前列腺特异性膜抗原(PSMA)是一种在几乎所有前列腺癌中高表达的细胞表面蛋白。在一些正常组织中表达受限。PSMA从肿瘤组织到非肿瘤组织的差异表达导致了对转移性前列腺癌患者治疗的许多靶向策略的研究。2022年3月,FDA批准将Luttium-177PSMA-617(Lu-177-PSMA-617)用于PSMA阳性转移性去势耐药前列腺癌(mCRPC)患者,这些患者已接受雄激素受体途径抑制和紫杉烷的治疗。因此,Lu-177-PSMA-617的使用预计将增加并变得更加广泛。在这里,我们描述后勤,技术,以及实施放射性药物治疗计划的辐射安全考虑,特别关注治疗管理操作程序的开发。下面列出了美国中心实施新的放射性药物治疗(RPT)计划的主要步骤,然后通过Lu-177-PSMA-617治疗的实例更详细地证明。
Prostate-specific membrane antigen (PSMA) is a cell surface protein highly expressed in nearly all prostate cancers, with restricted expression in some normal tissues. The differential expression of PSMA from tumor to non-tumor tissue has resulted in the investigation of numerous targeting strategies for therapy of patients with metastatic prostate cancer. In March of 2022, the FDA granted approval for the use of lutetium-177 PSMA-617 (Lu-177-PSMA-617) for patients with PSMA-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy. Therefore, the use of Lu-177-PSMA-617 is expected to increase and become more widespread. Herein, we describe logistical, technical, and radiation safety considerations for implementing a radiopharmaceutical therapy program, with particular focus on the development of operating procedures for therapeutic administrations. Major steps for a center in the U.S. to implement a new radiopharmaceutical therapy (RPT) program are listed below, and then demonstrated in greater detail via examples for Lu-177-PSMA-617 therapy.