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PSMA Targeted Therapy

Overview

PSMA-targeted therapy is a specialised radionuclide therapy primarily used for metastatic or advanced prostate cancer. This therapy uses radionuclides (commonly Lu-177, occasionally Ac-225) combined with a biomolecule that specifically targets the receptors on prostate cancer cells. Since PSMA radionuclide therapy is receptor-specific, it has fewer side effects than in conventional chemotherapy. PSMA therapy has been approved by the US-FDA (Food and Drug Administration) following the VISION Trial, confirming its effectiveness and safety. 

  • Advanced prostate cancer with metastasis
  • Cancer that has progressed despite androgen deprivation drugs
  • Cancers already treated with taxane-based chemotherapy or those unsuitable for it

Procedural steps involve the following:

  • Before the procedure, patient hydration is ensured, and IV hydration is provided if necessary.
  • Standard PSMA dosage is then slowly injected into the veins. The injection process usually takes just a few minutes.
  • PSMA-targeted therapy is usually an outpatient procedure. However, depending upon the local radiation guidelines, the patient may be discharged the very next day.

  • PSMA-targeted therapy is administered cyclically, usually 4-6 cycles, depending upon the response following every cycle.
  • Each cycle is administered with a gap of 6–8 weeks with multiple blood investigations to evaluate the treatment efficacy and side effects, if any. 

Patients undergo a pre-therapy evaluation, which includes:

  • PSMA PET scan: to ascertain the target expression, sometimes in conjunction with FDG PET CT
  • Serum PSA levels
  • Performance status (ECOG scale)
  • Comprehensive blood work: including CBC, liver (LFT), and renal function tests (RFT) 
     

Some patients may experience the following side effects:

  • Dry mouth (xerostomia) and dry eyes
  • Fatigue, nausea, vomiting, and loss of appetite
  • Transient drop in blood counts, which usually recovers within a month 

  • Most patients can resume normal activities within 1–2 days.
  • Adequate hydration is encouraged to help clear residual radionuclide.
  • Avoid close contact with pregnant women and children for a few days (duration varies with local safety guidelines).
  • Most patients experience pain relief from bone metastases within 2–4 weeks, leading to improved comfort and quality of life. PSMA radioligand therapy can be used for bony metastases.
  • Follow-up blood tests and scans are scheduled between cycles to monitor progress.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.