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Home/Blog/Ac-225 PSMA-617 in chemo-naive prostate cancer
Investigational · Ac-225 PSMA

Ac-225 PSMA-617 in chemotherapy-naive prostate cancer.

A sourced clinical guide to investigational Ac-225 PSMA-617 targeted alpha therapy in chemotherapy-naive metastatic castration-resistant prostate cancer — Sathekge's South African cohort data, the alpha-emitter rationale, the substantial xerostomia trade-off, and the research-protocol governance under which this is appropriately offered.

Dr. Ishita B. Sen
Dr. Ishita B. Sen, MDDirector & Chief, Nuclear Medicine · FMRI
Published
Reviewed by Dr. Dharmender Malik
12 min read
Last reviewed by Dr. Dharmender Malik on 13 May 2026 · this article reflects the published evidence and current clinical practice at FMRI Gurugram.

Introduction

Actinium-225 PSMA-617 (Ac-225 PSMA-617) is an alpha-emitter targeted radioligand therapy that has shown striking PSA response rates in early-phase studies of metastatic castration-resistant prostate cancer (mCRPC). Most published clinical experience comes from after failure of Lu-177 PSMA — salvage-line settings. A smaller body of evidence describes Ac-225 PSMA-617 used before chemotherapy in chemotherapy-naive mCRPC, principally from Mike Sathekge's group in South Africa. This article walks through that evidence, the alpha-emitter rationale, the substantial trade-off in salivary gland toxicity, and the governance framework under which this use is appropriately offered today.

The alpha-emitter rationale

Ac-225 is an alpha-emitting radionuclide with a half-life of approximately 10 days. Its decay chain produces multiple alpha particles, each depositing high-linear-energy-transfer (LET) radiation over a very short range (typically <100 micrometres). The clinical rationale for using an alpha-emitter on the PSMA-617 backbone, rather than the established beta-emitter Lu-177, draws on three properties[5]:

  • High-LET radiation — alpha particles produce densely ionising damage that is generally less repairable by tumour DNA repair pathways than beta-particle damage.
  • Short tissue range — alpha particles deposit energy over micrometre scales, potentially allowing energy deposition in single cells and small clusters that beta particles may underdose.
  • Activity per administration — substantially lower activity (typically 100 kBq/kg per cycle for Ac-225) than Lu-177 (7.4 GBq per cycle) reflects the higher per-decay biological effect of alpha particles.

The same physics that gives Ac-225 PSMA-617 its potential anti-tumour benefit produces its principal toxicity: salivary gland uptake of the PSMA-617 ligand delivers alpha-particle radiation to salivary tissue, with substantially greater xerostomia than is seen with Lu-177 PSMA-617[6].

The Sathekge chemo-naive cohort — the principal published data

The most prominent published cohort of Ac-225 PSMA-617 in chemo-naive mCRPC is from Sathekge and colleagues at the University of Pretoria, South Africa[1][2]:

  • 2019 (EJNMMI) initial cohort — 17 chemotherapy-naive patients with mCRPC treated with Ac-225 PSMA-617 (typically 100 kBq/kg per cycle, multiple cycles).
  • Reported outcomes: PSA50 response in 70% of patients (12/17); any-PSA-decline in 88%; reported tolerability profile dominated by xerostomia.
  • 2020 (JNM) follow-up — extended Sathekge series with predictors of overall survival and disease-free survival. The series reinforced the relationship between baseline tumour burden, PSA response depth, and survival outcomes.

These data are hypothesis-generating, not pivotal. The cohort sizes are small, the studies are single-centre, and there is no randomised comparator. The data establish feasibility and proof-of-concept; they do not establish that Ac-225 PSMA-617 is superior to or should replace established first-line and second-line therapy in chemo-naive mCRPC[7].

Ac-225 vs Lu-177 — the principal trade-off

Ac-225 PSMA-617 and Lu-177 PSMA-617 use the same targeting ligand and chelator; the differences are in the radionuclide and the resulting biology[8]:

PropertyLu-177 PSMA-617Ac-225 PSMA-617
Radiation typeBeta-emitter (mean tissue range ~0.7 mm)Alpha-emitter chain (range <100 μm)
LET (radiation density)Low-LET (more repairable)High-LET (less repairable)
Approval statusFDA / EMA approved (Pluvicto) for VISION-eligible mCRPC; PSMAfore extension to taxane-naive settingInvestigational; no regulatory approval for routine use
Evidence baseVISION (n=831), TheraP (n=200), LuPSMA, PSMAfore, PSMAddition — randomised dataSingle-arm cohort studies; no completed randomised comparative data
PSA50 response (selected setting)VISION: 46%; TheraP: 66%; LuPSMA: 57%Sathekge 2019 chemo-naive: 70%
Xerostomia profileMild-moderate, partially reversibleSubstantially more pronounced; can be severe and persistent
Supply & costMature commercial supply; established cost structureLimited supply (largely research-grade); cost reflects supply scarcity

The chemo-naive setting is precisely where the trade-off requires the most careful consideration: in heavily pre-treated patients with established Lu-177 PSMA progression, Ac-225 PSMA salvage is a more clinically intuitive choice — the toxicity is acceptable because the alternative is poor. In a chemo-naive patient with multiple established and untried options, the calculus is different[9].

The xerostomia trade-off — what to expect

Xerostomia (dry mouth) is the single most important quality-of-life consideration in Ac-225 PSMA-617 therapy[6]:

  • Frequency — common; most patients experience some xerostomia after Ac-225 PSMA-617 therapy. Severity varies with cumulative dose, baseline salivary function, and individual factors.
  • Severity — substantially more pronounced than with Lu-177 PSMA-617. Some patients experience severe and persistent xerostomia that meaningfully impairs eating, speech, sleep, and daily life.
  • Reversibility — often partial; some recovery is possible over time, but a meaningful proportion of patients retain persistent symptoms.
  • Mitigation strategies under research — salivary gland cooling, alternative targeting backbones, fractionation modifications — under active research with limited current evidence for routine clinical use.
  • Quality-of-life impact — particularly relevant for patients whose professional life or social functioning depends on uninterrupted speech (lecturers, singers, presenters) — should be flagged explicitly during informed consent.

For broader cross-therapy context on side effects see our companion side effects of nuclear medicine article. Xerostomia is consistently among the most reported reasons for Ac-225 PSMA-617 discontinuation or dose modification in published cohorts[10].

Established alternatives in the chemo-naive setting

Patients with chemotherapy-naive mCRPC have several established treatment options, each with substantial randomised evidence[11]:

  • Lu-177 PSMA-617 (PSMAfore setting) — the PSMAfore trial (Sartor et al., NEJM 2024) showed Lu-177 PSMA-617 vs ARPI switch in taxane-naive mCRPC, with median rPFS 12.0 months vs 5.6 months. PSMAfore led to a 2025 FDA label expansion of Pluvicto to include the chemo-naive setting[12].
  • Switching ARPI — abiraterone after enzalutamide failure, or vice versa, with documented though limited efficacy.
  • Docetaxel chemotherapy — established first-line chemotherapy in mCRPC; CHAARTED and STAMPEDE established docetaxel earlier in the prostate-cancer treatment sequence.
  • PARP inhibitors (selected biomarker-positive patients) — olaparib and rucaparib have specific approvals in BRCA1/2-mutated or HRR-deficient mCRPC.
  • Radium-223 — for symptomatic bone-predominant mCRPC, with documented OS benefit per the ALSYMPCA trial.
  • Continued ADT + ARPI plus the above — combination regimens per current NCCN, EAU, and ESMO guidelines.

The clinical question is not whether Ac-225 PSMA-617 might be effective in chemo-naive mCRPC — the Sathekge data suggest it can be — but whether it is the right choice for any given patient at this stage when established alternatives have larger evidence bases and lower toxicity profiles[9].

The current research-protocol framework

Centres offering Ac-225 PSMA-617 — particularly in the chemo-naive setting — should be operating under documented research-protocol arrangements with the following elements[13]:

  • Institutional research-ethics committee approval — formal IRB / IEC sign-off for the specific use case (chemo-naive vs salvage-line vs other).
  • AERB (or equivalent regulatory) licensure — for handling of Ac-225 source material and associated radiation safety.
  • Dosimetry capability — pre-treatment activity calculation, post-administration imaging, salivary gland dosimetry where feasible.
  • Helsinki-consistent informed consent — written, signed, covering investigational status, alternatives, expected toxicity (particularly xerostomia), and limits of current evidence.
  • Multidisciplinary review — urology, medical oncology, nuclear medicine, and palliative care input into individual treatment decisions.
  • Outcome reporting — prospective data collection allowing aggregation into research datasets that contribute to building the evidence base for future patients.

Patients should ask to see documentation of these elements before agreeing to Ac-225 PSMA-617 therapy. Centres unwilling or unable to provide this documentation are not appropriate venues for investigational therapy delivery[4].

Open research questions on Ac-225 PSMA-617 in chemo-naive mCRPC

Several questions remain genuinely open and are subjects of ongoing research[14]:

  • Does Ac-225 PSMA-617 produce randomised-evidence-grade outcome improvements over Lu-177 PSMA-617 in any specific patient subgroup? — no head-to-head randomised comparative data exist today.
  • What is the optimal dose, fractionation, and cumulative-activity schedule for Ac-225 PSMA-617? — substantial dosimetric heterogeneity exists across published cohorts.
  • Can xerostomia be meaningfully mitigated by emerging strategies (salivary gland cooling, alternative targeting backbones, fractionation)? — early data from several centres but no established standard.
  • What is the long-term marrow and renal toxicity profile relative to Lu-177 PSMA-617? — longer follow-up across larger cohorts is required.
  • For chemo-naive specifically, does Ac-225 PSMA-617 add anything over Lu-177 PSMA-617 (PSMAfore setting) given the substantial xerostomia trade-off? — the central open clinical question; awaits randomised trial data.

Indian experience with Ac-225 PSMA-617

Indian centres have published clinical experience with Ac-225 PSMA-617, mostly in the salvage-line setting after Lu-177 PSMA-617 progression[15]:

  • AIIMS New Delhi — Yadav, Ballal, Sahoo and colleagues have published Ac-225 PSMA-617 outcomes in mCRPC after Lu-177 PSMA-617 failure, with response rates and tolerability profiles broadly consistent with international cohort data.
  • Tata Memorial / BARC — Basu and colleagues have published on Indian Ac-225 supply considerations and clinical experience.
  • Supply considerations — Ac-225 supply globally remains limited; Indian centres typically source Ac-225 through international research collaborations or limited commercial channels under DCGI permissions and AERB licensure.

Use in the chemo-naive setting in India should be considered, at this time, an extension of the salvage-line research framework rather than a routine clinical option — with the documented investigational governance described above as a minimum standard[16].

The bottom line

  • Ac-225 PSMA-617 in chemo-naive mCRPC is supported by single-centre cohort data, principally from Sathekge et al. (n=17 in EJNMMI 2019; extended in JNM 2020), reporting PSA50 response ~70%[1][2].
  • Ac-225 PSMA-617 is not FDA or EMA approved for routine use and should be confined to research-protocol delivery with Helsinki-consistent informed consent[3].
  • Alpha-emitter rationale: high-LET radiation, short range, less-repairable DNA damage; same physics produces substantially greater salivary gland toxicity than Lu-177[5][6].
  • Xerostomia is the principal quality-of-life trade-off — common, often more severe and persistent than with Lu-177 PSMA-617, with mitigation strategies under active research[6].
  • Established alternatives in chemo-naive mCRPC have larger evidence bases: Lu-177 PSMA-617 per PSMAfore (rPFS 12.0m vs 5.6m), ARPI switch, docetaxel, PARP inhibitors (biomarker-positive), Radium-223 for bone-predominant disease[12].
  • Centres offering Ac-225 PSMA-617 should document IRB approval, AERB licensure, dosimetry capability, Helsinki-consistent consent, multidisciplinary review, and outcome reporting[13].
  • For most chemo-naive patients today, established Lu-177 PSMA-617 (PSMAfore-eligible) is the appropriate first PSMA-targeted option; Ac-225 PSMA-617 is appropriate to consider only inside a formal research framework[9].
Important

This article describes investigational Ac-225 PSMA-617 therapy in the chemotherapy-naive metastatic castration-resistant prostate cancer setting. Ac-225 PSMA-617 is not approved for routine clinical use. Information is provided for educational purposes and does not constitute a recommendation. Patient evaluation requires formal multidisciplinary review, and investigational therapy should be delivered only within a research-ethics framework with Helsinki-consistent informed consent.

"Ac-225 PSMA-617 in the chemo-naive setting is interesting biology in a small published cohort. It is not a substitute for established Lu-177 PSMA-617 therapy outside a formal research framework. The right question for a chemo-naive patient today is not 'why don't we try Ac-225 first?' — it is 'what do the established evidence-based options offer me first, and where would investigational alpha therapy fit if they fail?'"

Dr. Ishita B. Sen, MD · Director & Chief, Nuclear Medicine, FMRI

Ac-225 review · informed-consent framework · FMRI

Patients interested in Ac-225 PSMA-617 should expect a structured discussion at FMRI Gurugram covering established alternatives first (Lu-177 PSMA per VISION / PSMAfore, ARPI switch, docetaxel, PARP inhibitors where biomarker-eligible, Radium-223), the investigational status of Ac-225, the xerostomia trade-off, and — where applicable — research-protocol pathways with Helsinki-consistent informed consent.

Review options · WhatsApp +91 8800 988936
For patients & referring clinicians

Frequently asked questions

Q01 Is Ac-225 PSMA-617 approved for prostate cancer?

No. Ac-225 PSMA-617 is investigational. It has not received FDA, EMA, or DCGI approval for routine clinical use in prostate cancer. Its use is restricted to clinical trials and research-protocol settings with formal ethics oversight [3].

Q02 What is actinium 225 used for in prostate cancer research?

Ac-225 is the alpha-emitter radionuclide attached to the PSMA-617 ligand in Ac-225 PSMA-617 targeted alpha therapy. It is being investigated in metastatic castration-resistant prostate cancer, principally in the salvage setting after Lu-177 PSMA-617 progression and, in a smaller body of evidence (notably the Sathekge South African cohort), in the chemotherapy-naive setting [1][5].

Q03 What did the Sathekge chemo-naive cohort show?

Sathekge et al. (EJNMMI 2019; extended in JNM 2020) reported on 17 chemo-naive mCRPC patients treated with Ac-225 PSMA-617 at approximately 100 kBq/kg per cycle. They reported PSA50 response in 70% of patients (12/17) and any-PSA-decline in 88%. Xerostomia was the principal tolerability finding. The data are hypothesis-generating proof of concept, not pivotal randomised evidence [1][2].

Q04 How does Ac-225 PSMA-617 differ from Lu-177 PSMA-617?

Both use the same PSMA-targeting ligand and DOTA chelator. They differ in the radionuclide: Lu-177 is a beta-emitter with mean tissue range ~0.7 mm; Ac-225 is an alpha-emitter chain with range <100 micrometres and higher linear-energy-transfer (less DNA-repair-amenable) radiation. The clinical consequence: potentially more potent tumour-cell killing per binding event, but substantially greater salivary gland toxicity. Activity per cycle is much lower for Ac-225 (~100 kBq /kg vs 7.4 GBq for Lu-177) reflecting the higher biological effect per decay [5][8].

Q05 What is the most important side effect of Ac-225 PSMA-617?

Xerostomia (dry mouth) is the principal quality-of-life-limiting side effect. It is more frequent and substantially more severe than with Lu-177 PSMA-617, reflecting alpha-particle delivery to salivary gland PSMA-expressing tissue. It is often only partially reversible. Mitigation strategies (salivary gland cooling, alternative ligand backbones, fractionation) are under active research but no standard mitigation exists in routine clinical practice [6][10].

Q06 Should chemo-naive patients receive Ac-225 PSMA-617 instead of Lu-177 PSMA-617?

For most chemo-naive mCRPC patients today, the answer is no. Lu-177 PSMA-617 has substantial randomised evidence in this setting (PSMAfore, NEJM 2024: rPFS 12.0m vs 5.6m vs ARPI switch in taxane-naive mCRPC), regulatory approval, and a substantially milder xerostomia profile than Ac-225. Ac-225 PSMA-617 in the chemo-naive setting is supported by smaller single-centre cohort data with a more severe toxicity profile. The standard pathway is established options first, with investigational alpha therapy considered if established options fail [9][12].

Q07 What does the informed consent look like for investigational Ac-225 PSMA-617?

Helsinki-consistent informed consent for Ac-225 PSMA-617 should be written, signed, and disclose: (1) the investigational status and absence of regulatory approval; (2) the alternative established treatments (Lu-177 PSMA per VISION/PSMAfore, ARPI switch, docetaxel, PARP inhibitors where biomarker-eligible, Radium-223); (3) the specific risks, particularly substantial xerostomia; (4) the limited size of the chemo-naive evidence base; (5) the research-protocol arrangements under which therapy is being delivered. No claim of superiority over established alternatives should be made or implied [3][4].

Q08 What is the typical Ac-225 PSMA-617 dose?

Published cohorts have used activity around 100 kBq/kg per cycle of Ac-225 PSMA-617, typically delivered at 8-week intervals over multiple cycles. Specific activity and cycle count are adjusted based on response, tolerability (particularly xerostomia severity), and individual factors. Dosimetry capability is important — the activity is substantially lower than Lu-177 (7.4 GBq) reflecting the much higher biological effect per decay [1][14].

Q09 What is Ac-225 supply like in India?

Ac-225 supply globally remains limited. Indian centres typically source Ac-225 through international research collaborations or limited commercial channels under DCGI permissions and AERB licensure. The limited supply is one reason Ac-225 PSMA-617 use should be restricted to research-protocol settings with documented sourcing arrangements [16].

Q10 What about the marrow and kidney side effects of Ac-225 PSMA-617?

Published cohorts report marrow toxicity (cytopenia) and renal effects with a profile broadly similar to Lu-177 PSMA-617 — uncommon when patient selection is rigorous, more frequent in heavily pre-treated patients. The principal differentiating side effect from Lu-177 PSMA-617 is xerostomia. Longer-term marrow and renal toxicity comparisons require larger cohorts and longer follow-up than currently available [14].

Q11 What should I ask a centre offering Ac-225 PSMA-617?

Ask to see documentation of: (1) institutional research-ethics committee approval for the specific use case; (2) AERB or equivalent regulatory licensure for Ac-225 handling; (3) Ac-225 supply sourcing under DCGI permissions; (4) dosimetry capability; (5) written Helsinki-consistent informed consent that explicitly discloses investigational status, alternatives, and xerostomia risk; (6) multidisciplinary review documentation; (7) prospective outcome data collection arrangements. A centre unwilling or unable to provide these documents is not an appropriate venue for investigational therapy [4][13].

Q12 How do I review my PSMA-therapy options at FMRI?

At FMRI Gurugram, PSMA-therapy review covers established options first — Lu-177 PSMA-617 (VISION-eligible, PSMAfore-eligible), ARPI switch, docetaxel, PARP inhibitors where biomarker-eligible, Radium-223 for bone-predominant disease. Ac-225 PSMA-617 is discussed only as an investigational option for selected patients, within a research-protocol framework and Helsinki-consistent informed consent. WhatsApp +91 8800 988936 to begin a confidential review.

Citations & references

All clinical numbers above are sourced from the primary literature listed below. Every reference links to the open journal page or the regulatory archive — open in a new tab to verify.

[1] Sathekge M, Bruchertseifer F, Knoesen O, et al. 225Ac-PSMA-617 in chemotherapy-naive patients with advanced prostate cancer. Eur J Nucl Med Mol Imaging. 2019;46(1):129-138. View source ↗
[2] Sathekge M, Bruchertseifer F, Vorster M, et al. Predictors of Overall and Disease-Free Survival in Metastatic Castration-Resistant Prostate Cancer Receiving 225Ac-PSMA-617. J Nucl Med. 2020;61(1):62-69. View source ↗
[3] World Medical Association. WMA Declaration of Helsinki — Ethical Principles for Medical Research Involving Human Subjects. View source ↗
[4] Council for International Organizations of Medical Sciences (CIOMS). International Ethical Guidelines for Health-related Research Involving Humans. View source ↗
[5] Kratochwil C, Bruchertseifer F, Rathke H, et al. Targeted alpha-therapy of metastatic castration-resistant prostate cancer with 225Ac-PSMA-617: dosimetry estimate and empirical dose finding. J Nucl Med. 2017;58(10):1624-1631. View source ↗
[6] Feuerecker B, Tauber R, Knorr K, et al. Activity and adverse events of actinium-225-PSMA-617 in advanced metastatic castration-resistant prostate cancer after failure of lutetium-177-PSMA. Eur Urol. 2021;79(3):343-350. View source ↗
[7] Yadav MP, Ballal S, Sahoo RK, et al. 225Ac-PSMA-617 in metastatic castration-resistant prostate cancer after failure of Lu-177 PSMA-617: AIIMS experience. Eur J Nucl Med Mol Imaging. 2024. View source ↗
[8] Sgouros G, Bodei L, McDevitt MR, Nedrow JR. Radiopharmaceutical therapy in cancer: clinical advances and challenges. Nat Rev Drug Discov. 2020;19(9):589-608. View source ↗
[9] Gillessen S, Bossi A, Davis ID, et al. Management of patients with advanced prostate cancer — Report of the Advanced Prostate Cancer Consensus Conference. Eur J Cancer. 2023;185:178-215. View source ↗
[10] Kratochwil C, Bruchertseifer F, Giesel FL, et al. 225Ac-PSMA-617 for PSMA-Targeted α-Radiation Therapy of Metastatic Castration-Resistant Prostate Cancer. J Nucl Med. 2016;57(12):1941-1944. View source ↗
[11] NCCN Clinical Practice Guidelines in Oncology: Prostate Cancer. National Comprehensive Cancer Network. View source ↗
[12] Sartor O, Castellano D, Herrmann K, et al. 177Lu-PSMA-617 versus a change of androgen receptor pathway inhibitor in taxane-naive patients with mCRPC (PSMAfore). N Engl J Med. 2024;391(16):1500-1510. View source ↗
[13] Atomic Energy Regulatory Board (Government of India). Safety Code for Nuclear Medicine Facilities. AERB/RF-MED/SC-2 (Rev. 2). View source ↗
[14] Ling SW, de Blois E, Hooijman EL, et al. Advances in 225Ac-PSMA Targeted Alpha Therapy: Current State and Future Perspectives. Cancers (Basel). 2022;14(8):1990. View source ↗
[15] Sahoo RK, Yadav MP, Ballal S, et al. 225Ac-PSMA-617 PRLT in heavily pre-treated mCRPC: Indian institutional experience. Asia Ocean J Nucl Med Biol. 2023. View source ↗
[16] Drugs Controller General of India (CDSCO). Investigational New Drug application procedures and clinical trial framework for radiopharmaceuticals. View source ↗
[17] Hofman MS, Emmett L, Sandhu S, et al. [177Lu]Lu-PSMA-617 versus cabazitaxel in mCRPC (TheraP). Lancet. 2021;397(10276):797-804. View source ↗
[18] Sartor O, de Bono J, Chi KN, et al. Lutetium-177-PSMA-617 for Metastatic Castration-Resistant Prostate Cancer (VISION). N Engl J Med. 2021;385(12):1091-1103. View source ↗
[19] Hennrich U, Eder M. 177Lu-PSMA-617 (Pluvicto): The First FDA-Approved Radiotherapeutical for Treatment of Prostate Cancer. Pharmaceuticals (Basel). 2022;15(10):1292. View source ↗
[20] European Association of Urology. EAU-EANM-ESTRO-ESUR-SIOG Guidelines on Prostate Cancer. View source ↗
[21] Tagawa ST, Vallabhajosula S, Christos PJ, et al. Phase I/II study of fractionated dose 177Lu-J591 for progressive mCRPC. Cancer. 2019;125(15):2561-2569. View source ↗
[22] Parker C, Nilsson S, Heinrich D, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer (ALSYMPCA). N Engl J Med. 2013;369(3):213-223. View source ↗
[23] Sweeney CJ, Chen YH, Carducci M, et al. Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer (CHAARTED). N Engl J Med. 2015;373(8):737-746. View source ↗
[24] de Bono J, Mateo J, Fizazi K, et al. Olaparib for Metastatic Castration-Resistant Prostate Cancer (PROfound). N Engl J Med. 2020;382(22):2091-2102. View source ↗
[25] Beer TM, Armstrong AJ, Rathkopf DE, et al. Enzalutamide in metastatic prostate cancer before chemotherapy (PREVAIL). N Engl J Med. 2014;371(5):424-433. View source ↗
[26] Ryan CJ, Smith MR, de Bono JS, et al. Abiraterone in metastatic prostate cancer without previous chemotherapy (COU-AA-302). N Engl J Med. 2013;368(2):138-148. View source ↗
[27] Roviello G, Catalano M, Ravelli A, et al. Cost-effectiveness assessment of Lu-177 PSMA-617 in metastatic prostate cancer. Cancers (Basel). 2023;15(13):3290. View source ↗
[28] Hofman MS, Lawrentschuk N, Francis RJ, et al. Prostate-specific membrane antigen PET-CT in patients with high-risk prostate cancer (proPSMA). Lancet. 2020;395(10231):1208-1216. View source ↗
[29] European Association of Nuclear Medicine. EANM procedure guidelines for radionuclide therapy with 177Lu-labelled PSMA-ligands. Eur J Nucl Med Mol Imaging. 2019;46(12):2536-2544. View source ↗
[30] International Atomic Energy Agency (IAEA). Production, Quality Control and Clinical Applications of Radiopharmaceuticals. View source ↗
Dr. Ishita B. Sen
About the Author

Dr. Ishita B. Sen

MBBS · MD (Nuclear Medicine) · DNB · Post-doctoral Fellowship, Memorial Sloan Kettering Cancer Center, New York

Director and Chief of Nuclear Medicine at Fortis Memorial Research Institute. Co-founder of Theranostic Physicians Private Limited (TPPL). Two decades of clinical practice in PSMA imaging and PSMA-directed radioligand therapy, with one of the largest Indian institutional experiences in Lu-PSMA.

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Medical disclaimer All physicians and researchers profiled on this page hold appointments at the Department of Nuclear Medicine & Molecular Imaging, Fortis Memorial Research Institute, Gurugram. Theranostic Physicians Private Limited (TPPL) is the clinical practice entity through which they consult and treat patients. Treatment outcomes vary by individual case; clinical decisions are made on the basis of complete medical records, current imaging, and a multidisciplinary review.