Ac-225-PSMA for Castration Resistant Metastatic Prostate Cancer

The main specifications of alpha particles are its limited range in tissue of 20 cells in diameter, and high energy transfer causing cellular damage. Targeting Ac-225 drug constructs have potential in the treatment of cancer. Recently, alpha particle-emitting Ac-225-PSMA is being investigated in castration resistant metastatic prostate cancer.

It is unclear whether Ac-225-PSMA is better than other radiopharmaceuticals like radium-223 acetate. It can only be effective if the target has sufficiently high expression in target tissue. Xerostomia and some haematological toxicities as side effects of this therapy has been reported.

Several studies have reported on the use of PSMA-radioligand therapy with different indications for patients with castration-resistant metastatic prostate cancer. Most of these studies are retrospective and more prospective data are needed to understand some points relating to PSMA-radioligand therapy including the best treatment protocol, patient selection and stratification, and use of concomitant drugs.