Logistical, technical, and radiation safety aspects of establishing a radiopharmaceutical therapy program: A case in Lutetium‐177 prostate‐specific membrane antigen (PSMA) therapy

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 strategie...

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Bibliographic Details
Published in:Journal of applied clinical medical physics 2023-04, Vol.24 (4), p.e13899-n/a
Main Authors: Zoberi, Jacqueline E., Garcia‐Ramirez, Jose, Luechtefeld, David, Maughan, Nichole M., Amurao, Maxwell, Oyama, Reiko, Baumann, Brian C., Gay, Hiram A., Michalski, Jeff M.
Format: Article
Language:English
Subjects:
Androgens
Antigens
Calibration
Chemotherapy
commissioning
Drug administration
Drug dosages
Drug trafficking
Federal regulation
Gamma rays
Humans
Lutetium - therapeutic use
Male
Manufacturers
Manufacturing
Nuclear medicine
Other Topics
Patients
Physicists
Prostate
Prostate cancer
Prostate-Specific Antigen
Prostatic Neoplasms, Castration-Resistant - drug therapy
Prostatic Neoplasms, Castration-Resistant - metabolism
Prostatic Neoplasms, Castration-Resistant - radiotherapy
QA/QC
Quality control
Radiation
radiopharmaceutical therapy
Radiopharmaceuticals - therapeutic use
safety
Treatment Outcome
Workforce planning
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Summary: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.
ISSN:1526-9914
1526-9914
DOI:10.1002/acm2.13899