Lutetium-177 PSMA therapy is based on the notion that Lu-177 can stick to the surface of the cell membranes that make PSMA. Lutathera and Pluvicto, two drugs with lutetium, were the first to get FDA approval. Radiologists can use it if the tumor has spread to other body parts and isn't responding to chemo or hormone therapy.
Radium-223 dichloride, Xofigo, is used to treat advanced prostate cancer metastasizing to the bones. Radium's structure is also similar to that of Calcium, which is the main element in bone tissue. This similarity makes it easier for Ra-223 to get into bone metastases and kill cancer cells. Since there are no cancerous cells in the internal organs, this radioligand is given.
Actinium-225 PSMA therapy is a novel radioligand-based approach to treating cancerous tumors. The medication molecule can bind to the protein in the same way that Lutetium can. It is used in place of Lutathera in cases where the latter medication is ineffective against prostate cancer.