Is Lu-177 PSMA right for you? Quick eligibility check
Final eligibility is determined by a multidisciplinary team (medical oncologist, urologist, nuclear medicine physician) based on your full clinical picture. Our decision aid can help you prepare the conversation with your doctor.
How Lu-177 PSMA therapy works
Prostate cancer cells produce a surface protein called PSMA (Prostate-Specific Membrane Antigen) in massive quantities — roughly 100–1000 times more than healthy cells. This unique characteristic is what makes them targetable.
The therapy consists of a targeting molecule called PSMA-617 chemically attached to a radioactive atom of Lutetium-177. When given as an IV infusion, the PSMA-617 portion seeks out and binds to PSMA on prostate cancer cells — anywhere they exist in your body. The Lu-177 then releases short-range radiation (traveling only ~2 mm) directly into the cancer cell, damaging its DNA and killing it.
Because the radiation has such a short range, healthy cells nearby — that don't express PSMA at the same high level — are largely spared. This is why Lu-177 PSMA causes so much less collateral damage than chemotherapy.
The clinical evidence: VISION and PSMAfore trials
VISION trial (2021) — the trial that won FDA approval
VISION was a phase 3 randomized trial of 831 men with PSMA-positive mCRPC who had already received hormone therapy and chemotherapy. They were randomly assigned to receive either Lu-177 PSMA-617 (the drug studied was Pluvicto®) plus standard care, or standard care alone.
PSMAfore trial (2024) — moving earlier in the disease
The PSMAfore trial studied Lu-177 PSMA in men whose prostate cancer had progressed after hormone therapy but before they had received chemotherapy. The results showed that earlier use of Lu-177 PSMA led to longer progression-free survival than switching to a different hormone therapy.
This is reshaping clinical practice — many oncologists now consider Lu-177 PSMA earlier in the disease course, before patients have endured chemotherapy side effects.
How treatment is given
Frequency and duration
- Number of cycles: Up to 6
- Interval between cycles: 6 weeks
- Total treatment duration: ~7 months
- Infusion time: About 30 minutes per cycle
- Setting: Outpatient (most patients go home the same day)
What a treatment day looks like
- Arrival (8–9 AM): Blood tests, vitals, IV placement, hydration starts.
- Pre-treatment (60 min): Final eligibility check, signed consent, hydration continues.
- Infusion (30 min): Lu-177 PSMA-617 is given through your IV in a special radiation-shielded setting.
- Post-infusion observation (2–4 hours): Hydration continues, you urinate frequently to flush unbound medicine.
- Discharge: You go home with written instructions on radiation-safety precautions for the next 3–5 days.
See an hour-by-hour walkthrough →
Side effects and how they're managed
Very common (more than 1 in 5 patients)
- Dry mouth (xerostomia) — the #1 side effect. Salivary glands also express PSMA at low levels, so they pick up some medicine. Usually mild; rarely severe.
- Fatigue — typically mild to moderate, lasting a few days after each cycle.
- Nausea — usually mild and well-controlled with anti-nausea medication.
- Anemia (low red blood cells) — monitored with blood tests; transfusion rarely needed.
Common (5–20% of patients)
- Low platelets (thrombocytopenia)
- Low white blood cells
- Constipation or diarrhea
- Loss of appetite
- Back pain or bone pain (sometimes a sign of tumor response, not progression)
Rare but serious
Cost of Lu-177 PSMA therapy
The treatment fee covers the complete clinical care — scans, all sessions, monitoring, post-treatment verification, and local transport between your accommodation in India and our center for every visit. Flights, accommodation, and visa fees are arranged and paid separately.
Our pricing is delivered through in-house radiopharmaceutical preparation at our purpose-built hot lab, combined with efficient hospital infrastructure. The therapy is clinically equivalent to the imported branded product — same active radiation, same targeting molecule (PSMA-617), same clinical evidence.
Full cost breakdown and inclusions → | Plan your visit →
Receiving Lu-177 PSMA therapy with us
Our dedicated Lu-177 therapy center in India delivers Lu-177 PSMA therapy following international protocols (VISION, PSMAfore) at $6,000–$8,000 USD per session. Specialized radioligand therapy practice. In-house radiopharmacy preparing fresh Lu-177 PSMA-617. Multidisciplinary team. Patients from 22+ countries.
Why patients choose us → · Plan your visit →
Frequently asked questions
Is Lu-177 PSMA therapy the same as Pluvicto?
The active radiopharmaceutical is the same — Lu-177 attached to PSMA-617 (vipivotide tetraxetan). Pluvicto® is the commercial Novartis brand of this combination. Many Indian centers prepare Lu-177 PSMA-617 in their own in-house hot labs rather than importing the branded product. Clinically equivalent, significantly more affordable.
What can Lu-177 PSMA realistically do for my cancer?
It is a treatment that extends life and, for many patients, improves quality of life compared to other options. Median overall survival benefit in the VISION trial was about 4 months, but individual responses range from no benefit to multi-year disease control.
How do I know if my cancer is 'PSMA-positive'?
A PSMA PET scan (using Gallium-68 PSMA or F-18 PSMA) is performed before starting therapy. If your scan shows uptake in your known tumor sites, your cancer expresses PSMA and you may be a candidate. If uptake is weak or absent, this therapy is unlikely to help and your oncologist will recommend a different approach.
Can I have Lu-177 PSMA if I've never had chemotherapy?
The original FDA indication required prior chemotherapy. The 2024 PSMAfore trial showed benefit before chemotherapy, leading to expanded approval. Discuss with your oncologist whether you fit current eligibility criteria.
What if I'm already taking abiraterone or enzalutamide?
Lu-177 PSMA is typically given after these hormone therapies have stopped working. You'll usually continue your standard hormone backbone (e.g., LHRH agonist) while receiving Lu-177 PSMA.
Will I lose my hair on Lu-177 PSMA?
No. Hair loss is not a typical side effect of this therapy. This is one of the major quality-of-life advantages over chemotherapy.
Can I work during the 7 months of treatment?
Many patients continue working, especially in non-strenuous jobs. The first few days after each cycle may involve fatigue, but most patients return to normal activity within a week. Some adjustments around treatment days are typical.
What about radiation safety with my family?
For 3–5 days after each cycle, you'll follow simple precautions: stay about 1 meter from young children and pregnant women, sleep separately, use a separate toilet if possible, and flush twice. After that, normal contact resumes. See our detailed radiation safety guide.
What happens after my 6th cycle if it worked?
Follow-up scans and PSA testing every 3–6 months. Some patients have long-lasting responses. Others may eventually need additional therapy — including the possibility of an additional Lu-177 PSMA course, other systemic therapies, or clinical trials of next-generation theranostics like Actinium-225 PSMA.
What if Lu-177 PSMA doesn't work for me?
If PSA doesn't drop, or scans show progression, your oncologist will likely discontinue therapy and recommend alternative options — clinical trials, other systemic therapies, or palliative approaches. Our navigators can help you think through next steps.
Can I have Lu-177 PSMA in India as an international patient?
Yes. India is one of the leading destinations for Lutetium therapy. Our center in India provides international patient services including visa support, English-speaking coordinators, and accommodation help. See our international patient guide for details.
Do I have to do all 6 sessions with you?
No. We offer single sessions, partial courses, and split treatment between our center and your home country. Many international patients prefer to receive a few sessions with us and the rest closer to home — we coordinate detailed records-sharing and protocol notes with your home oncology team so the transition is seamless. Per-session pricing ($6,000–$8,000 USD) applies whether you do one session or all six.