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NEWS | Oct. 24, 2022

BAMC offers new prostate cancer therapy for patients

By Lori Newman Brooke Army Medical Center Public Affairs

The Brooke Army Medical Center Department of Nuclear Medicine is now offering a newly approved treatment for patients who have prostate cancer.

Other than skin cancer, prostate cancer is the most common cancer in American men. The American Cancer Society estimates that 268,490 men in the United States will be diagnosed with prostate cancer this year.

On March 23, 2022, the Food and Drug Administration approved the use of lutetium Lu 177 vipivotide tetraxetan for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) who have been treated with androgen receptor pathway inhibition and taxane-based chemotherapy.

On the same day, the FDA approved gallium Ga 68 gozetotide, a radioactive diagnostic agent for positron emission tomography (PET) of PSMA-positive lesions, for patients with metastatic prostate cancer for whom lutetium Lu 177 vipivotide tetraxetan PSMA-directed therapy is indicated.

According to the FDA, this is the first radioactive diagnostic agent approved in the use of a radioligand therapeutic agent. Radioligand therapy combines a targeting compound that binds to markers expressed by tumors and a radioactive isotope, causing DNA damage that inhibits tumor growth and replication. This therapeutic approach enables targeted delivery of radiation to the tumor while limiting damage to the surrounding normal tissue.

PET is a functional imaging technique that uses radioactive substances known as radiotracers to visualize and measure changes in metabolic processes, and in other physiological activities including blood flow, regional chemical composition, and absorption.

“What makes this treatment unique is the PSMA is used for PET imaging and for treatment,” explained U.S. Army Lt. Col. (Dr.) Nathan McWhorter, Department of Nuclear Medicine chief. “One type of radioactive particle is tagged to the pharmaceutical for imaging and a different type of radioactive particle is attached to the same pharmaceutical for treatment. This is called a theranostic. Theranostics is a treatment strategy that combines therapeutics with diagnostics.”

McWhorter said they are very excited to be able to offer this new treatment to patients here at BAMC.

“This has been a highly anticipated treatment. We have had several of our referring doctors from urology and radiation oncology who’ve been anxiously awaiting the arrival of this treatment,” he said.

“We are the first military medical treatment facility to offer this new treatment,” he added.

The treatment consists of a small volume of the drug being infused through an IV injection every six weeks for up to six treatments.

“We can’t say this is a cure, but it has shown to be very successful with prolonging not only the patient's life but also improving their quality of life,” McWhorter said. “We want our patients to be able to get out, go places, do things and live the life they want to live and not worry as much about the cancer they have.”

Retired Sgt. Maj. of the Marine Corps Harold G. Overstreet is the first patient at BAMC to receive the new treatment.

“I often tell people, regardless of what their ailment is, if you live long enough, they will find a cure sooner or later,” Overstreet said. “I think this is the next evolution, the next step. I’ve been going through cancer treatment for 20 years now and I think each one of them gets a little better.”

“I feel very fortunate to have been selected to be the first one here to receive this treatment,” the 78-year-old added. “Everybody has been very enthusiastic and supportive. The treatment you get here at BAMC is top-shelf, there’s none better. I believe military medicine is the best you can get.”

McWhorter said, “Our mission in Nuclear Medicine at BAMC is straightforward; we want the best, most state-of-the-art medicine available so our patients can have the highest quality of life.”