Lutetium-177 radioligand therapy
Cancer-seeking molecules carrying the radioactive metal lutetium-177, which delivers short-range radiation to tumours it binds; approved for neuroendocrine tumours and prostate cancer.
Overview
Lutetium-177 emits beta particles with a range of a few millimetres and gamma rays that allow imaging, making it the workhorse isotope of radioligand therapy. Lutathera (Lu-177 dotatate, approved 2018) targets somatostatin receptors on neuroendocrine tumours, and Pluvicto (Lu-177 PSMA-617, approved 2022) targets PSMA on prostate cancer; both improved outcomes in randomised trials. Supply of no-carrier-added lutetium, dosimetry and combinations with earlier lines of therapy are the current frontiers.
- PSMA / SSTR-positive cell
How it works
A peptide or small molecule with high affinity for a tumour receptor is chelated to Lu-177 and infused; bound molecules irradiate the cell and its neighbours over the isotope's 6.6-day half-life.
- Randomised survival benefit in two diseases
- Companion PET imaging selects patients
- Tolerable toxicity profile
- Isotope supply and logistics
- Marrow and kidney dose limits
- Resistance and heterogeneous uptake
Dependencies
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This document standardises how hospitals measure the actual radiation dose reaching a patient's kidneys and tumours during lutetium-177 treatment, laying the groundwork for shifting from a one-dose-fits-all schedule to treatment doses tailored to each patient's biology.
For men whose prostate cancer has grown after chemotherapy, a PSMA-targeted radioactive treatment worked at least as well as, and was gentler than, the chemotherapy drug it replaced - provided a PET scan first confirms the cancer takes up the PSMA tracer.
In a small early trial, most heavily pre-treated men with advanced prostate cancer responded to the PSMA-targeted radioactive drug, with manageable side effects, supporting the case for testing it in larger randomised trials.
Latest papers
topQuery for this technology: (TITLE:"Lutetium-177 radioligand therapy" OR ABSTRACT:"Lutetium-177 radioligand therapy" OR TITLE:"177Lu" OR ABSTRACT:"177Lu" OR TITLE:"Lu-177" OR ABSTRACT:"Lu-177" OR TITLE:"Lutetium-177" OR ABSTRACT:"Lutetium-177") AND (radiopharmaceutical OR radioligand OR radionuclide OR theranostic OR "nuclear medicine" OR "molecular imaging" OR radiotracer OR scintigraphy OR cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Lutetium-177 radioligand therapy, not a curated reading list.
Similar pages
not linked directly; found by shared links- PersonMichael Hofman
Shares LuPSMA trial: single-arm phase 2 study of 177Lu-PSMA-617 in metastatic castration-resistant prostate cancer, TheraP: [177Lu]Lu-PSMA-617 versus cabazitaxel in metastatic castration-resistant prostate cancer, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha, PSMA.
- TechnologyRadiopharmaceutical GMP and releasing a drug that decays
Shares Radiolysis (self-radiolysis of radiopharmaceuticals), Radioactive waste handling and disposal regulation, Hot lab and shielded treatment room capacity, Radioligand dosimetry.
- PersonKen Herrmann
Shares Wolfgang P. Fendler, Lutetium-177 dotatate, PSMA, Lutetium-177 vipivotide tetraxetan.
- InstitutionIRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori' (IRST)
Shares Somatostatin receptor 2, Lutetium-177 dotatate, PSMA, Lutetium-177 vipivotide tetraxetan.
- PersonMichael J. Morris
Shares TheraP: [177Lu]Lu-PSMA-617 versus cabazitaxel in metastatic castration-resistant prostate cancer, PSMA theranostics roadmap: antigen discovery → PSMA PET → 177Lu-PSMA-617 → earlier lines and alpha, PSMA, Lutetium-177 vipivotide tetraxetan.
- InstitutionWest German Cancer Center (WTZ), University Hospital Essen
Shares Wolfgang P. Fendler, Lutetium-177 dotatate, Lutetium-177 vipivotide tetraxetan, Neuroendocrine tumours.
- BottleneckSite readiness and referral pathway delays
Shares Radioactive waste handling and disposal regulation, Hot lab and shielded treatment room capacity, Clinical trial capacity for radioligand therapy, Lutetium-177 vipivotide tetraxetan.
- InstitutionInselspital, Bern University Hospital / University Cancer Center Inselspital
Shares Somatostatin receptor 2, Lutetium-177 dotatate, PSMA, Lutetium-177 vipivotide tetraxetan.