomatic therapy (e.g. pain relief medications). Very often, few methods are combined. If a patient has less than three metastases of not a huge size, he can be treated surgically or with the help of radiotherapy.

Hormone therapy

This treatment affects the primary male hormone (testosterone) and prevents it from reaching cancer cells and making them grow. So, it causes the death or the slowness of prostate cancer cells' growth.

Chemotherapy

Chemotherapy uses anti-cancer drugs which affect tumorous cells. In such a way, tumour growth can be slowed down. The most common chemotherapy include docetaxel (Taxotere) and cabazitaxel (Jevtana). These medications are usually prescribed in combination with steroids (hormones).

Lutetium-177 (PSMA treatment)

Options available for advanced prostate cancerRadioligand anti-cancer treatment combines therapeutic radioactive isotopes with cell-targeting compounds. It is a modern and promising method, approved by the U.S. Food and Drug Administration (FDA), and has shown high efficacy in treating advanced prostate cancer. The FDA-approved radiopharmaceuticals include Lutathera (Lutetium Lu 177 dotatate) and Pluvicto (Lutetium 177 vipivotide tetraxetan).

In normal prostate cells, a specific protein called prostate-specific membrane antigen is produced in low quantities. Still, in the tumorous tissue, the expression of the protein is multiplied many times. So, when the malignant process spreads to other organs, PSMA also appears in their tissues. With the help of radioisotope Lutetium-177, prostate cancer cells can be detected. This diagnostic procedure is performed during PET-CT, and doctors decide if the therapy can be applied after reviewing the results.

The Lu-177 radionuclide, in combination with a somatostatin analogue, cell targeting protein, creates a drug called Lutathera, which has become a particular type of therapy. It can attach to membranes of cancer cells and destroy them.

Results of Lu-177 and chemotherapy

The recent reports of Lutathera treatment for advanced prostate cancer have shown its high-promising efficacy. In addition, the results showed that the response level of Lu-177 therapy was higher than after chemotherapy and the level of adverse effects was lower.

In addition, patients' progression-free and overall survival were also reported to be higher after Lutetium therapy. As a result, modern studies focus on improving drug safety and reducing side effects.

Why is Lutetium treatment so effective?

Why is Lutetium treatment so effective?So, how does it work? Lu-PSMA delivers a small amount of radiation to prostate cancer cells anywhere in the body where its metastases have spread. The medication is injected intravenously, and one part of the drug molecule recognises the target cell and binds to its membrane. In such a way, the cancer cell takes the radiation dose and is damaged by the radioactive "payload".

The benefit of such drugs as Lutathera and Pluvicto is the precise direction of radiation. It travels only short distances outside the cancer cell and doesn't harm healthy tissue.

PSMA therapy with AiroMedical

As we understand, Lutetium therapy has become an approved evidence-based anti-oncological therapy method for advanced prostate cancer. And AiroMedical will help you to find an appropriate clinic with experienced specialists and state-of-art equipment for performing such kind of treatment.

Our database consists of hundreds of high-quality medical institutions worldwide that perform therapy for advanced prostate cancer using Lutathera and Pluvicto. The best hospitals for Lu 177 treatment are Helios Hospital Berlin-Buch, University Hospital Frankfurt am Main of Goethe-University and University Hospital rechts der Isar of the Technical University Munich. Don't hesitate to contact us and we will help you to find a choose solution!

References:

  1. National Library of Medicine: Update on radioligand therapy with 177 Lu-PSMA
  2. National Library of Medicine: Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer
  3. AiroMedical: Hospitals
  4. AiroMedical: Lutetium 177 Treatment Worldwide