First in-Africa isotope labelled theranostic procedure on prostate cancer patients


Steve Biko Academic Hospital/University of Pretoria and NTP Radioisotopes subsidiary of the South African Nuclear Energy Corporation in collaboration with ITG in Germany and AEC-Amersham has made provision for Professor Mike Sathekge to perform the first-in-Africa isotope-labelled theranostics procedure for prostate cancer on two patients.

NTP Group Managing Director, Ms Tina Eboka, said this has come together with the dedication of many who worked behind the scenes.  “NTP, its subsidiary company AEC-Amersham in association with ITG and Steve Biko Academic Hospital are proud of this milestone!  AEC-Amersham played a major role in ensuring the isotopes, peptides and sundry reagents necessary for the procedures, supplied by ITG, were timeously delivered to Professor M Sathekge at the Steve Biko Nuclear Medicine Department. NTP performed the labelling of the Prostate Specific Membrane Antigen (PSMA) together with an ITG representative who especially flew in from Germany.”

Professor Sathekge explained that Lutetium-177 (Lu-177) labelled (PSMA, a peptide) is used a targeting tracer and is very effective in detecting, and treating resistant metastatic or recurrent prostate cancer.  He said he believes that many prostate cancer patients will benefit from treatment with Lu-177 n.c.a added to carrier PSMA.  “Most prostate cases are often diagnosed at a late stage of the disease, hence Lu-177 PSMA is able to deal with both local and distant cancer, which may have spread to other parts of the body.”

Nuclear medicine specialists are excited about the potential of theranostics, a combination of therapy and diagnostics in which the same type of targeting molecule is used to obtain images and to deliver the therapeutic isotope dose, selectively, to the tumour site and to destroy cancerous cells.

In this procedure, PSMA is used as the targeting (or tracer) medium and is very effective in detecting, staging and treating recurrent prostate cancer. After performing a scan with Ga68 labelled PSMA to select patients who will benefit from therapy, the Lu-177 labelled PSMA is administered and transports the radioisotope selectively to the tumour(s), irradiating and killing the cancer cells and leaving healthy tissue unharmed. The full treatment involves a series of four intravenous injections, which are administered a month apart.  

Cancer of the prostate is the biggest carcinogenic killer, excluding skin cancers, of men in South Africa (16.3% of all cancer deaths and over 4 000 in number per year). Up to the age of 74, men have a 1 in 23 chance of developing prostate cancer and the rate is climbing as diagnosis improves and the population average age increases.

It is not yet known how many PSMA procedures will be in demand in South Africa but certainly it will be an appreciable number and will provide NTP with an additional weapon in the armoury that is progressively being assembled for fighting the scourge of cancer therefore bringing hope to many patients inflicted with prostate cancer in our country.


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