Theranostics: A New Therapy for Prostate Cancer at MMI

Recent advances have changed the way cancer patients can be treated, and Macquarie Medical Imaging is taking a leap forward in prostate cancer treatment. MMI is now offering  theranostics as a service for metastatic prostate cancer patients. 

Here’s everything you need to know about this innovative treatment for patients with metastatic prostate cancer.

Theranostics Service at MMI

Macquarie Medical Imaging Theranostics service is a cancer therapy service that uses isotopes that are labelled with antibodies to specifically target certain types of cancer with a radiation dose.

The radioactive isotope (Lutetium 177)is linked to the PSMA targeting agent that is able to stick to the receptors of the prostate cancer cell. The beta radiation is then able to damage or destroy the prostate cancer cell.

Patients for the theranostics service would be predominantly outpatients. However, we also accommodate inpatients. 

This type of therapy and process is well placed at Macquarie Medical Imaging. The theranostic service uses Lutetium-PSMA therapy, which in some cases  reduces the tumour size and prevents them from multiplying. This also alleviates the symptoms patients with prostate cancer are suffering with. 

Theranostic therapy is the broader name given to radio-labelled agents that specifically target certain types of cancer cells with an alpha or beta-emitting radionuclide.

The purposes of this new service are the following:

  • To expand into the rapidly developing field of theranostic therapy 
  • To participate in trials/research 
  • To offer new theranostic therapies as they become available

MMI had 350 successful infusions of Lutetium-PSMA between April 2017 and January 2019. Positive changes to the patients included: 

  • Pain suppression
  • PSA (Prostate-specific antigen) suppression
  • Improved quality of life
  • Improved mobility
  • Increase in energy level
  • Generally feeling better/well

How It Works

MMI has the facilities and equipment to administer the therapy, monitor the patient, and store radioactive waste. Here are the steps that patients need to take:

  1. patients obtain a referral from their regular GP or specialist
  2. The patient would contact MMI to make an appointment to see our oncologists/nuclear medicine physician, who would ascertain candidacy for treatment.
  3. An appointment for the therapy would then be booked in. Therapy takes place at MMI as a day therapy procedure. 
  4. Once the patients has their infusion, they remain in MMI’s therapy rooms where they will be infused with a further 2 liters of IV saline, served lunch, and monitored by our nursing and technical staff. 
  5. Most patients will be discharged four hours after the completion of their therapy. Some patients will stay six hours, depending on their level of hydration and radioactivity. 

MMI also has the facilities to perform any type of diagnostic medical scans, including PET-PSR, as part of the patient’s workup and to monitor the effects of the therapy.

The proposed innovation is a new paradigm in precision oncology. 

The use of radio-labelled radioisotopes for targeted therapy is not new to cancer therapy. These have been used in neuroendocrine tumours (current standard of care). Its extension into prostate cancer treatment has seen considerable progress in completion of head-to-head trials in Phase II and Phase III:

Both are closed to recruitment. 

Here are some insights from the trials:

  • Prostate is a radio-responsive disease. It is also a highly effective palliative therapy for localised metastatic disease. For extensive metastases, a systemic approach to treatment is utilised.
  • Radionuclide therapy uses systemically administered tumour-targeting agents to deliver a therapeutic radionuclide and provides another avenue for the application of radiation in the treatment of metastatic prostate cancer.
  • The five-year survival rate for men with prostate cancer who develop metastatic disease is 29% despite advances in therapy.
  • PSMA is over expressed in virtually all prostate cancers and its expression is increased in poorly differentiated, metastatic and castration-resistant carcinomas.
  • Lu-PSMA offers a therapeutic target in patients with metastatic prostate cancer with limited treatment options. The reports in the literature of 177Lu-PSMA are very encouraging despite their variable use in terms of both administered activity and the number of cycles administered.
  • All of the studies included patients who were heavily pre-treated with 44-100% receiving prior systemic chemotherapy and 43-100% either abiraterone or enzalutamide.

For further information please contact MMI, and inquire about theranostics today. Stay tuned for our next news blog were we will introduce our clinical lead specialist for Macquarie Theranostics services.

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