Seoul St. Mary's Hospital said on the 31st that it has performed more than 200 cumulative targeted radiation treatments for patients with metastatic prostate cancer. The milestone comes about six years after the hospital became the first in South Korea to begin lutetium-177 (Lu-177) prostate-specific membrane antigen (PSMA) radioligand therapy in November 2020.
Lu-177 PSMA radioligand therapy exploits the fact that a protein called PSMA is expressed far more heavily in cancer cells — particularly those that have spread to other parts of the body — than in normal cells. In patients whose tumors show sufficient PSMA expression on imaging tests, a therapeutic radiopharmaceutical bound to the radioisotope lutetium-177 is injected intravenously. The drug circulates through the bloodstream, binds selectively to cancer cells and then emits radiation, in the form of beta particles, that acts only over a distance of a few millimeters, damaging the DNA of the cancer cells. Because the radiation is released inside the cancer cells to kill them, surrounding healthy cells are less exposed to the treatment and are largely spared. The approach is commonly called a "radiation missile," since it delivers radiation-emitting material deep into enemy territory to attack the target.
In South Korea, Pluvicto, developed by Swiss drugmaker Novartis, won approval from the Ministry of Food and Drug Safety in May 2024 and is in use as the leading Lu-177 PSMA radioligand therapy. It is indicated for patients with PSMA-positive metastatic castration-resistant prostate cancer whose disease progressed despite treatment blocking the androgen receptor pathway or taxane-based chemotherapy.
This approach of linking imaging tests that identify targets abundant in cancer cells with drugs that attack those same targets is known as theranostics, a term that has recently emerged as a new focus in medicine. A combination of "therapy" and "diagnostics," it is a precision medicine technique that uses the same target for both diagnosing and treating cancer. Beyond Pluvicto, Seoul St. Mary's Hospital has actively participated in clinical trials of multiple PSMA theranostics drug candidates under development by domestic and overseas pharmaceutical companies, contributing to the advance of new treatments and the accumulation of clinical evidence. Over the past five years and nine months, 84 patients with metastatic prostate cancer have received Lu-177 PSMA radioligand therapy at the hospital. Led by the urology department, medical staff from medical oncology, nuclear medicine, radiation oncology, radiology and pathology jointly weigh the stage of the cancer, prior treatment history and the patient's overall health to decide whether and in what order to administer treatment, and they also manage side effects during treatment and responses afterward. The hospital's biggest differentiator is its in-house production facility for diagnostic radiopharmaceuticals, built through cooperation with a domestic company.
"Seoul St. Mary's Hospital has the conditions in place to reliably connect everything from imaging diagnosis to treatment planning," Hospital Director Lee Ji-youl said. "Building on this infrastructure and our multidisciplinary collaboration capabilities, we will expand our participation in domestic and international theranostics clinical trials and work to ensure that more patients can benefit from radioligand therapy."
