Prostate cancer is the most common malignant cancer in men. One in five men will develop prostate cancer in his lifetime. In most cases, the disease is curable, but prostate cancer is responsible for about 10 percent of all cancer-related deaths in men. Once prostate cancer has spread, there are limited treatment options. One of these options is radioligand therapy with 177Lu-PSMA. In this therapy, a protein that binds to PSMA receptors on the prostate cancer cell is labeled with radioactive 177Lutetium. When this labeled protein is injected into the vein, it binds precisely to the tumor, resulting in targeted internal radiation. This 177Lu-PSMA therapy has been shown to be more effective and better tolerated than, for example, cabizitaxel chemotherapy. It is generally well tolerated with few side effects, such as salivary gland dysfunction or changes in blood counts (e.g., anemia). I introduced this therapy with my team at the University Hospital of Vienna in 2013 and can look back on an experience of more than 500 therapies. I would be happy to assist you with my extensive expertise. In a study conducted under my direction at the Clinical Department of Nuclear Medicine at the AKH Vienna, we were able to show that the vast majority of patients respond positively to this therapy. [1] 

 

An innovative advancement of this treatment is therapy with the alpha emitter 225Actinium (225Ac), which is more effective due to its type of radiation. Even in patients who have been unsuccessfully treated with 177Lu-PSMA, 225Ac-PSMA often leads to a response to therapy. In many cases, however, it may make sense to start with the more effective 225Ac-PSMA therapy and then continue with 177Lu-PSMA. Careful consideration of the options for 225-Actinium-PSMA is therefore necessary for each individual patient in order to weigh up the right time, opportunities and risks based on the clinical situation.