Success story after 3 sessions of radioligand PSMA therapy with 1x Actinium-225 & 2x Lutetium-177 Sean Kenny was first diagnosed with prostate cancer in December 2020, when he just turned 51 y.o. Before landing in our clinic, he had undergone multiple treatments, including 6x Docetaxel, antihormonal therapy, immunotherapy and cryotherapy. He chose to pause ADT…

In the ever-evolving battle against cancer, the field of radiopharmaceuticals has emerged as a potent weapon, and alpha emitters such as actinium-225, astatine-211, and lead-212 are quickly gaining prominence. These alpha-emitting isotopes are revolutionizing cancer treatment, offering targeted therapy with the potential to eradicate malignant cells while minimizing damage to surrounding healthy tissue. Alpha Emitters:…

Radioligand therapy (RLT) utilizing 177Lu-PSMA gained initial approval in the USA as a final recourse once all other treatment options have been exhausted. However, quite a few ongoing trials are exploring the potential for deploying this therapy earlier in the course of the disease due to its demonstrated safety, efficacy, and relatively low incidence of…

Peptide receptor radionuclide therapy (PRRT) has significantly advanced in the last two decades within the realm of neuroendocrine tumours (NETs), leveraging the overexpression of somatostatin receptors characteristic of these tumours. This same receptor profile is also prevalent in nearly all meningiomas, with expression of somatostatin receptor 1 & 2 (SSTR1 / SSTR2), rendering PRRT a…

  In the realm of medical diagnostics, the groundbreaking procedure of 68Ga-PSMA PET/CT has emerged as a game-changer, offering unprecedented insights into the assessment and management of prostate cancer. Its extraordinary precision enables clinicians to visualize prostate cancer at a molecular level. It has revolutionized the diagnosis, staging, and personalized treatment strategies for prostate cancer,…

Nuclear medicine is the fastest growing medical field, specifically in cancer treatment. It is extremely effective and low in side effects affording patients a prolonged and higher-quality life compared to conventional treatments like chemotherapy. It is also very versatile and applied in treatment of many cancer types. Our clinic not only provides cutting-edge therapies such…

A study evaluating the efficacy and safety of 177Lu-PSMA radioligand therapy for treating mCRPC in octogenarians demonstrated that radioligand therapy is safe and effective also in elderly patients. Moreover, patients who have not previously undergone chemotherapy had a better and longer-lasting response both in terms of overall and progression-free survival. chemotherapy-pretreated chemotherapy-naïve PSA response rate…

The challenge of the radiation therapy in cancer treatment lies in achieving an optimal radiation level within tumours and metastases, effectively eradicating cancer cells while minimizing harm to surrounding healthy tissues. The combination of Stereotactic Body RadioTherapy (SBRT) and internal radioligand therapy (RLT) with 177Lu-PSMA appears to be precisely the way to maximize the treatment…

Cancer operates insidiously, shaping a distinct microenvironment even before the emergence of actual cancer cells. This inherent challenge makes crucial early detection difficult. Enter the groundbreaking ‘tracer,’ designed to detect the FAP alpha receptor on cancer-associated fibroblasts (CAF). This innovative approach unveils the early fingerprints of cancer, akin to fingerprint powder, facilitating early diagnosis that…

Radioligand PSMA therapy with the lutetium isotope 177Lu has proven to be very effective against metastatic prostate cancer. Nevertheless, there is still a share of patients who do not respond to this treatment. A possible reason may be insufficient radiation dose delivered to the cancer cells so that they are able to survive. So scientists…

PSMA PET/CT is the current mainstay diagnostic tool to stage prostate cancer, especially valuable if metastatic, and to decide on the right treatment (suitability of radioligand therapy 177Lu-PSMA). The newest study has established that it can also be used to evaluate the effectiveness of the treatment with Androgen Receptor Pathway Inhibitors (ARPIs). The cited study…

PSMAfore trial by Novartis (Phase III trial of 177Lu-PSMA-617 in taxane-naïve patients with mCRPC) has not only met its primary endpoint of radiographic progression-free survival (rPFS) but has shown amazing results with the potential to change the clinical practice, as presented at 2023 ESMO conference. Radioligand therapy (RLT) with 177Lu-PSMA-617 in pre-chemo patients brought about the…

Although rare (orphan) and slow growing cancer type, some neuroendocrine tumors (NETs) are associated with rapid progression and poor prognosis. Original authorization for 177Lu-DOTATATE (Lutathera®) was based on the results of the NETTER-1 trial for inoperable midgut NETs. In the NETTER-2 trial 177Lu-DOTATATE has now also demonstrated its efficacy in patients with Grade 2 and…

Before the therapy After 3 sessions of PSMA radioligand therapy Control scan a year later

Fibroblast activation protein (FAP) is overexpressed in the tumor microenvironment or stroma of over 90% of solid tumors, what makes it a promising target for both therapeutic and molecular imaging applications. FAP-targeting molecular imaging has been quickly gaining steam in cancer diagnostics. It is especially useful for tumors with a strong desmoplastic (forming fibrous tissue)…

Effectiveness of 177Lu-PSMA without prior chemotherapy Since the end of the VISION trial that proved 177Lu-PSMA to be an effective treatment of metastasized prostate cancer, the next question arose – does it work even better if applied earlier in the course of the disease? An exciting study has now demonstrated that 177Lu-PSMA applied prior to…

    Manufacturing radioligands is an extremely complex and time-sensitive process, because radiopharmaceuticals need to be “delivered” directly to the cancer cells within days after being synthesized. This is what personalized targeted radionuclide therapy, a game-changer in oncology, is all about. Having our own laboratory and highly proficient radiochemists helps us serve our patients in-time…

Some prostate cancer cases will never develop metastases or any clinical symptoms and are defined as clinically insignificant. Accurate diagnosis able to differentiate between clinically significant and insignificant lesions leads to better disease management. The latest research of our working group has demonstrated that combined hybrid imaging using [18F] fluoromethylcholine (FMC) PET and [68Ga]Ga-PSMAHBED-CC conjugate…

As many trials with 177Lu-PSMA radioligand therapy (RLT) have demonstrated, a reduction of PSA of over 50% leads to statistically significant increase in overall survival. Our clinic’s results show the reproducibility of this data. After 3 sessions of 177Lu-PSMA PSA decreases by an average of 68%. Preserving remissions and increasing quality of life of our…

Following FDA approval in March 2022, European Medicines Agency (EMA) also approved Pluvicto® (lutetium (177Lu) vipivotide tetraxetan) of Novartis in December 2022 for targeted radioligand treatment of progressive PSMA–positive metastatic castration-resistant prostate cancer. The EMA approval is based on the results from the Phase III VISION trial, in which “radioligand therapy with 177Lu-PSMA-617 prolonged radiographic…

  We are thrilled and proud to share that our colleague Prof.Dr. Alexander Haug has been awarded The European Awards in Medicine 2022 in the field of nuclear medicine.

  The patient A.G., 72 y.o., a molecular biologist himself, was diagnosed with metastatic prostate cancer in September 2018. After the conventional standard-of-care treatment (chemo- and antihormonal therapy) there were still residues of the primary tumour in the prostate, and lymph nodes and bone metastases. Up to date he has gone through 9 sessions (3…

Manufacturing personalized radioligands in the laboratory https://www.minute-medical.com/wp-content/uploads/2022/07/Lab-story.mp4

The study of FAPi-based lutetium-177 therapy in the All India Institute Of Medical Sciences in New Delhi was meant to investigate the therapeutic efficacy and safety of 177Lu-DOTAGA.(SA.FAPi)2 in RR-DTC patients. 15 heavily pre-treated (min 2 lines of prior treatment with lenvatinib and/or sorafenib) patients with the disease progression were selected based on FAPi PET/CT.…

TheraP, a phase II trial comparing radioligand treatment with 177Lu-PSMA-617 to the chemotherapy using cabazitaxel was finalized with 177Lu-PSMA demonstrating a clear advantage over the chemotherapy. Probands’ selection criteria 200 men with mCRPC, overwhelmingly ADT-pretreated (91%), were selected based on 68Ga-PSMA PET/CT and 18F-FDG PET/CT. 68Ga-PSMA PET/CT was meant to detect the sufficiency of PSMA…

After the conclusion of the Vision trials the urological associations start gradually adjusting their Prostate Cancer guidelines, both in diagnostics and treatment. EAU now strongly recommends: PSMA PET/CT (with gallium-68 or fluorine-18) as a more accurate diagnostic method than CT and bone scan for the staging of high-risk prostate cancer (PSA > 20 ng/mL, or…

While theranostics has immensely improved overall survival and quality of life of NET and prostate cancer patients and is increasingly becoming mainstream, the science is tirelessly working on the next big thing – pan-cancer theranostics based on fibroblast activation protein (FAP) found in the cancer-associated fibroblasts (CAF). With many widespread cancers in question, this would…

Bone metastases are a common secondary cancer of many cancer types, such as breast (70%), prostate (85%), lung and kidney cancer (40%), due to the unique bone microenvironment. Tumors mostly metastasize to axial skeleton (i.e. bones of the trunk and pelvis) rather than to appendicular skeleton (limbs and girdles) along the distribution of the red…

Fluorine-18 is a commonly used isotope utilized for conducting PSMA-PET/CT to stage prostate cancer, due to its longer half-life and higher production capacity as compared to Gallium-68. The latest study, however, has demonstrated superiority of Ga-68, because of the focal unspecific uptake of F-18 in the bones of ribs and pelvis. Without additional follow-up exams…

How oft is the Lu-PSMA treatment conducted? The usual cycle consists of 3 sessions with 6 to 8 weeks interval in-between. Our more restrictive treatment regimen of 3 initial cycles with an interval of only 4 weeks in-between demonstrated >80% response rates even in heavily pre-treated patients. This treatment does not care, “where” the metastases are:…

177Lu-PSMA therapy improves health-related quality of life in patients with mCRPC On Friday, 17 September 2021, Novartis announced further positive findings from the VISION trial: 177Lu-PSMA-617 therapy delays worsening of physical functioning and the onset of pain symptoms in patients with mCRPC. Hence, beyond extending overall survival and progress-free period, this Breakthrough Therapy also improves…

National Comprehensive Cancer Network, an alliance of cancer centers in the US, whose guidelines in oncology are applied to treating cancers, has added 68Ga-PSMA-PET imaging to its clinical practice guidelines for prostate cancer. Moreover, it recognized the high precision of this diagnostic tool as a primary stand-alone method and scrapped conventional imaging as a necessary…

On 23 March 2021 Novartis announced positive results of the phase III trial with radioligand therapy 177Lu-PSMA-617 in patients with castrate-resistant metastatic prostate cancer (mCRPC) after taxane chemotherapy and several androgen deprivation therapies (ADT). Over a median follow-up of 20.9 month, the therapy demonstrated an increased overall survival rate by a median of 4.0 months…

Frontiers in Urology

Working group headed by Prof. Markus Hartenbach was able to demonstrate the outstanding diagnostic value of PSMA PET / MRI in biopsy-proven prostate cancer. PSMA-PET/MRI can provide an accurate staging of newly diagnosed prostate cancer. In addition, treatment strategies were changed in almost a third of the patients due to the information of this hybrid…

The working group headed by Prof. Markus Hartenbach MD was able to demonstrate the superiority of PSMA PET in the diagnosis of biochemical recurrence of prostate cancer, even at low PSA levels. Moreover, this diagnostic tool adds significant information to standard CT/MRI, changing treatment strategies in a significant number of patients. PSMA-positive lesions were detected…

Markus Hartenbach wins Oncology Council’s Young Investigator Award of the North American Association of Nuclear Medicine.

Interview with Priv.-Doz. Dr. Wolfgang Wadsak in Onko News Austria, No. 7-8, October 2023 (German) With PSMA radioligand therapy, nuclear medicine offers a promising, non-invasive procedure for diagnosing and treating prostate cancer, that has hardly any side effects and a life-prolonging effect even in the final stages while maintaining a good quality of life. 2023_11_07_Onko_News_EANM

Joint EANM procedure guideline / SNMMI procedure standard for prostate cancer imaging 2.0 EANM and SNMMI have updated their joint PSMA PET/CT procedure guideline for prostate cancer imaging with the most recent information. “This guideline supports physicians in recommending, acquiring, interpreting and reporting the results of PSMA-ligand PET/CT for initial diagnosis, staging and restaging of…

Video: Nuclear imaging 68Ga-DOTATATE and PRRT 177Lu-DOTATATE explained (English) NET Patient Education Conference of NET Research Foundation on Theranostics (PRRT), Stanford, US, March 2017

New phase III 177Lu-PSMA-617 trial in mCRPC patients at the stage of antihormonal therapy

New phase III 177Lu-PSMA-617 trial in mCRPC patients who have not undergone chemotherapy.

ASCO 2021: Phase III Study of Lutetium-177-PSMA-617 in Patients with Metastatic Castration-Resistant Prostate Cancer (VISION)

The New England Journal of Medicine: “Lutetium-177–PSMA-617 for Metastatic Castration-Resistant Prostate Cancer” 

Novartis announces positive result of phase III study with radioligand therapy 177Lu-PSMA-617 in patients with advanced prostate cancer

Phase 3 Trial of 177Lu-Dotatate for Midgut Neuroendocrine Tumors  Informationen zu Lutathera

68Ga-PSMA 11 ligand PET imaging in patients with biochemical recurrence after radical prostatectomy – diagnostic performance and impact on therapeutic decision-making

Alpha emitter radium-223 and survival in metastatic prostate cancer. Information zu Xofigo

[177Lu]-PSMA-617 radionuclide treatment in patients with metastatic castration-resistant prostate cancer (LuPSMA trial): a single-centre, single-arm, phase 2 study