Radioligand Therapy

Following your scan, your case will be reviewed at a multidisciplinary team meeting, and if you are a suitable candidate for Lu-177 PSMA therapy, a consultation will be arranged. During this consultation you will have a medical assessment, and your doctor will answer any questions you may have.  

You may also meet our Radiation Oncologist if you have been referred from another hospital.

These will be arranged for you through the nursing team at Mater Private. Two weeks prior to your planned treatment a number of tests will be carried out to check your haemoglobin, white blood cell and platelet levels, and your renal and liver function, to ensure that the treatment can go ahead.

If your scan shows that the carrier molecule is accurately locating the cancer cells in your body, you will normally begin the Lutetium-177 PSMA Therapy within a month. The treatment is carried out in the Nuclear Medicine department, which is located on the ground floor of the Mater Private Hospital, Eccles Street. In Ireland, nuclear medicine physicians are usually also radiologists and it is normal for the nuclear medicine department to be based in the radiology department. The therapy is given in cycles with patients usually having treatment every six weeks, for up to six cycles. A clinical review will be carried out approximately 3 to 4 weeks after every second cycle of treatment to check how effective the treatment is and whether the treatment should be continued or other treatment options considered.

At the end of your treatment cycles you will have another PSMA PET/CT scan to review how effective the therapy was and what you should expect from it. You will then be discharged back into the care of your referring consultant.

You will need regular blood tests. Your consultant will advise you on this. 

Yes. Currently in Ireland we have access to two Lu-177 PSMA products. The first is Lu-177 PSMA- 617, a Novartis product which is known by the commercial name Pluvicto. This is fully licensed by the European Medicines Agency.

The second product is Lu-177 PSMA- I&T which is produced under a standard known as GMP by Curium in Finland.

Both products are used extensively all over Europe.

RLT is used for the treatment of men with metastatic castration-resistant prostate cancer (mCRPC), a type of prostate cancer that has spread to other parts of the body and no longer responds to standard treatments. You must also have adequate PSMA protein on your cancer cells. This can be confirmed with a Fluorine-18 PSMA scan or a Gallium-68 PSMA PET/CT scan.  

Prostate cancer depends in part on testosterone to grow and spread. Hormone therapy reduces the amount of testosterone made by your testicles, thus slowing down the growth of cancer cells. Hormone therapy can be used alongside radioligand therapy for some patients. 

The treatment is delivered in cycles, with patients having up to six  treatment cycles spaced six weeks apart.

No, Radioligand Therapy is administered as an outpatient procedure. Patients receive an intravenous infusion of Lutetium-177 PSMA, following which your radioactivity levels are monitored until you can go home. Patients will still need to take precautions when at home, such as restricting contact with those around you, sleeping alone for a period of time and following good hygiene practices. The medical physics team will discuss these precautions with you prior to your treatment and provide written instructions for you to follow. and your team will advise you on this.

• Helps you live longer: Research has shown that this treatment can extend life by several months compared to standard treatments.
• Relieves pain and symptoms: Many patients report having fewer cancer-related problems, and a better quality of life.
• Less damage to healthy tissue: This therapy targets cancer cells very precisely, which reduces the risk of damaging healthy tissue.
• Highly effective: A significant percentage of patients see a decrease in their PSA levels and the size of their tumour size.
• Less severe side effects: While there are side effects to the treatment, they are less common and milder than those from chemotherapy.
• Outpatient treatment: You can go home on the same day.

Lutetium -177 PSMA therapy is generally well-tolerated, but as with all cancer treatments there are potential side effects. The most common of these include: tiredness, dry mouth, nausea, loss of appetite, changes in bowel movements, vomiting, weight loss, stomach pain, low blood counts and urinary tract (kidney) infection. There is also a small risk of damage to the kidneys, shortness of breath and developing another cancer.   

Your Mater Private oncologist may decide to refer you based on your specific situation and needs.