Actinium-225 is used for radioligand therapy of advanced prostate cancer. It is a promising technique that allows the destruction of primary and metastatic tumors by the radioactive substance injected intravenously. You can undergo Actinium-225 cancer treatment in specialized oncology centers abroad. Use the Booking Health service to find a suitable clinic, specify the cost, and make an appointment for convenient dates.
Principle of the method
A radiopharmaceutical that targets PSMA is injected into the patient’s body.
PSMA (prostate-specific membrane antigen) is a glycoprotein that is produced in large amounts in cancer cells, in much smaller amounts in normal prostate tissue and is absent in other tissues. It is used as a target for the radiopharmaceutical.
The radiopharmaceutical binds selectively to PSMA. As a result, the radioactive substance, Actinium-225, is delivered to the cancer cells while not accumulating in normal tissues.
Once the cancer cells take up the Actinium-225, they are killed by the radiation. There is little or no damage to normal tissues, although radioligand therapy can cause mild side effects to the hematopoietic system, salivary glands, and kidneys.
Who is eligible for Actinium-225 cancer treatment
Radioligand therapy is a promising metastatic prostate cancer treatment. The first evidence of efficacy was published in 2016, and the first drug for systemic radiotherapy was Lutetium-177.
Already in 2017, a new radionuclide was tested: the results of Actinium-225 were published. This drug is currently a promising treatment option for patients who did not benefit from PSMA therapy with Lutetium-177.
Applications of radioligand therapy:
- Castration-resistant prostate cancer – continued progression of the disease against the background of hormone therapy
- Ineffectiveness of chemotherapy, contraindications to chemotherapy, or patient refusal due to poor tolerability
Therapy with Actinium-225 is successfully used in such patients because this drug is well-studied, has demonstrated high efficacy, and has an excellent safety profile.
Actinium is also used when:
- Lutetium-177 did not work, tumor foci did not shrink after administration of the radiopharmaceutical
- Lutetium-177 treatment was initially effective, but the cancer has progressed and the patient no longer benefits from radioligand therapy
Comparing Lutetium-177 vs Actinium-225
A systematic review of safety studies of radioligand therapy with Lutetium-177 and Actinium-225 showed different rates of side effects for these two radionuclides. Lutetium-177 has a higher incidence of serious side effects, while Actinium-225 has a higher incidence of mild side effects.
| Actinium-225 | Lutetium-177 | |
| Dry mouth | 77% | 37% |
| Decrease in white blood cell count | 17% | 19% |
| Leukopenia of at least III degree | 7% | 9% |
| Decrease in platelet count | 15% | 20% |
| Thrombocytopenia of at least III degree | 7% | 7% |
| Kidney damage | 9% | 10% |
| Nephrotoxicity of at least III degree | 1% | 0,6% |
Comparative efficacy studies have not been performed because Actinium-225 is a promising isotope. However, cases have been described in which Actinium-225 provided a response to treatment in situations where patients no longer responded to treatment with Lutetium-177. These data suggest that the drug should be considered for second-line radioligand therapy.
Which outcomes you can expect
After administration of Actinium-225, the following is observed:
- Biochemical response – decrease in blood PSA levels, indicating a decrease in tumor burden
- Reduction of tumor foci according to the results of radiation studies (objective response)
- In some cases, tumor lesions may disappear completely after several cycles of Actinium-225 therapy
- Long relapse-free periods (remission) in many patients
- Improvement in longevity and quality of life
- Reduced risk of prostate cancer complications
This method of prostate cancer treatment is safe and well-tolerated. For most patients, the only side effect is dry mouth, while other toxicities are rare. With excellent treatment results, Actinium-225 therapy is better tolerated and causes fewer toxic reactions compared to chemotherapy.
If you want to undergo this innovative prostate cancer treatment, use the Booking Health service. Here you will find the best cancer clinics in the world. On the Booking Health website, you can find out prices, compare the costs of services in different hospitals, choose a clinic, make an appointment for treatment on convenient dates, and get travel organization services. Leave a request on the site and medical travel specialists will find you a specialized cancer center where you can undergo Actinium-225 therapy for prostate cancer.
