PSMA Therapy | Dr Ishita B Sen | Nuclear Medicine Therapy | FMRI

PSMA is a membrane glycoprotein which is expressed on the Prostate Cancer Cells. It expressed on normal Prostate Cells also but in Prostate Cancer Cells it is expressed many many times more than the normal Prostate Cancers Cells. Also, as the Prostate Cancer becomes more Castrate Resistant or Hormone Resistant, the expressions of PSMA increase. So, the more aggressive the Prostate Cancer the more is the expression of PSMA. And this PSMA serves as a brilliant target for us to both image as well as to treat patients of Prostate Cancer. So, when we talk about Imaging, we use a radioisotope like Gallium 68 or F-18 which emits rays which we can use for imaging. And these radioisotopes are labelled with a small body which targets these PSMA receptors which are expressed on the tumour cells.
So, this combination of the radio isotope with the small body is known as a radioligand. And this radioligand is injected intravenously and inside the body of a patient it seeks out all the sites of prostate cancer and its metastasis it accumulates, it gets attached to the PSMA receptors which are expressed on the prostate cancer cells it is internalized this radioligand complex is then internalized within the cell and it stays there and because of the radioactive tail which this radioligand has it emits certain rays which are then picked up by the Pet CT-Scan. And these images are then co-register to very high-resolution CT Scan images to give us a holistic picture of both, the extent of disease as well as detecting all the sites where this prostate cancer has metastasised. So, this serves as a invaluable tool for determining whether the patient is eligible for a treatment which addresses just the prostate gland or in cases where there is some spread the patient may actually need to going for a systemic therapy as compared to a local therapy like surgery or like radiation.
Now the same PSMA receptor may be used for treating patients of prostate cancer especially those patients who have become castrate resistant or hormone resistant. Now in these kind of tumours the use of this radioligand is for treating these tumour sites and hence the radio isotope which is used may be a beta or an alpha emitting radioisotope which has the potential to actually cause DNA breaks in the tumour cells resulting in their cell death. So now the common radioisotopes which are used for this radioligand therapy are Lutetium which is Lutetium 177 or in cases of an Alpha PSMA Therapy it is Actinium 225 which is used as the radioisotope.
Note:
The content provided on this video is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.
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