LUTETIUM - 177

Requisition Forms

Prostate-Specific Membrane Antigen (PSMA)

Procedure description:

Lutetium-177 is a medium-energy β-emmiter. PSMA is a transmembrane enzyme with a large transcellular domain that is significantly over-expressed on the cell surface which is approximately over 85% of prostate adenocarcinoma. Metastatic or non-metastatic Castration-Resistant Prostate Cancer (mCRPC) is defined by two (2) consecutive PSA progressions (two weeks apart) to a 25% increase over nadir or the appearance of new lesions on imaging despite hormonal manipulation leading to serum testosterone levels below 50 ng/dl.

Indications:

  • Patients with PSMA-positive mCRPC, who progressed under at least one novel androgen axis drug and at least one taxane regime.

  • Patients with PSMA-positive mCRPC, who progressed under at least one novel androgen axis drug and docetaxel but are still possible candidates for receiving cabazitaxel.

  • Patients with PSMA-positive mCRPC, but taxane-naive mCRPC who progressed under at least one novel androgen axis drug.

Patient selection:

PSMA-targeted therapy will only be effective against tumor lesions with sufficient expression of the target receptor. The PSMA tumor expression should be evaluated using molecular imaging (Gallium-68, Tc-99mPSMA SPECT Scintigraphy, or F-18-PSMA PET).