Nuclear medicine with lutetium-177 is booming in the treatment of metastatic prostate cancer.

Soon there will be new treatments for metastatic prostate cancer available, based on the nuclear medicine PSMA linked to the radioisotope Lu-177. As prostate is a common disease, the use of this isotope will increase spectacularly.

The Netherlands Cancer Institute and NRG have jointly published an article in which they describe which treatments with Lu-177 are currently being developed around the world. The article in the European Journal for Nuclear Medicine and Molecular Imaging shows that even if only a few of these developments turn out to be successful, new treatments will soon be available for a large number of patients. This is a great success within nuclear medicine, to which the Netherlands has made a major contribution. Dutch hospitals have pioneered the development of medicine based on Lu-177 and the production of Lu-177 has started at NRG.

This development implies that in the future the Lu-177 production needs to be increased strongly. At the moment Lu-177 is produced in reactors such as the High Flux Reactor in Petten. But one might wonder if it can be done differently: for example, for the production of Mo-99, another important isotope, alternative techniques are in development. A good reason why the article discusses possible alternatives for producing Lu-177 as well. Not only accelerators and reactors are being assessed, but also ‘accelerator-driven reactors’ and even nuclear power plants are included into the analysis.

The conclusion is that the production of Lu-177 can be competitive in research reactors only. Therefore, these are essential in the upscaling of the Lu-177 production and confirms the great value of research reactors in the world of nuclear medicine.

Nuclear medicine based on Lu-177 are booming. Reactors are and will be necessary to produce Lu-177.