Actinium-225 PSMA Therapy: Revolutionizing Treatment for Metastatic Prostate Cancer
Prostate cancer is the most widespread type of oncological pathology among men. Doctors from all over the world pay attention to timely prophylaxis and diagnostics because at the early stages this disease is treated much easier. When the process is beyond the stage 1-3, especially when there are metastases in other organs and the skeleton, there are only a few therapeutic options. Targeted alpha irradiation with the help of the radioisotope 225 Actinium, which is also known as Actinium-225, is an innovative technique that precisely destroys tumor cells and metastases even when the other treatment methods are ineffective.
Why do the doctors need Actinium-225, if they already have Lutetium-177?
PSMA therapy with Lutetium-177 has become firmly established in the practical medicine of developed countries. As an active source of beta radiation, this isotope helps in the diagnostics and treatment of metastatic prostate cancer. Despite the high effectiveness of the method, not all patients respond to Lutetium-177 therapy.
Actinium-225, as opposed to Lutetium-177, is a unique source of alpha radiation. Each atom of Actinium-225 emits four high-energy alpha particles during the decay. Alpha radiation causes double breaks in the DNA of tumor cells. At the same time, a similar influence on neighboring healthy cells is absent due to the short range of alpha radiation, namely 0.04 mm.
Actinium-225 cancer treatment is effective even in cases when all other therapeutic possibilities have already been tried. It helps patients with metastatic cancer, who are resistant to chemotherapy and hormonal drugs. A two-year study of men with metastatic prostate cancer showed that even patients in critical condition can respond to therapy and achieve stable condition after 3-4 sessions. Even in the case of PSMA therapy with Lutetium-177 ineffectiveness, the substitution of the radionuclide with Actinium-225 significantly improves the results of therapy and future prognosis. The flexibility of Actinium-225 PSMA therapy in medicine is particularly noteworthy, as it offers multiple integration points within the treatment timeline. This versatility allows oncologists to employ radiopharmaceutical Actinium-225 before, after, or as a replacement for Lutetium-177 therapy. In some cases, it may even be considered as a pre-chemotherapy option, broadening the spectrum of treatment strategies available to patients. This adaptability in application timing, coupled with its potent therapeutic effects, positions Actinium-225 as a valuable tool in the evolving landscape of innovations for advanced prostate cancer management.
The results of PSMA-therapy with Actinium-225
The first clinical, biochemical and radiological results of PSMA therapy with Actinium-225 reveal themselves within a few weeks after completion of the procedure. The most notable aspects among them are:
- PSA level. After Actinium-225 treatment, its level reduces by 50% or more in all patients. In some patients' cases, it even falls below the laboratory detection level – 0.1 ng/ml.
- Improved disease control as demonstrated by the results of the PSMA PET/CT. The results of tomography demonstrated a decrease in the number and size of metastases as well as regression of the primary tumor.
One major advantage of actinium-225 for prostate cancer as a therapeutic intervention is the low risk of relapse. The largest clinical trials of PSMA therapy with Actinium-225, which lasted 3 years, recorded remission periods of up to 2 years in patients with the advanced stages of prostate cancer. In general, life expectancy and quality significantly increased after treatment. Other studies have shown that chemotherapy-naive prostate cancer patients had more than 90% decline in PSA levels after receiving Actinium-225 PSMA therapy. Preliminary results of the other large studies also demonstrated clinical benefit (radiographic progression-free survival) among metastatic castration-resistant prostate cancer patients who progressed on hormone therapy.
Actinium-225 PSMA therapy for metastatic prostate cancer has also shown promising clinical trial results, potentially improving prostate cancer survival rates compared to traditional pharmaceuticals. While the cost of treatment and price of Actinium-225 are currently higher than Lutetium-177, superior properties of Actinium, including a shorter half-life and higher energy emission, may justify the expenses. The use of Actinium-225 exploits its ability to deliver localized, high-energy radiation to cancer cells potentially offering better outcomes in Lutetium-177 vs Actinium-225 comparisons for advanced prostate cancer cases.
| Survival rate | Disease progression | PSA levels | Side effects | Cost (EUR) |
|---|---|---|---|---|
| may vary greatly* | remission up to 2 years | 50-90% | xerostomia (dry mouth) | 17,000 - 28,000 per cycle |
*Data varies greatly depending on the previous treatment strategies, number of cycles administered, and patient health status.
How will the treatment be carried out?
The patient stays in the department of nuclear medicine when PSMA therapy with Actinium-225 is performed. Both a therapy session with Actinium-225 and monitoring in the hospital take only 3-4 days. After that, the person returns to his normal life. Such a period is sufficient to ensure that the power of radioactive radiation is reduced to the permissible level and that the patient may return to society.
Before starting therapy, an obligatory examination is carried out. It includes PSMA PET/CT of metastases in the spine. Once the results of the examination are received, preparation for the procedure begins. This implies the following:
- Insertion of venous catheters for the convenience and safe injection of radiopharmaceuticals.
- Cooling of the salivary glands to slow the blood flow and, accordingly, reduce the accumulation of the radiopharmaceutical. Normally, the tissues of the salivary glands actively accumulate radionuclides and can be damaged.
- Intravenous injection of saline provides additional protection of the kidneys.
The intravenous injection of the radiopharmaceutical through the catheter takes only 10-15 seconds. Actinium-225 spreads throughout the body with the blood flow and binds to the prostate cancer cells. Radionuclide distribution is controlled with the help of scintigraphy because it allows to additionally assess the presence and the size of metastasis in the bones. It should be noted that the procedure is well-tolerated. When PSMA therapy with Actinium-225 is carried out, there are no significant side effects which are typical for conventional radiation therapy or intensive chemotherapy at the stage of metastasis. Short-term nausea may occur and is easily eliminated with the help of symptomatic treatment. The only significant side effect reported by the patients is dry mouth. As a result, Actinium-225 PSMA therapy has demonstrated a relatively safe profile as opposed to most standard treatments for prostate cancer.
In order to achieve the most favorable result, Actinium PSMA treatment is performed in several sessions. This prolongs the time the radionuclide remains exposed to the cancer cells, thereby increasing the effectiveness of the procedure. The number of procedures is determined by the physician individually based on the clinical situation and the results of the follow-up examinations.
Where can you undergo PSMA therapy with Actinium-225?
PSMA therapy with Actinium-225 is actively performed in Germany, in the home country of this type of treatment. It is German specialists in cooperation with the research centers, who developed this technique, evaluated its effectiveness during the clinical trials, and eventually introduced it into practical medicine. With their exceptional attention to details, devotion to innovations, and expertise in oncology, Actinium-225 treatment in Germany will meet your expectations of high-quality service and solid experience.
Fortunately, German clinics are open to international patients and eagerly take them for treatment. In particular, these are:
- University Hospital Frankfurt am Main, Department of Nuclear Medicine
- University Hospital Carl Gustav Carus Dresden, Department of Nuclear Medicine
- University Hospital Erlangen, Department of Nuclear Medicine
- University Hospital Bonn, Department of Nuclear Medicine
- University Hospital Duesseldorf, Department of Nuclear Medicine
The procedure of registration for the PSMA therapy with Actinium-225 in this case has its own peculiarities. For competent and effective communication with the administration of clinics, it is better to use the help of Booking Health, a medical tourism operator. Booking Health helps thousands of prostate cancer patients every year to undergo treatment and defeat the disease. We accompany the patient from the moment of choosing the clinic till returning to his native country. Our company considers all the medical and organizational details, such as:
- Issuing of an invitation to get a visa for treatment as quickly as possible
- Fixing an appointment at the suitable time
- Organization of a preliminary examination, including PSMA PET/CT
- Transfer from the airport to the clinic and back to the airport
- Services of the interpreter and your personal medical coordinator
- Health insurance against complications covering up to 200.000 euros
- Preparation and translation of medical reports and recommendations from the clinic
- Assistance in subsequent communication with the physician, including remote consultations with the help of unique medical document management system E-doc and the organization of further treatment
Booking Health makes the latest medical achievements available. Patients from all over the world can undergo PSMA therapy with Actinium-225 right now, without waiting for adjusting this technique to the possibilities of their countries. Save your precious time and energy looking through countless hospitals by contacting Booking Health to get personalized treatment options in the field of prostate cancer management.
Advanced Cancer Treatment: Patient Success Stories with Booking Health
Frequently Asked Questions of Our Patients
Send request for treatmentActinium-225 PSMA therapy is a type of radionuclide therapy, which utilizes targeted alpha particles to treat metastatic castration-resistant prostate cancer (mCRPC). It involves linking the radioactive isotope Actinium-225 to a molecule that specifically binds to prostate-specific membrane antigen (PSMA), which is overexpressed on prostate cancer cells.
The therapy delivers high-energy alpha particles to PSMA-expressing cancer cells, causing double-stranded DNA damage and cell death while minimizing harm to the surrounding healthy tissue.
The treatment is administered by means of intravenous injection in a specialized nuclear medicine facility. Patients typically receive the therapy in cycles, several weeks apart, under close clinical monitoring for efficacy and side effects.
Clinical studies report PSA decline in over 75% of patients with remarkable tumor response and improved progression-free survival in selected mCRPC cases. However, outcomes may vary depending on individual disease factors.
Access is typically available through clinical trials or specialized centers in countries with regulatory approval for the procedure. A referral from an oncologist or urologist is often required.
The cost can vary widely, ranging from $30,000 to $100,000 per treatment cycle, depending on the country, availability, and healthcare system coverage.
Actinium-225 PSMA therapy offers highly targeted treatment for metastatic prostate cancer, effectively destroying cancer cells while minimizing damage to the surrounding healthy tissues. It's particularly beneficial for patients who have not responded to conventional therapies.
Actinium-225 is generally more potent than Lutetium-177 due to its higher-energy alpha radiation and longer half-life time. It can be effective in cases where Lutetium-177 has failed, potentially offering better results for patients with advanced prostate cancer.
While generally well-tolerated, some patients may experience mild side effects such as dry mouth, fatigue, and nausea. Serious side effects are rare. Your doctor will monitor you closely during treatment.
How does Actinium-225 PSMA therapy impact life expectancy for patients with metastatic prostate cancer?
Clinical trials have shown promising results with some patients experiencing significant tumor reduction and improved quality of life. While individual results vary, some patients have seen survival times extended by months or even years compared to standard care.
Choose treatment abroad and you will get the best results for sure!
The Booking Health portal presents 41 German clinics specializing in PSMA therapy with Actinium-225
See the interview for more information:
RADIONUCLIDE TREATMENT OF PROSTATE CANCER IN GERMANY – interview with Prof. Dr. med. Stefan Dresel
Authors:
This article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova, and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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