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IALCH’s Nuclear Medicine Department provides First Targeted alpha therapy to Prostate Cancer Patients


The Department of Nuclear Medicine at Inkosi Albert Luthuli Central Hospital treated the first 11 patients with metastatic castrate-resistant prostate cancer in January 2023 with Actininum-225 PSMA and Actininum-225 DOTATATE under the leadership of Prof Mariza Vorster.

Inkosi Albert Luthuli Central Hospital (IALCH)/ University of KwaZulu Natal’s Nuclear Medicine department became the second site in the country, the first in the province and one of only a handful globally to label 225Actinium- PSMA and Actininum-225 DOTATATE in-house and provide targeted alpha therapy to prostate cancer patients and patients with metastatic neuroendocrine tumours.

Actinium-225 PSMA is targeted radionuclide therapy that is given as an outpatient, where a total of on average 4 doses are usually needed and administered at 2-month intervals. There is a growing body of evidence that demonstrates remarkable responses with improved survival and quality of life in heavily pre-treated castrate resistant prostate cancer patients who have no other treatment options.

Prostate-specific membrane antigen (PSMA) is overexpressed in metastatic prostate cancer and has been found to be a suitable target for imaging and therapy. The 225Ac labelled derivative, 225Ac-PSMA-617, has shown a remarkable therapeutic efficacy in mCRPC patients and has fewer and less severe side effects compared to chemotherapy. Patients initially undergo 68Ga-PSMA-11 positron-emission tomography/computed tomography (PET/CT) before 225Ac-PSMA-617 treatment to determine whether there is sufficient expression of the PSMA target.

This therapy will likely have a huge impact on the lives of patients with prostate cancer who are not responsive to other therapies, and should provide some much needed hope for these patients. The therapy will also save costs for the health department as targeted therapies have less side effects compared to systemic therapies. Prof Mariza Vorster brings several years’ worth of expertise form Steve Biko Academic Hospital’s Nuclear Medicine department. That department, under the leadership of Prof Mike Sathekge, has pioneered targeted alpha therapy (TAT) with 225Ac-PSMA in the continent and has clearly demonstrated its remarkable impact.

Until now, our patients have been travelling all the way to Steve Biko Academic Hospital via ambulance for treatment with 225Ac-PSMA. IALCH had secured only 2 slots every 2 months due to the high demand of 225Ac-PSMA with the increasing incidence of prostate cancer globally. Having access to this form of therapy locally, allows us to reach and help more patients. Prof Vorster has expressed her heartfelt gratitude to the medical management at IALCH and the entire team at IALCH’s department of Nuclear Medicine, for their integral roles in realising this dream.

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