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Embracing the Practical Aspects of Theranostics With Prostate-Specific Membrane Antigen–Targeted Lutetium-177

Treatment options for men with metastatic castration-resistant prostate cancer are rapidly changing. In addition to novel anti-androgens and taxane-based chemotherapy, radiopharmaceuticals are having an increasing role. Although calcium-mimetic theranostics have been in use for years, newer approaches use molecularly targeted radiation therapy by conjugating isotopes to prostate-specific membrane antigen (PSMA) and in so doing directly target prostate cancer cells; 177Lutetium-PSMA-617 is perhaps the best-known member of this new class. Expanding our capacity to deliver targeted beta-emitters requires additional planning and equipment. Having delivered close to 200 doses of 177Lutetium-PSMA-617 at our center, we offer practical advice about patient selection, radiation safety, treatment administration, and toxicity monitoring. Although this blueprint is not the only way to expand a theranostics program beyond Radium-223, we offer our institutional experience with 177Lutetium-PSMA-617 as an example to programs seeking to expand their radiopharmaceutical programs. We must rise to meet the patient-driven demand for these innovative and effective therapies.

Charlotte E. Manogue, Wenzhou Chen, Anthony Mazza, Audrey Dang, Brian Lewis, Christopher J.D. Wallis, Jodi Layton, Pedro Barata, Oliver Sartor, Kendra M. Harris

Departments of Medical Oncology; Radiation Oncology, Tulane University School of Medicine, New Orleans, Lousiana; Division of Urology, Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Division of Urology, Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada

Source: Charlotte E. Manogue, Wenzhou Chen, Anthony Mazza, Audrey Dang, Brian Lewis, Christopher J.D. Wallis, Jodi Layton, Pedro Barata, Oliver Sartor, Kendra M. Harris, Embracing the Practical Aspects of Theranostics With Prostate-Specific Membrane Antigen–Targeted Lutetium-177, Practical Radiation Oncology, 2022, ISSN 1879-8500.
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